When Home Care Is Not Enough—Signs and Steps Forward

By 2050, an estimated 90 million people across the United States will hit the 65-and-older age bracket. There are many implications of the …

· 16 min read

By 2050, an estimated 90 million people across the United States will hit the 65-and-older age bracket. There are many implications of the growing aging population, but one of the most pressing is the challenge of caring for our seniors who can no longer live independently, without help.

Currently, around 15 million seniors receive home care, and this number keeps growing. Home care is a form of senior care that allows the individual to stay in their residence but still receive the care they need.

Using in-home care enables patients to remain in a familiar environment and benefit from a range of treatments and care services, including medical care, non-medical support, skilled nursing, physical therapy, and personal care.

However, there are also cases where it becomes clear that home care is not enough. There are clear signs that a family member or caregiver’s health or personal life is suffering while they’re trying to assist their senior loved one in daily life.

But as a senior’s health declines and they need increased medical assistance, family members will need to consider home care alternatives. These alternatives allow them to ensure that their aging loved ones receive the attention and care they deserve.

Let’s take a look at different types of home care alternatives and what they can offer your loved ones.

Types of Home Care for Seniors

Before diving into home care alternatives, it’s essential to understand that home care services are not a one-size-fits-all format. Instead, there’s a variety of options for home care for seniors, whether that’s from you as the caregiver or entirely from a professional caregiver who provides senior care services.

On the other hand, if your loved one requires medical care, a physician can certify that they need home health services, such as skilled nursing care or help from home health aides or occupational therapists.

This type of care is usually provided for around 21 days. If your loved one needs care beyond the 21 days permitted, their physician can recertify them every 60 days. Medicare or other forms of private insurance cover some of the costs of nursing assistance or other types of home health care. 

Home health care is different from senior home care. Home care services include activities of daily living (ADLs) and non-medical services that help seniors get the most out of their days, such as transportation services, meal preparation, and companionship.

Let’s dive into what types of services and care you can expect with each type of senior home care.

Home Care

Woman receiving in-home care

Home care refers to assistance with daily living activities in the patient’s residence or private apartments. 

Most seniors who choose a home care agency will receive personal care, such as help with bathing and eating, medication reminders, meal preparation, light housekeeping, help with household chores, and assistance with mobility.

Home Health Recovery Care

If a senior has been injured or is dealing with a temporary illness, recovery care can provide the medical care that they need. Skilled medical staff will help the senior recover. You might also hire a caregiver to provide personal care, companionship, and help with household chores.

Respite Care

When home caregivers or families are not available to care for a senior, they can seek respite care. This type of home care relieves caregivers from their duties and helps the senior with personal care, medication reminders, light housekeeping, and other services.

Skilled Nursing Care

If you have a senior at home who has an injury or illness but does not want to be enrolled in a nursing home or rehabilitation facility, you can utilize skilled nursing care.

An at-home skilled nurse can provide the senior with medical treatment, nutritional guidance, wound dressing, bandage changing, medication administration, and other types of treatments in the comfort of their home.

Hospice Care

Hospice programs offer palliative care, pain management, and comfort to patients who have a terminal illness and have six or fewer months to live. Many seniors choose to relocate to a hospice facility, but some choose to receive this care at home.

Hospice involves medical care and different types of therapy to make the patient more comfortable and to provide emotional support to them and their families in such a challenging time.

If you want to learn more about in-home care options, check out our blog on the different types of home care.

Types of Out-of-Home Care Alternatives

Home health care works well for seniors who can perform some activities on their own and who don’t need long-term or round-the-clock medical care.

However, if living at home alone becomes a threat to their well-being, if they feel too lonely, or if aging in place becomes too overwhelming for family members who might be handling some of the caregiving, it might be time to explore other options.

The reality is that home care services might not be enough for the remainder of your loved one’s life. A senior’s health might deteriorate to the point that they need more professional and continuous, long-term care.

At that point, it’s time to consider home care alternatives that provide the patient with the professional attention and community that they need to improve or manage their condition.

Here are some of the most common programs for out-of-home care.

Senior Living

seniors in senior living home

Senior living provides older patients with a place they can live in, surrounded by people with whom they can spend their final years. Residents live in a retirement community or a senior housing community together with other older adults, but there’s no formal care.

Residents are responsible for their medications and health care but find comfort in living with others, especially if they don’t want to live alone.

In senior living communities, seniors have a high level of independence and can leave any time they want. They also have a lot of companionship but do not get the necessary care they would get with home health services or other out-of-home alternatives.

Assisted Living

Assisted living facilities are similar to senior living facilities, but they also provide non-medical care alongside the community environment.

These facilities help seniors with personal care needs, such as bathing, grooming, mobility, and the companionship that comes with living in senior communities. Most assisted living facilities do not have medical professionals, so seniors are responsible for their own medical care.

Respite Care

Similar to home respite care, seniors also have the option of getting respite care and assistance in designated facilities. These facilities and programs provide seniors with medical and non-medical temporary care.

Seniors have a high level of independence since they can leave at any time they want. They also receive some companionship and high-quality medical care.

Nursing Home

Seniors with serious health issues need round-the-clock assistance provided by nursing home care. Patients living in a nursing home receive medical care and personal care as they attempt to rehabilitate and improve their conditions. 

Nursing homes are entirely voluntary, but patients may be bound to the facility.

They have companionship with other residents, so they are not alone. The nursing home level of care is of the highest quality, so families usually opt for this home care alternative when their loved one requires medical assistance.


Patients who have a terminal illness and have six months or less to live may need to consider nursing home alternatives.

While hospice and nursing homes may provide the same or similar care, hospice is designed to support patients with a limited lifespan, ensure pain management, and offer emotional comfort.

Adult Foster Care or Day Care

Adult foster care or daycare provides seniors with long-term daily living and care or temporary care. 

Adult foster care services are long-term care facilities designed to care for, protect, and supervise adults or seniors who have developmental disabilities, are mentally ill, or have physical challenges.

These facilities provide medical and non-medical assistance and are similar to nursing homes but aren’t necessarily aimed at only seniors. Residents are prohibited from leaving and must follow medical advice.

Adult daycare programs allow seniors to visit facilities and receive care and companionship every day. These facilities are completely voluntary, and seniors or adults who cannot fully care for themselves but love the comfort of their own homes usually choose to visit these facilities during the day.

Choosing the Right Care for Your Family Members

With so many options for senior care, it can be challenging to choose the one that provides the best care for your loved one. Before selecting a type of care or facility, consider these four factors.

#1: Assess Your Loved One’s Level of Independence

Caring for a senior family member who requires 24/7 supervision can be difficult. When your loved one doesn’t have a lot of independence, whether physical or mental, they need a facility that can provide the necessary round-the-clock care to help them live the best life possible.

When a senior or adult has a low level of independence, it’s natural to be concerned about their health and safety. The best facilities in these cases can be nursing homes, assisted living facilities, or adult foster care.

Seniors and adults who have a higher level of independence may be better suited to respite care, adult daycare, or senior living.

#2: Understand the Need for Companionship

Some seniors or adults love having the companionship of their family and friends. If they spend the entire day at home with no one to talk to, they can feel isolated and alone.

In these cases, seniors might want to live in senior living facilities or frequent adult daycare, so they can have the chance to meet people, make friends, and attend social events that will brighten their mood. 

#3: Ask About Their Preferences

If the senior or adult you are caring for does not have any mental issues and can make their own decisions, their care preferences should be their own. Ask them where they would like to spend the final years of their life. Whether that’s at home, in an assisted living facility, or somewhere else is ultimately their choice.

#4: End-of-Life Care

If an adult or senior has a terminal diagnosis and only a few months to live, hospice care may be your only option. These facilities are designed for people to feel comfortable and live the rest of their lives with as little pain as possible.

Families can visit their loved ones and spend as much time with them as they want while not bearing the heavy responsibility of the care services that are necessary.

It’s important to understand that medical professionals drive end-of-life care options, and you or your loved one cannot decide to enroll in a hospice facility on your own. You’ll need a physician’s certification.

The Costs of Senior Care

woman doing finances

Once you understand home care options and out-of-home alternatives, you should also be aware of the cost implications.

Costs of Home Care

Home care is usually paid by the hour, and your expenses depend on the type of insurance coverage and the agency you choose. You will also have to consider that the home care team might have to travel, so they might add their travel and equipment transportation costs to your bill.

You might also have to pay a deposit or even make pre-payments for a set number of hours of care.

The final cost will also depend on the type of care needed – adults or seniors that require extensive medical care will have higher costs.

Before settling on home care alternatives, you should check how much coverage you get from your insurance provider. Medicare and Medicaid may cover home care staff and equipment costs in some circumstances but will not provide coverage for medication.

Cost of Alternatives

Home care alternative costs can have a similar or higher cost. A senior living facility is estimated to have a cost of $1,000 to $4,000 per month, while assisted living communities can be as high as $4,000 a month as well.

Nursing homes are more expensive given the medical care provided, so they could cost up to $7,000 per month. If you have an older adult who requires memory care, such as for Alzheimer’s or other illnesses, then you will incur an additional cost.

But before you decide that home care is a more affordable option, check with your insurance provider about coverage. Many programs, including Medicaid and Medicare, cover costs related to an assisted living community or nursing home.


When home care services aren’t enough, it’s time to consider alternatives, such as senior living communities and assisted living facilities. The costs can be high, but insurance might cover many of them.

When your senior needs extra assistance or wants to live in a senior community, these alternatives can fulfill your loved one’s needs in a way that aging in place cannot. 

But for older adults who want to continue living at home, home care services might be all that your family needs to ensure the best quality of life. Home care can also relieve some of the responsibility on the shoulders of family caregivers. 

Seniors who choose to remain in the comfort of their home and are considering home care agencies should look at 24 Hour Home Care. Our caregivers are compassionate and trustworthy, and we ensure they have all the relevant certifications.

We provide respite care, companionship, light housekeeping, meal preparation, medication reminders, and other home care services. So get in touch and take the first step toward ensuring your loved ones get the company and care they deserve.

More like this