Home Care vs. Nursing Homes: What’s the Difference?
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Home Care vs. Nursing Homes: What’s the Difference?

John Skelton, BSN | February 3rd, 2022

As your loved one ages and you realize they need more day-to-day help, it can be hard not to let personal feelings of guilt interfere with care decisions. Understandably, many seniors wish to remain at home as long as possible, and you may have to make difficult choices about their living arrangements. Evolving care needs may call for extra, specialized support that family caregivers can’t provide.

Home care may be sufficient for assistance with daily activities, but seniors with more serious medical needs may need the skilled medical care offered at a nursing home. Consider which type of care may be right for your loved one as you weigh options.

Nursing Homes

     In-Home Care

     Assisted Living

     Independent Living

     Memory Care

     Nursing Homes

     Adult Day Care

What is home care?

Home care is nonmedical care provided in a senior’s home, often on an hourly basis. This type of care is often best suited for older adults who may not require constant supervision but need help with household tasks and activities of daily living (ADLs) — including bathing, dressing, and managing medications.

Home care aides offer personal care and services such as help with:

     Housework and laundry

     Meal planning and preparation

     Transportation to doctor’s appointments or errands

A key advantage of home care is it typically offers a variety of services that are customized to meet your loved one’s specific needs. The same personalization goes for the amount of care needed, which may range from a couple of hours a week to around-the-clock care.

Other home care benefits seniors enjoy include:

     Receiving one-on-one care in a familiar setting

     Developing a personal relationship with their professional caregiver

     Maintaining their independence, while receiving help with tasks as needed

If an aging loved one does need a higher level of care, a nursing home isn’t necessarily the only option. Home Health is another type of home-based care for patients who need professional medical assistance but can still live safely at home without the need for around-the-clock supervision. This type of home-based care is typically prescribed by a doctor for people who need medical support from licensed nurses and health professionals at home after an injury or hospitalization.

Live-in care vs. nursing homes

Seniors who need more care throughout the day may opt for live-in care over moving to a nursing home or another senior living facility. A live-in-caregiver resides in the home with the care recipient. In some instances, live-in care may be a cost-effective option compared to other senior care options.

Not to be confused with around-the-clock care or overnight care, which typically involves two to three caregivers working in shifts, live-in care is provided by one caregiver who remains on site all the time for up to four to five days a week. Live-in caregivers’ shifts are scheduled in 24-hour periods, with allotted times for caregiving, as well as breaks for sleep and respite.

Live-in home care has many benefits, but it usually doesn’t offer the skilled medical care found at nursing homes. If your loved one has complicated medical problems, nursing home care may be right for them. Eventually, providing care in a senior’s home can become costly and time consuming as their care needs increase.

While nursing homes are already equipped and staffed to provide around-the-clock care and supervision, in order to continue caring for a loved one in their own home, family caregivers may be required to:

     Oversee and monitor care aide performance

     Renovate their home with safety modifications, such as walk-in tubs or widened doorways

     Purchase all household supplies and personal care items, in addition to the costs of in-home care aides

Additionally, although home care agencies will typically provide back-up care, family members may need to step in and provide care if an independent caregiver is sick or needs the day off.

What is a nursing home?

A nursing home, sometimes called a skilled nursing facility, is often recommended for someone with more complex care needs such as a serious medical condition or very limited mobility. Nursing homes offer around-the-clock medical care and support from licensed health professionals.

Residents in nursing homes can typically expect these services:

     Daily meals

     Assistance with ADLs



     Rehabilitative therapies

     Skilled nursing care

     Around-the-clock supervision

Nursing homes are staffed 24/7 and usually have more security measures in place than what can be provided in a home setting. These can include cameras in entrances, check-in protocols, and fall prevention programs, which help lower the risk of injuries and wandering in patients with Alzheimer’s and other forms of dementia. Living accommodations are usually furnished private or semi-private rooms that typically include en suite bathrooms and emergency call buttons.

However, while a move to a nursing home may be able to provide the supervision and skilled medical care that your loved one needs, there may be downsides to the transition. In addition to not being surrounded by the familiar comforts of home, a nursing home resident may:

     Feel like they’ve lost their independence

     Miss out on personalized one-on-one care

     Experience a lack of privacy and a more limited schedule

     Struggle with adjusting to a new routine and environment

     Become overwhelmed or drained by day-to-day social interactions with staff and other residents

Additionally, nursing homes are usually more expensive than home care because of the cost of skilled nursing services, room and board, and any additional amenities offered. Nursing home services aren’t as customizable as with home care, so some patients can end up paying for amenities they don’t need or use.

How do you know when it’s time for home care vs. a nursing home?

Moving an aging parent into a nursing home is often a personal and emotional experience. Feelings of guilt usually weigh heavily on family caregivers, while seniors face feelings of fear and grief over their loss of independence. In the end, the decision should be based on your loved one’s individual health needs.

Whether a loved one wants to move into a nursing home becomes irrelevant when their care needs reach a point where you constantly question whether it’s safe for them to be alone at all. If your loved one has a chronic health condition, requires around-the-clock medical support or supervision, and has trouble getting out of bed or navigating around the home, then it may be time to seriously consider the benefits of a nursing home.

On the other hand, your loved one may have less complicated medical needs that require some assistance and supervision, such as limited mobility after an injury. If you’ve made all the necessary safety modifications to help them avoid hazards in their home, they’re still able to live relatively independently, and they’re in good health otherwise, then home care can be a great option.