Care and Housing Options for Older Adults


As we age, many of us will need assistance with everyday things like cooking or taking medication. Others will need ongoing care to meet medical needs. That’s when it may be time to consider enlisting help, from hiring in-home care to moving into one of the many different senior living or end-of-life housing facilities.

Here’s a general guide to see which type of care or housing might be best for you or your family member as you start your search. Remember, each facility provides a different range of services, so it’s a good idea to make a list of what kind of services you might want or need so you can compare. In addition, if you plan to use Medicare or Medicaid for some services, make sure the facility is certified to accept them.

In-home care with a visiting nurse or home care aide

The vast majority of Americans age 60 and older would prefer to stay put in their home, also known as aging in place, according to a 2012 AARP survey. Hiring a visiting nurse or a home care aide to come to you can be one way to help you do so. Some in-home care providers can live with you, while others can come several times a week, depending on the level of care you need. Home care aides can help you get dressed, assist with bathing and grooming and taking medication, make simple meals, and take you shopping or to doctors’ appointments. Visiting nurses or other health care professionals are for those who need more careful monitoring of their medical needs, including the administration of intravenous drugs or operating more complicated medical equipment.

Payment: Private; Medicare or Medicaid may cover some services

Average cost: $12 to $50 an hour

Assisted living

Assisted living facilities are for older people who can do many things on their own (and definitely like to have some sort of independence) but cannot do so safely on a daily basis. Residents live in a private room or suite, with a bathroom, but meals are taken communally in a dining area. There’s help with medication and housekeeping, and there are usually many activities planned during the day. Some provide transportation to area shops.  There are nursing services available, but usually not on a 24-hour basis.

Payment: Private; Medicaid

Median monthly cost: $3,750

Also known as: supportive care facility, assisted care community, personal care home

Nursing homes

Nursing homes are for people who need 24-hour medical care. Long-term residents usually have complex medical health issues that need skilled nurses at all times, while short-term residents may be those recovering from an illness or surgery. Unless you pay extra for a private room, most rooms are shared. Meals can be eaten communally in a dining area or be taken in your room.

Payment: Private; Medicaid; Medicare (for short-term stays only)

Median monthly cost: $7,148 for a semi-private room or $8,121 for a private room.

Also known as: skilled nursing facility, long-term care facility

Continuing care retirement communities

A continuing care retirement community is part assisted living and part nursing home. It’s a layer cake of services and lifestyles that can be adjusted when needed. For example, you might move into the independent living or assisted living portion, living in your own room and partaking in various daily activities. But if a health issue arises and you need 24-hour nursing care, you can move into the nursing home division without leaving the same campus, as the residence is often called. Couples can split their time between various levels; if one needs nursing care round the clock, the healthier partner can stay in the independent living section.

Payment: Private. There are many payment tiers with CCRC’s (you pay for what services you think you’ll use) so its best to check with a financial planner or trusted family member to see if you can afford it. Most require a sizable entry fee and have monthly charges.

Average monthly cost: Entrance fees range from low to mid-six figures; monthly charges range from $2,000 to $5,000.

Group homes

From the outside, a group home looks like a regular private home. Inside, however, several seniors live together with help from a live-in caregiver. The caregiver does the daily cooking, cleaning, and medication disbursements, and will help residents get dressed and bathe. It’s for older individuals who want to live in a smaller, more private space, rather than a facility with dozens of people in a large building.

Payment: Private; Medicaid

Average monthly cost: $1,500 to $3,500

Also known as: residential care home, adult family home

Memory care

If your loved one has Alzheimer’s disease or another form of dementia, there are several options. Some group homes care only for those diagnosed with the illness, while some assisted living and nursing homes have a memory care floor or building dedicated to residents with memory issues. There’s usually a staff that works round the clock at these facilities, providing very structured daily activities. There are security measures placed at these residences; many also offer secure outdoor walking areas.

Payment: Private; Medicaid

Average monthly cost: Add another $1,500 to the average monthly cost of an assisted living or nursing home facility.


For the seriously ill, hospice involves 24-hour medical treatment so an individual is most comfortable during the final phase of life. It’s about pain management and finding emotional and spiritual comfort, and not curing an illness. Individuals who require hospice care usually have an estimated life expectancy of six months or less. Those employed by a hospice include doctors, nurses, home health aides, social workers, clergy members, and therapists. You can stay in a hospice facility, or choose to have services provided to you in your own home.

Payment: Private; Medicaid; Medicare

Average monthly cost: $6,000 to $10,000

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