Guides · Care and health
Senior Care Options: In-Home Care, Assisted Living, Memory Care and Nursing Homes
The options run from help at home to 24-hour skilled nursing. Here is what each provides, who it suits, how it's paid for, and where to find local help.
By naveen · Updated · How we research our guides
What to know
- Senior care options range from help at home and adult day programs, to assisted living, memory care units for people with dementia, and nursing homes with nursing care and 24-hour supervision.
- The main difference between them is how much care they provide, and the right fit depends on what your parent needs help with now.
- Medicare doesn't pay for long-term care in any of these settings; personal funds, Medicaid for people who qualify, and long-term care insurance are the other ways to pay.
- The federal Eldercare Locator, at 1-800-677-1116, connects families to local services for older adults.
- Retirement Checklist puts care decisions in order with the money and legal steps they depend on.
Senior care options run from help at home and adult day programs to assisted living, memory care units for people with dementia, and nursing homes, and they differ in how much care each provides. Medicare pays for none of them as long-term care.
What are the main senior care options?
Help at home, adult day programs, assisted living, memory care and nursing homes, described here in the National Institute on Aging's (NIA) terms:
| Option | What it provides | Who it suits |
|---|---|---|
| Help at home | Personal care, chores, meals, transportation and health care at home, plus home safety changes | A parent who wants to stay put and can with help |
| Adult day programs | Social activities, exercise, meals, personal care and basic health care in a nearby facility | A parent at home whose caregiver needs a break during the day |
| Assisted living | A room or apartment, meals, help with personal care and medications, 24-hour supervision | A parent who needs help with daily care, but less than a nursing home provides |
| Memory care | Special Alzheimer's units with staff trained in dementia care | A parent living with Alzheimer's or another dementia |
| Nursing home | Nursing care, 24-hour supervision, therapy and help with everyday activities | A parent who can't care for themselves and may need ongoing medical care |
For more on the three residential settings, see assisted living, memory care and nursing homes.
Can your parent stay at home?
Sometimes, with help. NIA calls it "aging in place" and describes home-based care covering personal care, household chores, meals, transportation, money management and health care. Home changes help too: NIA suggests fixing dangers "such as loose stair railings and poor lighting" and installing grab bars near toilets and in the tub or shower.
Adult day care "can provide a much-needed break for caregivers at home," NIA says, and respite services provide short-term care when a regular caregiver isn't available. The people matter as much as the house: NIA notes that "Family, friends, and neighbors are the biggest source of help for many older people." If several of you share the load, our guide to siblings caring for aging parents covers dividing the work.
What is the difference between assisted living and a nursing home?
The level of care. NIA says assisted living "is for people who need help with daily care, but not as much help as a nursing home provides." Nursing homes, "also called skilled nursing facilities," offer services that "focus more on medical care than most assisted living facilities," including nursing care, 24-hour supervision and physical, occupational and speech therapy.
Memory care sits alongside both. NIA says "Some assisted living facilities have special Alzheimer's units with staff who check on and care for people with dementia," and some nursing homes have special Alzheimer's care units too.
How are senior care options paid for?
From a mix of sources. NIA says people "may rely on a variety of payment sources, including personal funds, federal and state government programs, and private financing options." Medicare covers a short skilled nursing stay, up to 100 days per benefit period after a qualifying inpatient hospital stay of at least 3 days in a row (Medicare.gov). It doesn't pay for long-term care services, "including care in a nursing home or in the community" (Medicare.gov).
That leaves savings and income, long-term care insurance if a policy exists, and Medicaid for people who qualify. According to the Administration for Community Living (ACL), Medicaid covers "long-term care services in nursing homes, and long-term care services provided at home, such as visiting nurses and assistance with personal care." For assisted living, NIA says Medicaid "may provide coverage for some aspects of assisted living, depending on the state and whether the person is eligible." Our guide to how to pay for nursing home care puts the sources side by side.
How does health care fit in?
Through doctors trained in older adults' care, and through the yearly Medicare plan review. A geriatrician is a doctor "board-certified in internal medicine or family medicine" with "extra training in geriatrics," according to the American Geriatrics Society's Health in Aging Foundation, which suggests seeing one when an older adult "sees many different healthcare providers and needs help coordinating care." And every year from October 15 to December 7, the Medicare Annual Enrollment Period is the window to change health and drug plans as needs change (CMS).
Where can you find local help?
Start with the Eldercare Locator, which describes itself as "a public service of the Administration for Community Living connecting you to services for older adults and their families." It can be reached at 1-800-677-1116, and you can call or send a text message to trained staff. It can also point you to the local Area Agency on Aging. ACL says these agencies "coordinate and offer services that help older adults remain in their homes," such as home-delivered meals and homemaker assistance.
What questions are worth asking?
- What does your parent need help with now, and what might they need in a year?
- What does your parent want, and have they been asked?
- Who in the family can help, how often, and for how long?
- What would pay for care, and does your parent have a long-term care policy?
- Who has the legal authority to sign admission paperwork or handle money if your parent can't?
Every guide in care and health
Frequently asked questions
What are the levels of senior care?
They run from help at home and adult day programs, to assisted living for people who need some help with daily care, to memory care units for people living with dementia, to nursing homes with nursing care and 24-hour supervision. The main difference is how much care each provides, and the right level depends on what your parent needs now.
Does Medicare pay for assisted living?
No. Medicare doesn't pay for long-term care, and NIA says it does not pay for assisted living. Medicare Part A can cover a short stay in a skilled nursing facility, up to 100 days per benefit period after a qualifying inpatient hospital stay of at least three days in a row, but not ongoing custodial care.
What is the difference between assisted living and memory care?
Assisted living offers a room or apartment, meals, help with personal care and medications, and 24-hour supervision for people who need help with daily care. Memory care means special units for people living with Alzheimer's or another dementia; NIA says some assisted living facilities have them, with staff who check on and care for people with dementia.
How do I find senior care services near my parent?
Start with the Eldercare Locator, a public service of the federal Administration for Community Living, at 1-800-677-1116 or eldercare.acl.gov. It connects families to services for older adults and to the local Area Agency on Aging, which coordinates services such as home-delivered meals and homemaker help for older adults in its area.
Can Medicaid pay for care at home?
It can. The Administration for Community Living says Medicaid covers long-term care services at home, such as visiting nurses and help with personal care, for people who qualify. Eligibility rules and covered services vary from state to state, and ACL says your State Medical Assistance office is the best source for how to qualify.
Getting started
The right care option depends on what your parent needs and wants, and on the money and legal pieces behind it. The plan this site builds asks four questions, including which state your parents live in, and puts the steps that matter most for your family in order. It's free and takes about 90 seconds.
Sources
- National Institute on Aging, Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care: What each residential setting provides and who pays.
- National Institute on Aging, Alzheimer's Caregiving: Finding Long-Term Care: Special Alzheimer's care units.
- National Institute on Aging, Home Safety Tips for Older Adults: Lighting and grab bars.
- National Institute on Aging, Services for Older Adults Living at Home: In-home help, adult day care and respite services.
- National Institute on Aging, Aging in Place: Growing Older at Home: Home-based care and support from family and friends.
- National Institute on Aging, Paying for Long-Term Care: Personal funds, government programs and private financing.
- Medicare.gov, Long-term care coverage: Medicare's statement that it doesn't pay for long-term care.
- Medicare.gov, Skilled nursing facility care: The 100-day skilled nursing limit and the three-day hospital stay rule.
- Administration for Community Living, Medicaid and long-term care: Medicaid coverage of long-term care in nursing homes and at home.
- Administration for Community Living, Eldercare Locator: The federal service connecting families to local help for older adults.
- Administration for Community Living, Area Agencies on Aging: What local Area Agencies on Aging do.
- American Geriatrics Society Health in Aging Foundation, Basic Facts about Geriatrics: What geriatricians are trained in and when to see one.
- CMS, Medicare Open Enrollment: The October 15 to December 7 open enrollment period.
More on what this tool does and doesn't do, or browse everything we've written.