When a parent needs more support, families quickly run into a confusing vocabulary. Three terms come up most often, and they mean very different things.
Home care (non-medical)
Home care means help with daily life at home: companionship, bathing and dressing, meals, housekeeping, errands, transportation and supervision. It is provided by caregivers, personal care aides or companions, either through an agency or independently. It can be a few hours a week or around the clock.
Usually paid by: the family, long-term care insurance, some Medicaid programs and some VA benefits. Original Medicare generally does not pay for it when it is the only care needed.
Home health care (medical)
Home health care is skilled care ordered by a doctor and delivered at home by licensed professionals: nurses, physical, occupational or speech therapists. Typical examples are wound care after surgery, injections, monitoring a new condition or rehabilitation after a fall.
Usually paid by: Medicare, Medicaid or private insurance when eligibility rules are met, such as being homebound and needing intermittent skilled care. Visits are usually short and time-limited.
Assisted living
Assisted living is a residential option: an apartment or room in a community that provides meals, housekeeping, activities and help with daily activities, with staff available around the clock. Rules and licensing vary by state.
Usually paid by: private funds, sometimes long-term care insurance, and in some states Medicaid waivers for services (not room and board).
Side by side
| Home care | Home health | Assisted living | |
|---|---|---|---|
| Where | At home | At home | In a community |
| Type of help | Daily living, companionship | Skilled medical care | Housing plus daily help |
| Provided by | Caregivers, aides | Nurses, therapists | Community staff |
| Needs a doctor's order | No | Yes | No (assessment on admission) |
| Schedule | Flexible, by the hour or live-in | Short visits | 24/7 setting |
Many families combine them
It is common to have a home health nurse visit twice a week after a hospital stay while a caregiver helps with meals, bathing and company the rest of the time. Later, if needs grow, a family may consider assisted living or more hours at home.
How to decide
- Does your loved one need medical tasks done? Ask the doctor about home health.
- Is the main need daily help and company? Home care is often the most flexible option.
- Is being alone at night unsafe, or is the home no longer workable? Compare round-the-clock home care with assisted living.
On CaregiverCrew you can compare independent caregivers for non-medical home care, see their rates and talk to them before you decide.
Sources: Medicare.gov, "Home health services"; National Institute on Aging, "Residential Facilities, Assisted Living, and Nursing Homes".
This article is general information for families and caregivers. It is not medical, legal or financial advice. For decisions about health, benefits or employment, speak with a qualified professional.
