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Compare Costs: Assisted Living, Nursing Home, Home Care

Compare the Costs of Nursing Homes, Home Care and Assisted Living

Assisted Living can be a surprisingly affordable alternative. Need to compare your senior living options? These are the average monthly costs or Senior Living in Massachusetts:

Nursing homes $10,000 - $12,000+
Home health care live in
(overnight “sleeping” or "awake" staff)
$9,000 - $17,000 
 (living expenses are extra)
Home health 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

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 Massachusetts 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 in Massachusetts also offer a medicaid program for lower-income seniors, but not all do.

Cost / Benefit Analysis

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 simply assume their loved one needs a Nursing Home. For seniors who have manageable chronic health issues and may need some 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 is true not just because Assisted Living is a more affordable option than a Nursing Home. Assisted Living promotes independence and emphasizes wellness in a dignified homelike setting. Nursing homes take care of 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 nowhere else to go - 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.

How to Compare the Cost of Staying at Home with Home Health Care vs. Assisted Living

Living in an Assisted Living community, with overnight awake staff and services available 24 hours a day, is much less expensive than comparable 24-hour Home Health Care live-in services. In fact, the average TOTAL cost of an Assisted Living community in Massachusetts is comparable to what a Home Health Care agency charges, on average, for just six hours of daily personal care assistance, shopping, meal preparation and other services by a home health aid.

Expense Calculator

Use our Expense Calculator for a complete list of all of the living expenses that you should be looking at when comparing costs.

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 at Assisted Living communities where personal care is available 24 hours a day, along with restaurant-style dining, 24-hour security, housekeeping and laundry services, programs for social, fitness, cultural and educational pursuits, private van transportation, and more.

It is also important to carefully weigh the “intangibles” - 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 at an Assisted Living community that may not be available at home, even with Home Health Care.

Senior lifestyle and well-being

If your loved one needs minimal assistance with some daily activities and at least some assistance can be provided by family and friends (such as meals, laundry, housecleaning and home maintenance), perhaps a couple of hours a day of Home Health Care would work for your situation. In this case, Home Health Care 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.

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 Massachusetts
  • “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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