There are several factors to consider when deciding on either home care or nursing home care for a loved one. Safety, socialization, medical needs, and cost of care are essential factors that go into making the right choice.
Consulting with home care agencies and then touring various nursing homes will give you a better idea of which option best meets the needs of your loved one. The following are some questions to ask yourself when weighing the option of home care or nursing home care.
Is It Safe To Remain At Home?
Your loved one’s safety is the priority. Since mobility and minimizing fall risks are so essential to senior wellbeing, the home must be made safe and accessible.
Ideally, seniors should have:
- A single-level area in the home that accommodates their sleeping, bathroom, living room, and social needs without stairs or hazardous thresholds.
- Flooring that is navigatable via wheelchairs, canes, or walkers.
- Bright, motion-sensitive lighting to make up for vision loss and night blindness.
- Cupboards and closets organized with the things they use most- in reach to minimize the need for bending or getting up on a stool or stepladder.
- Rugs that are securely fastened to prevent ridges, wrinkles, or looped corners or edges.
- Bathroom spaces that are easily navigated with a wheelchair or walker.
- Grab bars near toilets and shower (shower seat and hand-held faucets are ideal).
- Secure railings and wheelchair-accessible ramps replacing stairs at entries/patio doors.
You can visit the AARP’s guide on Aging-Friendly Home Improvements for more suggestions about making a home safe and accessible.
Are There Acute, Long-Term Medical Needs?
Most home care agencies provide companionship and personal care assistance, serving basic, day-to-day needs such as meal preparation, laundry, housekeeping, medication reminders, and more. Outside of medication reminders, however, home care aides are not able to provide medical assistance.
If your loved one requires temporary medical assistance or wound care after hospital discharge, a VNA (Visiting Nurses Assistant) would be able to help with those medical needs. VNA services are provided through insurance, and the frequency of visits is dependent on your health care plan.
However, a VNA is not a long-term solution. In many instances, home care aides work alongside VNAs to provide care for elderly patients that need medical care. You can speak with healthcare providers for more information about whether or not a home health service can be brought in temporarily.
If the client has long-term healthcare needs, a nursing home or post-acute care center is usually a good decision. Nursing homes have licensed nurses and physicians on-site and CNAs who can monitor the patient’s health and implement the most necessary treatments or interventions on-site.
Home care agencies like ours still work with clients at many nursing homes and assisted living facilities to provide additional care and social connection.
Does The Client Require Acute Memory Care? (dementia, Alzheimer’s, etc.)
Does your loved one have Alzheimer’s or another dementia-related condition? Home care is undoubtedly an excellent option to provide qualified care and supervision during the early- and mid-stages of dementia.
Home care support allows families more time and flexibility in choosing a memory care center or nursing home that accommodates the needs that arise as patients progress into later stages of dementia.
If you opt to keep your spouse or loved one at home for the duration, make sure you work with a home care agency experienced with memory care and keeps their staff up-to-date with the latest research on dementia and Alzheimer’s care.
A healthy diet, exercise, music and reminiscence therapy, social engagement, games, and puzzles are essential parts of keeping the neurons firing to slow down the progression of the disease. If you hire a less-qualified caregiver, your loved one may be sitting idle all day, leading to a faster progression and decline.
Is Socialization Important For Your Loved One?
There is no doubt that social engagement is essential to senior wellbeing. Remaining engaged with a variety of people minimizes the risk of senior depression and anxiety. It also slows down the progression of memory loss.
While nursing homes provide 24/7 care, social support and interaction are not as personalized as home care. At home, our aids can provide companionship and support for social outings.
When it comes to socialization, you don’t need to choose between a nursing home and home care. We also work with residents in nursing homes to provide opportunities for social interaction.
Is A Pet Part Of The Equation?
If your loved one has a beloved cat or dog, it’s a serious consideration – especially if they live alone.
Never underestimate the importance and legitimacy of a senior’s relationship and level of affection for his or her pets. If you feel that a home is a safe place, it can be made accessible, and there are no serious medical needs, it might be worth bringing qualified care in for the duration of the pet’s life unless you can find a facility that allows pets.
If that isn’t possible, and allow time for your loved one to come to terms with it, process the transition, and grieve. You can also see if there is a nursing home with a resident pet or one that works with local volunteer agencies to bring service dogs/cats onsite for loving and petting.
Have You Evaluated the Costs?
Cost of care is an additional consideration when deciding between home care and a nursing home.
According to the Genworth Financial 2020 Cost of Care Survey, the national average hourly cost of a Personal Care Aide in the U.S. is $23.50 and $24 an hour for a Home Healthcare Professional. Locally, Massachusetts ranks as one of the more expensive states for care, with in-home care costs averaging $29 per hour.
Still, the cost of care for in-home care is by far less than the cost of care in a nursing home. In-home care for 6-hours of personal, one-to-one care is about $186 per day. The cost for care in a nursing home, where residents receive less than 6-hours of personal care, is about $415 per day.
*Assumes in-home care is provided 6 hours per day.
While cost likely isn’t the only factor in your decision, it’s still an important one. You can read more about cost, including the cost for overnight visits, by visiting this page.
To get a quick estimate of the cost for in-home care based on your loved one’s needs, you can use this calculator. Or contact us to discuss those needs and options.
Choosing Home Care vs. Nursing Home
When it comes to planning the next steps, please remember that home care and nursing homes can work together to provide the right level of care. Most home care agencies have a social worker on staff that can talk with you about home care services to help you with your decision.
Likewise, social workers at nursing homes can talk through emotional health and life in the nursing home. Both will surely agree on the benefits of working together to support the best interests of your loved one.
If you are undecided, starting with a home care agency can be a good baby step into the planning and adjustments necessary, even if it turns out a nursing home best serves your loved one’s needs.