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In-Home Care vs Assisted Living Facility: A Comparison Guide

Finding the best living situation for yourself or aging loved ones can be a struggle for many families as they wade through different options. While we are active proponents of happier aging at home, this post is not meant to persuade you to always use home care. We’re here to be a resource for you, to help you (or your loved one) age the way you want—with choice and dignity—in a place where you want to be.

We’ve identified 7 aspects we know to be essential when comparing in-home care vs an assisted living facility (ALF). Let’s take a look:


Consider the space where you or your loved one will feel most comfortable and what their preferred size of living area is.

  • In-home Care – Primary place of residence. First floor bedroom or a first floor room to put a bed is highly beneficial, as is first floor bathroom. Home is, of course, as big or small as you have.
  • Assisted Living Facility – Square footage generally ranges from 250sq. ft. to 600 sq. ft. for a room. ALFs vary widely in room options (private, double occupancy, multi-room suites).


Managing medications is a crucial part of a care plan. Both in-home care and assisted living facilities can excel at staying on top of a client’s medications.

  • In-home Care – Skilled home health agencies (like Silver Lining Home Healthcare) can provide and administer medications. Additional resources that can verify medications are taken (i.e., like the Livi or a Medication Compliance program from SafeinHome) can help your loved one stay medication compliant at home.
  • Assisted Living Facility – Nurses oversee and administer medications. For most assisted living facilities, the more medications your loved one has, the higher the monthly cost of care.


Time with friends and family. Exercise classes. Church gatherings. Pursuing a favorite pastime. Socialization opportunities such as these promote physical, mental, and cognitive benefits for seniors.

  • In-home Care – Socialization in the home setting is focused on encouraging family and friends to come to your loved one’s home or having your loved one venture out for lunch dates, bus trips, exercise classes or any social event (if physically able).
  • Assisted Living Facility – Socialization in the assisted living setting is easy because it’s quite accessible. Most assisted livings have an activities director to coordinate activities ranging from chair yoga to playing games to watching a school choir come and perform. This is a perk to living at an ALF.


Evaluation, prevention, and early detection are the pillars of safety whether in the home or in an assisted living facility.

  •  In-home Care – Prevention and early detection are the main focus around safety in the home. Even with a person present 24/7, Mom or Dad could still have a fall related to a variety of environmental and physical factors. In-home care agencies help clients create a safe environment in their homes by:
    • Performing a Home Safety Evaluations and making adjustments
    • Creating a care plan with physical exercises and the use of adaptive equipment
    • Taking advantage of early detection devices that detect and send alerts in the case of a fall (SafeinHome is one example).
  • Assisted Living Facility – Just like in-home care, prevention and early detection are the goals of an assisted living facility. An ALF is designed to keep clients as independent as possible, which means they often don’t have any more oversight than an individual would in a home environment. Systems like SafeinHome can work in an ALF just like it can in the home. Something to be aware of: Safety precautions often aren’t as customizable in an ALF as they are in a home environment.

Dementia Care 

Deciding on care for a loved one with dementia or Alzheimer’s disease can be one of the toughest decisions. In many cases, there is a desire to keep a loved one in familiar surroundings for as long as possible.

  • In-home Care – 1:1 personalized care in familiar surroundings is a benefit to home care. In-home care can also be a great support to one’s primary caregiver.
  • Assisted Living Facility – Typical ratio may be closer to 5 clients to 1 staff member. Not all ALFs have memory care units or they are best suited for those in the early stages of the disease. A memory care unit is typically a separate wing or residence of a facility that is staffed 24/7 by staff who are specifically trained to care for the needs of dementia patients.


Understandably, the cost of care is a major consideration. Consider care as an investment into your loved one’s quality of life. Still, we know that sometimes money is the biggest factor into how much care can be obtained. Think about “what is the alternative to this cost?” For example, home care may sound expensive until you see the costs of burnout, losing a job/taking off work to provide the care yourself, or using a facility. Genworth provides a widely used long-term care calculator to help you gauge the cost of care in your area.

  • In-home Care – Depends on availability of additional resources and level of care required. To a certain point, home care is cheaper than an ALF; 24/7 in-home care is not. There are multiple options instead of doing 24/7 care (i.e. technology to supplement actual people care). Hourly rates for in-home care range from $18-30 for Instrumental Activities for Daily Living, $20-35 for Activities of Daily Living, and $50-130 for nursing care.
  • Assisted Living Facility – Most have a base price or “Level 1” price. Depending on level of involvement required (personal care, medication management, etc.), the price increases. In Delaware, the average monthly cost is $5350.

Care Coordination

“An ounce of prevention is worth a pound of cure.” And so it is with Care Coordination. Care Coordination exists to help your loved one maintain a normal life while staying on top of health concerns before they snowball into health crises. Scheduling and attending important medical and non-medical appointments, coordinating social activities (loneliness is the biggest contributor to depression in older adults!), and bringing in or recommending additional resources are all functions of Care Coordination and work to prevent issues before they arise.

  • In-home Care – Varies based on agency. Having the right agency that can actually manage all of your care and coordinate the details can be the key to success for aging in place.
  • Assisted Living Facility – Typically streamlined and overseen by an on-site Director of Nursing.

Choosing Both

Did you know that home care could actually be provided at an Assisted Living Facility to supplement one’s care? It is yet another option to consider. Like most options, in-home care and assisted living can both be the right option for you. And that can be a good “problem” to have. If your family is struggling with this decision, know that you are not alone. A Care Specialist at Silver Lining Home Healthcare can take your unique situation into account, help you weigh the options and design a care plan for your loved one.

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Call: 302.724.7902
Email: jackie@silverlininghealthcare.com
Address: 24 Hiawatha Lane
Dover DE 19904