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What’s the Difference Between Home Health, Home Care, & Assisted Living?


If you think home health and home care are the same thing, you’re not alone. The terms are incredibly similar, and many people use them interchangeably. However, there are some important differences between the two services. Assisted living, on the other hand, is quite a bit different as your loved one will not be living in their home; however, it does share many of the same freedoms.

What Is Home Health

Home health care is medical care. Also known as skilled care, home health care refers to care provided by a licensed medical professional. Home health care services include:

  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Skilled nursing services, such as wound care, catheter and colostomy care, and diabetes care
  • Social work, such as case management, patient advocacy, counseling, and help finding community resources

Home health aides are also referred to as nurse aides, nursing assistants, certified nursing assistants, and geriatric aides.

What Is Home Care

Home care is nonmedical care. Also known as private services, home care refers to care provided by caregivers, usually called home care aides, that focuses on helping seniors with the daily activities they need to engage in life and remain safe and healthy. Home care services include:

  • Companion care
  • Personal care
  • Transportation services
  • Memory care services

Home care is also referred to as personal care, attendant care, non-medical care, and companion care.

What is Assisted Living

Assisted living offers many of the services mentioned above, the only difference being that Assisted living is a type of housing and care for older adults who need assistance with activities of daily living (ADLs), such as bathing, dressing, and eating. Assisted living communities provide a home-like setting with personalized care services, as well as social and recreational activities. Services provided by assisted living communities may include:

  • Help with ADLs
  • Medication management
  • Meals and snacks
  • Housekeeping and laundry
  • Transportation
  • 24-hour on-site staff

Most assisted living services encourage seniors to make their own choices while providing them with the information they need to make informed decisions and choose healthy options.

When to Use Home Health

Home health care is often prescribed to help older adults recover from a serious health issue. For example, if your dad has a hip replacement surgery, a therapist might visit him at home every morning to provide physical therapy, monitor his pain and medications, and track his vitals and recovery progress.

Home health is often recommended following an inpatient hospitalization, rehabilitation, or a stay at a skilled nursing facility to help a senior transition back to independence. Other times when home health is beneficial might include when a senior has had a recent medication change or when a senior experiences an overall decline in functioning.

Because home health is considered medical care, it is covered by medical insurance, including Medicare and Medicaid.

When to Use Home Care

Home care is used primarily to help older adults with the activities of daily living. For example, if your mom is functioning well at home but vision problems prevent her from driving and she sometimes forgets her medications, a home care aide might visit the house every afternoon to drive her to appointments, help her balance her checkbook, and offer medication reminders.

Home care is often recommended for seniors who need assistance with the activities of daily living, ranging from grooming to meal preparation. Other times when home care is beneficial might include when a senior doesn’t drive but requires transportation or when a senior lives alone and may be at risk for social isolation.

Because home care is considered unskilled or nonclinical, it isn’t covered by medical insurance and is usually covered by private pay or long-term care insurance.

When to Use Assisted Living

Assisted living is usually considered a permanent solution for either of the situations mentioned above. It can help seniors with their daily tasks and also offer them the medical assistance they need, depending on their level of independence. It is a good option for older adults who are no longer able to live safely and independently at home and generally need help with their daily activities but need the round-the-clock care of a nursing home. It is an excellent option for seniors who are looking for a supportive environment where they can interact and be a part of a community with other people their age. If this is an affordable option for your parent or loved one, it is a great option to help them improve their quality of life.

What Signs Should You Look Out for if Considering Assisted Living Vs Home Care for Your Loved One?

If you are the caregiver for an aging parent, you know how challenging it can be to try and manage your own personal life and cater to all of their needs as well. This extra demand on your time can take a toll on you, both emotionally and physically. Juggling extra trips to the store and frequent visits to your parent’s house each week can leave you drained, with little time and energy left for your own family. While friends and family have offered assistance, your desire to care for your parents independently, just as they did for you, is commendable. However, considering the strain on your resources, exploring additional support might be in everyone’s best interest.

Vital signs to consider would be if they are having difficulty with daily activities such as bathing, dressing, and eating. If they are falling frequently or have been injuring themselves repeatedly while engaging in daily activities. If they are having a hard time managing their medications or they often forget to take essential prescriptions. If you see signs that they are feeling isolated or lonely or if they are having difficulty keeping their home clean and safe.

When to Use a Combination of Care Services

The main goal of both services is to provide personalized care that keeps seniors as independent, safe, and comfortable as possible so they can maintain a high quality of life. Home health and home care often work together to help seniors.

For example, a home care aide might help your mom remember to take daily medications while a home health nurse might adjust or change her medications as needed. Or perhaps a home health physical therapist can work with your dad’s doctor to adjust his physical therapy if it’s not working while a home care aide might encourage your dad to do their physical therapy, watch for problems, and let the PT know how the daily exercises are going.

Often, seniors and their families find a team approach of using home care services to supplement home health services provides the best solution.

Where to Use Home Health and Home Care Services

Although home health and home care are primarily provided in a residential home, caregivers can also provide assistance to seniors wherever they call home, including in assisted living facilities, in hospitals, on vacation, or in a variety of other settings.

Home Health vs. Home Care Comparison Chart

The chart below highlights some of the key differences between home health and home care.

Services Typically OfferedHome HealthHome CareAssisted Living
Skilled careYesNoYes
Therapy toward rehabilitationYesNoYes
Administers medicationsYesNoYes
Changes or adjusts medications as neededYesNoYes
Gives medication remindersYesYesYes
Performs medical testsYesNoYes
Performs wound careYesNoYes
Formally monitors health statusYesNoYes
Helps with activities of daily livingYesYesYes
Offers overnight supervisionNoYesYes
Prepares and/or delivers mealsNoYesYes
Performs light housekeepingNoYesYes
Helps with personal grooming and hygieneNoYesYes
Helps with transferringNoYesYes
Helps with toileting or incontinenceNoYesYes
Provides transportationNoYesYes
Provides companionshipNoYesYes
Provides respite careNoYesYes

Comparing In-home Care and Assisted Living Costs

Is opting for assisted living the ideal decision, or would engaging an in-home caregiver be more suitable? To make this important choice you need to fully understand assisted living vs home care costs. What expenses are associated with in-home care, covering bathing, medication management, grooming, cooking, and housekeeping? How does this measure against the costs of assisted living, where similar services can be provided, tailored to your routine and requirements?

You can use this infographic to compare in-home care and assisted living expenses. It’s essential to note that the figures presented below represent averages for the state of Massachusetts. Therefore, when evaluating costs, take into account your loved one’s actual monthly expenses and specific community figures you might be contemplating.

Cost of In-Home Health/In-Home Care

Contrary to expectations, aging in your home might incur higher costs than residing in a senior living community, especially when medical or living assistance is necessary. Even with a mortgage-free home, financial stability, and relatively good health, the accumulated residence expenses can become significant. Home maintenance can be costly, and unexpected breakdowns of your vehicle may lead to expensive repairs or the need for a new one, introducing an additional monthly financial burden. In the event of illness requiring extra assistance, home health care expenses can be substantial, even for a brief period. Emergencies further escalate costs, including medical services, ambulances, and emergency room visits, potentially reaching astronomical figures.

Relationship Cost of Ongoing Family Involvement

On average, family caregivers spend 24.4 four hours per week providing care, and nearly one-quarter Of caregivers spend 41 hours or more per week providing care, according to the National Association of Caregivers and AARP. Additionally, caregivers spend 13 hours per month researching care services on information on the disease, coordinating physician visits, or managing Financial matters.

Home Health Care Is Built on an Hourly Basis

There are multiple types of Home Care, including personal care and companion, private duty nursing care, and Home Health care, and the hourly cost ranges from $13 to $30 per hour if your parent does need expensive services, home health care costs can be lower than assisted living. However, the cost can quickly add up, especially if the medical problems your loved one is facing are complex or likely to change over time. Does your parent have a high care need or a chronic disease such as diabetes, cognitive heart failure, or chronic obstructive pulmonary disease? Then, it might be more cost-effective to consider an assisted living facility.

Cost of Assisted Living

The expenses associated with assisted living in Massachusetts fluctuate based on factors like community, location, and required care level. Typically, individuals anticipate monthly costs ranging from $6,000 to $10,000 for standard assisted living. For specialized Alzheimer’s and dementia care, the expenses tend to be higher.

Monthly charges generally include rental costs, utilities, dining services, housekeeping, activities, programming, personal care, and various other services and amenities. Nevertheless, certain communities might impose extra fees for services like medication management or elevated levels of care.

Factors Affecting Cost for Assisted Living:

The cost of assisted living can be influenced by various factors, including:

  1. Community: Pricing structures vary among different communities, emphasizing the importance of comparing costs from multiple options before making a decision.
  2. Location: Assisted living communities in major cities and urban areas typically come with a higher price tag compared to those in rural settings.
  3. Level of care needed: Residents requiring more assistance with activities of daily living (ADLs) generally incur higher fees than those needing less help.
  4. Services and amenities: Additional services and amenities, such as transportation, laundry, and beauty salon services, may be offered by some communities at an additional cost.

Assisted Living Payment Options:

There are several payment options available for assisted living, including:

  1. Private pay: Residents utilize their personal cash assets to cover assisted living expenses.
  2. Long-term care insurance: While long-term care insurance can assist with costs, it’s important to note that not all policies cover assisted living.
  3. Medicaid: A government program, Medicaid, can aid low-income residents in covering assisted living expenses.
  4. Veteran’s benefits: Eligible veterans may access benefits designed to assist in covering the costs of assisted living.

For an in-depth look at the home health and home care options available, signs your loved one needs additional help or support at home, how home health and home care professionals are trained and licensed, and how to pay for home health and home care services, download our Guide to Home Health & Home Care Services.

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