Compare Assisted Living and Home Care

Comparing Senior Living Costs

Comparing the costs of In-Home Care Services to those of Nursing Homes and Assisted Living? Depending on the amount of services you are looking for, Assisted Living can be a surprisingly affordable alternative.

This chart compares the average monthly costs for Skilled Nursing Facilities, Home Health Care services, and Assisted Living and Memory Care Assisted Living Communities in New England.*

Skilled Nursing Facilities (Nursing Homes)$10,000 – $12,000+
Home Health Care (live-in with overnight care)$9,000 – $17,000 (living expenses are extra)
Home Health Care (Daily assistance 6 hours a day) $4,140 – $5,040 (living expenses are extra)
Assisted Living Communities $3,200 – $7,500
 Assisted Living with Memory or Alzheimer’s care  $5,500 – $9,500

*(2019 averages)

Cost / Benefit Analysis

How to Do a Cost / Benefit Analysis: Assisted Living vs. Nursing Home

Nursing Homes are required to provide intensive, 24-hour skilled nursing and related care, therefore their costs are much higher than residential-style Assisted Living. In most of New England, those who pay privately for a Nursing Home placement spend on average $10,000 – $12,000+ per month while Assisted Living is about half that. However, once a senior’s private assets run out, a subsidized “medicaid bed” in a Nursing Home could be a lower cost than an Assisted Living community. Some Assisted Living communities also offer a medicaid program for lower-income seniors, but not all do.

In making this comparison and ultimate decision, it’s important to know whether your loved one would be a good candidate for Assisted Living. It’s unfortunate how many people automatically assume their loved one needs a Nursing Home. For seniors who have manageable chronic health issues and may need daily support with personal care and managing their medications, but do not have complex medical problems that require around-the-clock skilled nursing care, Assisted Living is a much better alternative to a Nursing Home placement. This reasoning is not limited to Assisted Living’s affordability over a Nursing Home. Assisted Living promotes independence and emphasizes wellness in a dignified homelike setting. Nursing Homes care for people who are sick and need round-the-clock skilled nursing care; their institutionalized settings are not conducive to encouraging independence.

Years ago, seniors who had some daily personal care needs and were not safe at home alone had limited options – Nursing Home placement was the feared but only option. Today, there are many options available to seniors that offer appropriate types of personalized care and a broad array of services and amenities in a place to call home that offers more cheerful surroundings, privacy, space and dignity than typically found in a Nursing Home, and at a lower cost.

Accurately Compare Costs of Senior Living Options

To accurately calculate a comparison of costs between Home Health Care and Assisted Living, be sure to add all the “at home” living expenses to the cost of Home Health Care and then compare this total budget number to the monthly fee at an Assisted Living community. Home Health Care does not cover ANY living expenses (such as housing, property taxes, utilities, maintenance and meals). These costs are INCLUDED in the monthly fee in Assisted Living, where personal care is available 24 hours a day, along with restaurant-style dining, housekeeping and laundry services, programs for social, fitness, cultural and educational pursuits, private van transportation, and more. Be sure to carefully weigh the “intangibles” benefits as well, all the other factors that impact a senior’s lifestyle and well-being.

  • Does your loved one have companionship and social outlets at home?
  • Is there an opportunity to enjoy the outdoors?
  • Do they have access to transportation to get out and about?
  • Do they have access to stimulating lifelong learning, exercise classes and other programs?

These are some of the extra benefits and amenities available while living in an Assisted Living community that may not be available at home, even with services coming in. If your loved one needs minimal assistance and at least some of that help can be provided by family and friends (such as meals, laundry, housecleaning and home maintenance), perhaps a few hours a day of Home Health Care would work for your situation, and in this case may be the less expensive option for you. But, again, be sure to include an analysis of all of the intangibles to help make the right decision for your loved one.

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Senior lifestyle and well-being

Here is some more detailed information about the costs of Home Health Care detailed on the chart above:

  • Home Health Care agencies average $23-$28/hour in New England
  • “Non-certified” Home Health Care “live-in” caregivers who sleep at night would cost at least $9,000/month for 24-hour coverage (living expenses are all extra – this just covers staff time)
  • “Certified” Home Health Care staff coverage who are awake at night would require 2-3 shifts of different caregivers and cost $17,000/month (again, living expenses are extra)
  • Just 6 hours a day of Home Health Care at the lower end of the average hourly rate at $23/hour costs $4,140/month

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