How to Choose Between Assisted Living and In-Home Care the DMV Area
Do assisted living and in-home care offer the same services?
Staff at assisted living facilities and in-home caregivers can perform many of the same services in support of an older adult. These include personal care, washing and dressing, ensuring safe mobility and medication reminders. Both can also assist with transportation to doctors and other healthcare appointments, facilitate social outings and provide companionship.
Comparison of In-home Care vs Assisted Living.
While assisted living and in-home care will be able to provide many of the same services, there are significant differences in the experience they provide that go beyond one being offered in residential housing and the other in the home. Let's take a look at some of these key differences:
Level of care needed.
Assisted Living facilities can offer higher levels of care and support. Most will provide meals, laundry and housekeeping to residents and staff are available round-the-clock to help with personal hygiene, bathing and toileting, safe mobilization and medical monitoring. Some nursing care may also be provided such as medication management and wound care. Assisted living facilities are usually governed by the licenses and laws of the State such that the environment and services offered to residents meets minimum standards but also that the overall experience of assisted living is fairly uniform across facilities and for all residents. In-home care is much more variable and flexible and can be tailored to an individual's needs and circumstances. In-home caregivers can provide almost any type of help or support in the home while home care services can be gradually introduced as the person needs them, from a couple of hours a week for help with shopping and light housework to 24hr care, even end of life care.
Safety and security.
This is a big consideration for many. Assisted living typically offer 24/7 security, emergency response systems and staff available in case of emergencies. Many also offer medical monitoring to residents with chronic illness. In general, home care cannot offer a comparable level of security and supervision and recipients of care in the home rely more on their caregivers, family and surrounding community to stay safe. Personal alarms or one of many medical alert and fall detection systems can
Social support and community.
Assisted living provides opportunity for social engagement in communal spaces where residents can meet informally, through participation in planned activities and during organized social outings. While assisted living may offer a ready-made community to residents, moving to residential housing has the potential downside of uprooting an older adult from their existing social networks and community, and may even result in less contact with family. Remaining in the home as care needs increase requires more effort to ensure socialization and maintain relationships but has the advantage that these existing relationships may be more familiar and meaningful to the person.
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How to Choose Between In-home Care vs Assisted Living.
When an loved one or older adult starts to need care to stay safe and healthy, choosing between assisted living and in-home care is a big decision and one which very much depends on that individuals unique needs, circumstances and preferences. Make sure to consider the following:
Assess the individual's care needs: Can these be met with regular visits to the home from a qualified in-home caregiver or is around-the-clock help and supervision now required that are more effectively provided in an assisted living facility? There is no clear line between the two, however, as even 24hr care, with all required services, is available both in assisted living and from in-home caregivers working in shifts but the in-home option takes more effort to organize than in a facility.
Consider safety: As frailty increases, some older adults become at high risk of falling, others with debilitating chronic illness can suffer frequent medical emergencies while persons with dementia may try to wander, particularly at night. If being alone for any period of time is potentially unsafe, assisted living is set up to be a better solution than home care, particularly if continual supervision and monitoring is the only or main care need. Also, not all homes are suitable for aging in place, due to poor maintenance, steep stairs and other hazards and while home modifications can help, it may be easier to opt for residential care.
Individual preferences: AARP reports that over 80% of seniors want to age in place, which is possible with the use of in-home care versus turning to living in an Assisted Living facility. The comfort and familiarity of home and continued access to friends and established community all make in-home care the most desirable option for many. Individual preferneces differ however, and other older adults may appreciate the convenience and amenities offered by assisted living.
Availability of care: Access to in-home care varies with location, generally being more consistent in urban areas than more rural locations. Be sure to investigate the needed services can be reliably delivered before choosing in-home care. In contrast, while an assisted living facility can always be found, it may be some distance from the individual's family, friends and community making it difficult for them to maintain important connections.
Cost: In-home care is generally cheaper than assisted living up until more than 40 hours of care a week is required. The cost of in-home care varies with hours of care required per week as well as location and level of care. Also take into account the ongoing cost of maintaining a home and mortgage vs a facility where accommodation, maintenance and meals are usually included in the price. We dive into the cost of care in more detail below.
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