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For many these days, the ideal approach to aging involves aging in place—staying in your home and taking the steps necessary to remain independent for as long as possible. Many are still choosing the better-known options: retirement communities, assisted living facilities, and other institutions designed to care for older people. But an increasing number of seniors are choosing to stay at home and get whatever help they need to remain there.

Aging at home comes with all the same challenges: Health and mobility issues present threats to independence wherever you live. But home care agencies—which provide all the services that come with an assisted living facility, but do so in the client’s own home—can enable a senior to remain at home throughout the aging process, and at a cost comparable to other options.

Because many seniors choose to age in place because of their emotional attachment to a particular home or community, home care can also give loved ones the reassurance that their family members are being well cared for without forcing seniors into an unfamiliar, and possibly distressing, environment—and home care can, if needed, keep seniors at home all the way through the end of life. What’s more, home care can also expand the range of options available to any senior, allowing them to choose to stay at home—or seek care outside of it—as best suits their situation.

Kinds of Care

Before we talk about choosing between home care and out-of-home care, we should probably talk about the types of care available to people looking for help as they age. Roughly speaking, they fall into two main categories: the types of care you can receive in your home, and the types you can only receive by leaving home.

In-Home Care

There are various kinds of help that someone can receive at home:

Care Outside Of The Home:

Choosing the Right Care For You

Talking about different types of care in the abstract, however, doesn’t make it any easier to figure out whether you should age in place or enter one of the various types of facilities that offer care. That’s because every person’s situation is unique, and every person has unique needs and motives as they choose the type of care they want.

For that reason, it may help to walk through some scenarios that families find themselves in, and use them to guide your decision-making as you choose your next step.

Scenario 1: What If It’s A Healthy Senior Living Fairly Independently?

One situation that often arises is a healthy senior who lives fairly independently who nevertheless feels that they need some help. This can range from organization or home maintenance to ordinary household chores, like cleaning or laundry, that the client wants to take a rest from after a lifetime of work.

Home care—in particular the lower-level type of care often referred to as companion care—is probably the best bet in this situation: if everything else is going well, why leave home for a facility? Home care can also offer some additional advantages, depending on the situation: for example, if the senior is far from loved ones, the caregiver can give the family updates on the client’s condition, and provide reassurance that might not otherwise be available.

Note, however, that even healthy seniors often choose to move to some sort of senior living arrangement. Many seniors would rather downsize than continue to wrestle with the challenges of home maintenance, and senior living and assisted living can be a great option if a senior must give up their home for some other reason—to move to closer to family, for example.

Scenario 2: What If It’s A Senior With Health Challenges Living Alone?

A healthy, independent senior has plenty of choices, naturally. Things get more complicated if you or your loved one is confronting significant physical challenges. In such a situation, assisted living could be the best choice, but it’s not automatically the right way to go: home care can expand the range of options—and may still be necessary before and after the move to assisted living.

One of the first questions to ask is whether health challenges are isolating the senior from their friends or loved ones. If no friends or family live nearby, then assisted living might well be worth a look. On the other hand, some seniors find the move to a facility isolating, too, as limits on space and privacy can make visits less attractive for friends and family. In this situation, it’s also important to remember that many home care companies provide transportation—to social events as well as medical appointments—and so home care can help with isolation as well.

One issue that sometimes arises as seniors lose their independence is that the family begins to be (understandably) concerned about the health and well being of their loved one. In such cases, many turn to assisted living as a means of gaining peace of mind about the patient’s health and safety. Such concerns are natural, but home care agencies can also help provide reassurance about seniors with health or mobility challenges who live at home. In addition to paying visits, home care companies will often supply their clients with medical alert systems that allow the user to summon help even when they can’t reach a phone; many agencies also offer special services that will advise about safety risks in the home and even take steps to make the home safer.

Ultimately whether the senior’s health warrants moving into a facility comes down to the senior’s own preferences. Certainly assisted living may be an option, but there are many reasons, including a simple desire to keep the house in the family, that can make home care a much more attractive option.

Scenario 3: What If The Senior Has A Spouse With Different Care Needs, But They Want To Stay Together?

Sometimes couples find themselves in a scenario where one of them needs a different level of care than the other. This can lead to a lot of distress, since it’s generally not possible, for example, for someone to take up residence in a nursing home who doesn’t need nursing care—even if their life partner does. And when one partner doesn’t need a facility at all, finances can be an issue: the proceeds from the sale of a home are one of the main ways seniors finance their stay in an assisted living facility, but if one member of a couple hopes to continue in the home, that source will be unavailable.

Home care can open up some new possibilities in this scenario. Having an onsite caregiver available for a few days a week can relieve a spouse of some of the most burdensome aspects of care, and even if one spouse needs more involved care or around-the-clock supervision, hiring a caregiver can allow both spouses to remain in familiar surroundings.

Scenario 4: What If The Client Has More Serious Health Problems?

Beyond these scenarios, you begin to enter situations where some sort of institutionalization may be necessary. But the choices are still not as cut-and-dried as they may appear at first. For example, Alzheimer’s and dementia can appear to significantly increase the need for an assisted living or specialized memory care facility. But especially in the early stages, home care can provide those with memory impairments the supervision they need when other caregivers aren’t available or need a break from their duties. Many home care companies offer special services for those with Alzheimer’s, too, and that type of attention, combined with the comfort of being in familiar surroundings, can make it easier for friends and family to connect with a loved one with memory impairments.

Apart from Alzheimer’s, there are other ailments that can require more involved care, and can make staying at home untenable. But it should be noted that for many of these ailments, the appropriate facility is probably going to be one that provides nursing care, which is a more expensive proposition than assisted living. If the person needs skilled nursing care, then that need should form the basis of comparison if expense is a factor.

Finally, someone will often find themselves needing to enter a facility for an acute crisis like an injury. At that time, they and their family may feel that their only option is to go from the hospital (or rehabilitation facility) into a nursing home or assisted living community. Here again, though, home care can open up more choices: many home care agencies offer services designed specifically to facilitate recovery, and for someone desiring to return to the fully independent life they lived before a setback, these types of home care may make institutionalization unnecessary.

Scenario 5: What About The End Of Life?

No one likes to think about death, and making arrangements around the end of life can be an unpleasant experience. That’s why it’s easy to respond in crisis mode and turn to an institution—most likely a skilled nursing or hospice facility—when a loved one is approaching death. But if a senior is already at home, or could be released from an institution, hospice care at home could be the better choice. It allows the client and their loved ones to avoid the antiseptic environment of a facility and allows everyone involved to treasure those last days in familiar surroundings.

It’s important to be guided by medical professionals as one makes this decision: depending on the underlying condition, the end of life can present enormous challenges to family and caregivers, and it’s possible that the senior’s comfort will be best served in a facility. At the same time, the senior may be more comfortable at home, and if those overseeing their care don’t object, then the family should explore receiving end-of-life care at home. Such care can require a combination of home care and home health care, but it also means that a senior who loves their home and a family who loves to return there can maintain that connection all the way to the end.