Highgate Senior Living Blog

Assisted Living vs. Home Care: How to Choose

How to figure out how much help your loved one needs

Healthcare professional giving a resident his medication

According to a Pew Research Center Survey, 25% of Americans with at least one parent age 65 or older say their parents need help handling their affairs or caring for themselves. But, managing a parent’s affairs or providing care has become more and more difficult for adult children to manage on their own. Single-income households have become far and few between and many middle-aged adults find themselves working into their later years to achieve financial stability for retirement.

Aging parents have noticed this shift too. In the article You Don’t Want to Burden Them, 46% of survey respondents mentioned being worried about the burden it would cause adult children when considering family involvement in their care.

Approaching the Conversation

While most parents appreciate the occasional concern from their children about their well-being, approaching the conversation about needing more support can be somewhat tricky if your parent hasn’t yet realized they need help themselves.

One woman who was interviewed for You Don’t Want to Burden Them recalled, “They're constantly bugging me about something. I mean they're saying did you do this or that . . . how are you feeling, where are you going, are you going to try to do this or that?”

So, what’s the best approach? Here are some tips:

1. Start with a List

Rather than having multiple individual conversations with your loved one, start with making a list of the things you’ve noticed your parent might need help with. 

“Watch for things that are out of the norm,” says Megan Wilson, Community Relations Coordinator at Highgate at Billings. “Does your mom still get together for lunches with church friends or participate in her book club? Are you noticing pill boxes aren’t empty? Is there food in the fridge that is going bad?”

Make a list of everything they might need help with on a daily, weekly, and monthly basis. Think about these key areas:

  • Family support
  • Home safety
  • Medical needs
  • Cognitive health
  • Mobility
  • Social interaction
  • Meal preparation
  • Personal hygiene

Being able to see the whole picture can help in determining just how much help your loved one might need and if staying at home is contributing to isolation or a change in mood.

2. Include Other Family Members

“It’s super important for a family, and as many family members as possible, to sit down together and assess what the primary needs are,” says Brian Kraft, Executive Director at Highgate at Billings.

Avoid disagreements in front of your loved one by not understanding how other siblings feel about your parent’s current situation and possible solutions.

According to a U.S. News article, other common mistakes siblings make when parents are aging are: not showing appreciation or support for the primary family caregiver, automatically reverting to childhood roles when care decisions need to be made, and not planning for the tough realities ahead, which leads us to….

3. Think About Yourself

In addition to assessing what your loved one needs, it is critical to think about yourself, too. How much help can you and your family realistically provide?

It is important to think about this in terms of long-term, ongoing help. Nearly 60 percent of caregivers provide care for more than three years and 15 percent provide care for more than 10 years. Home care does not provide 24-hour support and the likelihood that you or other family members will need to pitch in to cover the support not provided by home care is highly likely.

It is best to make an honest assessment early in the process so you do not get yourself into a situation that is not sustainable. If you take on too much and burn out physically or emotionally, you will not be able to help your loved one or yourself.

4. Include Your Loved One

Any good relationship is founded on mutual trust and respect. Your parents want to take care of themselves. Their own needs. Their own health. And, they prefer not to view themselves as needing help. But they also hope that help will be available if they need it.

Your parents might want you to wait as long as possible before you bring up their driving skills, but that does not mean there aren’t other conversations you should be having.

Positioning yourself as a partner, rather than someone who is swooping in to make changes is an important step when considering what kind of additional care and support your parent might need. Before sharing any observations you might have, ask your parent how they feel and what they are finding they might need more help with.  

Frustration and disdain when approaching the care conversation with a loved one are often caused by the fear of losing of the ability to make their own decisions. Approaching the conversation aggressively can escalate this fear quickly.  

Making the Decision

While home care allows your parent to receive assistance in the home they currently live in, assisted living allows residents to receive care and supportive services without compromising their safety.

One more consideration when deciding on home care or assisted living is by looking at Instrumental Activities of Daily Living (IADLs), which are used to determine the ability of an individual to live in their own home. Instrumental activities of daily living include: managing personal finances, taking medications, using the phone, shopping for food and clothing, housework, and meal preparation. If your parent is struggling with any of these activities, it’s likely time to start discussing assisted living where your parent will have access to transportation, delicious and nutritious dining options, a variety of recreation and activity programs, and care and supportive services.

Although deciding between assisted living and home care can be difficult, you’ve already taken a big step in the right direction researching your options. Learn more by downloading our most recent eBook How to Decide: In-Home Care or Assisted Living.

How to Decide: Home Care or Assisted Living