Martha Wellman, whose name has been changed to protect her privacy, and her sister, Barbara, both lived a plane ride away from their parents, who had planned to age independently at home well into their 80s and 90s.
Both daughters made frequent trips to visit their parents, who slowly began to be less able to manage everyday household tasks.
An individual was hired to cook their meals and drive them to appointments and wherever else they wanted to go. For a while this worked well, but when their mother fell and ended up in the hospital, they realized that living independently with minimal help was no longer safe for their parents.
The daughters weighed their parents’ options: They could go to an assisted living community near one of their daughters, or they could hire home care, which would allow them to continue to age at home with more in-home senior care.
“Although the constant travel and supervision from afar was hard, I’m glad my parents were able to age together in their own home and ultimately die at home within six days of each other,” Wellman says. “It feels like that was the way it was meant to end, and my sister and I, who were both with them when they died, were at peace with the decisions we’d made.”
With more than 4 million Americans turning 65 each year between 2024 and 2027, according to the Alliance for Lifetime Income, millions of families are facing the same difficult decision the Wellmans struggled with.
Here’s what you need to know about home care vs. assisted living.
[READ: How to Choose the Right Senior Living Facility: A Checklist]
What Is the Difference Between Assisted Living and Home Care?
According to an AARP survey, 75% of American adults age 50 and older want to age in their own homes, but they also acknowledge that they will eventually move due to financial, physical and safety concerns.
“Sometimes it’s just not feasible to stay at home,” says Kate Granigan, chief engagement officer at Alder, a Boston area lifecare management consulting firm.
Home care
Home care is nonmedical in-home care that allows seniors to maintain their independence while remaining safely in their own homes. Home care services, usually provided by home health aides, can include help with activities of daily living (ADLs), such as bathing, dressing and toileting, meal preparation, medication management and light housekeeping.
To age in place, the home needs to be set up to make it safer. For example, walk-in tubs may be needed, doorways may have to be widened, and nonslip floors may have to be installed.
“Sometimes being cared for at home is a luxury because in addition to hiring help, home maintenance costs, utilities and other costs still have to be paid,” says Michelle Clevenger, a geriatric social worker at Northwestern Medicine.
Assisted living
is a residential senior living option for people who need help with ADLs and basic or occasional medical care. It’s generally for people who can no longer live safely on their own but don’t require 24/7 care that a nursing home would provide.
Life at assisted living facilities allows seniors to have their own apartments or rooms. Staff members are available to help, but because the staff is caring for many residents, there isn’t much one-on-one intensive care.
[READ What Are the Levels of Senior Living?]
Pros and Cons: Aging in Place vs. Residential Care
There are benefits and drawbacks to both home care and residential care.
Pros and cons of home care
If you and your aging loved one are considering home care, here’s what you should consider:
Pros and cons of assisted living
While some seniors voluntarily elect to live in an assisted living community, others opt to begin by being cared for at home. But when full-time care becomes necessary, many can no longer afford to remain in their own homes.
[READ: Understanding the Different Senior Care Options.]
Modern Home Care: The Role of AI and Passive Remote Monitoring
New advances in technology have made aging in place safer and viable. Thanks to passive monitoring and AI, these modern tools are revolutionizing home care by shifting it from reactive to proactive.
— AI. Tracking and monitoring devices and early warning systems use sensors to learn your loved one’s behavior patterns. By using health data and predictive analytics, AI-enabled devices can spot trends, such as decreased mobility or movement and more frequent trips to the bathroom, to alert caregivers and families of their loved one’s health changes before emergencies happen.
— Passive remote monitoring. Passive remote monitoring uses smart home technology — such as smart refrigerators, bathroom sensors (to detect bathroom frequency), mattress sensors, fall detection devices and other home motion sensors — to improve health and safety for seniors. These monitoring tools can track their daily routine and alert caregivers to any variations or changes.
2026 Cost Comparison: Is Home Care Cheaper Than Assisted Living?
Comparing costs of home care vs. assisted living is a key factor when deciding what level of care your loved one needs.
Home care is typically cheaper than assisted living, which can vary widely depending on what the community offers. But it can add up as more specialized care is needed. Be sure to know upfront what exactly the costs cover and when there may be extra charges.
“When making the decision between remaining at home with care or moving to an assisted living community, do a lot of research, become familiar with the people who will be taking care of your loved one, and if you decide to move your loved ones to one of these communities, consider hiring an outside professional third party to periodically assess care,” says Lina Supnet-Zapata, CEO and co-owner of Mir Senior Care Management and Care Consultants in Austin, Texas.
| Feature | Home Care | Assisted Living Facility |
| Costs of Care | Varies widely based on amount and type of care needed. | Varies widely by community type, location, level of care and services. |
| National Median Cost (Full-Time) | Approximately $34 per hour or about $6,483 per month (for full-time care), according to Genworth and CareScout’s Cost of Care survey. | The median monthly average is $5,900, Genworth and CareScout report. |
| Additional Housing Costs | Resident is still responsible for mortgage/rent, maintenance and utilities. | Basic monthly fee typically covers room and board, eliminating separate housing costs (mortgage, rent, utilities, home maintenance). |
| Basic Services Covered | Varies by agency; generally includes help with ADLs, meal prep, medication reminders and light housekeeping. | Basic monthly fee typically covers room and board, housekeeping, staff and basic social activities. |
| Potential Extra Charges | Primarily depends on the number of hours and specialized care required. | May include additional costs for specialized services, such as medication management, or higher levels of care. |
[Read: Assisted Living Costs: A Guide to Expenses and Payment Options]
How to Pay for Senior Care: Medicare, Medicaid and Private Pay
Whether you choose home care or assisted living, it’s important to understand how to cover the costs of senior care.
| Home Care | Assisted Living Facility | |
| Medicare Coverage | Does not cover custodial care (nonmedical ADL assistance). Covers limited necessary services only if “homebound” with a doctor’s order for skilled nursing or therapy. | Does not cover the cost of assisted living. |
| Medicaid Coverage | Covers home care only when a doctor orders it and only for a limited number of hours. | Does not cover the cost of most assisted living communities. |
| Long-Term Care (LTC) Insurance | Most policies typically cover services (personal care, skilled nursing, homemaker services) if the resident meets certain requirements (trouble with two or more ADLs). Coverage varies widely. | Many policies will pay for assisted living, but coverage varies widely. |
| Primary Payment Method | Private pay, Medicare/Medicaid (limited) or LTC insurance. | Primarily private pay (out-of-pocket) by residents and their families or LTC insurance. |
5 Signs It’s Time to Move from Home Care to Assisted Living
If your loved ones begin to have trouble being independent
, you’ll have to decide whether you need to hire more help for home care or make the move to assisted living.
Here are the top five common signs it’s time to make the transition to an assisted living facility.
1. Caregiver burnout and constant family worry
When you don’t live close by and you’re losing sleep worrying about your loved one’s safety, that’s a major sign that home care isn’t enough and it may be time for a move from in-home care to assisted living.
The worry that your loved ones are alone without enough help is often the start of a family discussion about assisted living. It may take some time for the family to agree on where your loved one will continue to age, but this usually begins the process.
2. Increasing medical acuity and ADL support needs
Hiring in-home caregiving ranges from part-time companionship to 24/7 caregiver help with one-on-one assistance. When your loved one begins to need increasingly more help, it may be time to consider assisted living, which is usually less expensive than remaining in your own home once a higher level of care is needed, and it often alleviates the increased burden on your family for caregiving responsibility.
3. Safety and fall risks at home
When you’re considering whether your loved one can remain at home, you’ll need to assess the safety of their home environment and compare that with the safety features at an assisted living community.
Falls are the leading cause of injury-related deaths and hospitalization for older adults. Unless your loved one can be monitored at home around-the-clock, it may be safer to move to assisted living.
4. Home care costs exceeding monthly facility fees
The cost of home care may start adding up if more hours and specialized in-home care providers are required. It may be more affordable to look at assisted living communities, which tend to be less expensive than 24/7 home care. Be sure to factor in any extra charges assisted living facilities may add on as needs increase.
5. Chronic loneliness and social isolation
Loneliness and social isolation are serious health hazards for seniors and increase the risk of premature death and dementia. It may be more beneficial for your loved one to move to an assisted living community, where they can thrive socially and make friends.
Bottom Line
In the United States, unfortunately, good home care and assisted living costs are not considered a human right but a luxury and are extremely expensive.
Some planning in advance can help to make some of it affordable, and you may want to consult a financial planner.
For those who can afford it, the choice between aging at home or in an assisted living facility will depend on who is around to help and what an older person’s specific needs are. It’s a very personal family choice, as there are pros and cons to each kind of living situation.
More from U.S. News
The True Cost of Aging: A 2026 Budget Comparison of Senior Living and Aging in Place Options
7 Signs It’s Time to Move to a Senior Living Facility
A Guide to Senior Apartments and Where to Find Them
Assisted Living vs. Home Care: What’s the Difference? originally appeared on usnews.com
Update 02/23/26: This story was previously published at an earlier date and has been updated with new information.
