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In-home Care Versus Care in a Nursing Home

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This is it. Your loved one needs continuing care and you have to figure out how to manage it. You have several options to choose from –read about them in my previous post. In this post I will compare care in a nursing home (long term stay) and care by private pay home care companies for seniors who can’t live on their own, need constant supervision and assistance with activities of daily living or ADL’s.

There are three main things you should consider before making the decision between nursing home and home care: quality of life, nurse availability, and cost. Let’s discuss each of them

1. Quality of life

What does it mean? For most of people quality of life means staying at home, enjoying their own arrangements and being independent in their scheduling and life-long habits.

In this situation, home care may be the best choice. Your loved one can continue to live somewhat independently at home and receive personal attention by a caregiver who will provide assistance with personal care, appointment escorts, and duties such as cleaning, laundry  & cooking.

Also, you can choose a caregiver with whom you feel most comfortable.  A caregiver who demonstrates understanding, good communication and has a great rapport, sometimes helps more than medication.

Another advantage is a personal approach. Home care is flexible in respecting the client’s preferences, including daily schedule, meals preparation and any small things that may be big things for your loved one.

2. Availability of a nurse on site

The biggest advantage of nursing homes is the availability of supervision by a Registered Nurse on site 24/7.  Most private pay home care companies don’t provide that service.  So if your parent has medical condition that requires constant nurse’s assistance, care in a nursing home is likely the best option.

Before making the choice, take a closer look at your loved one’s needs. Your parent might need nursing care for certain tasks like changing catheters, dressing wounds and regular medical evaluations. In that situation you could hire a visiting nurse for couple of hours several times a week. There is an option as well to hire licensed practical nurse (LPN) for 24/7 but it will cost you a fortune.  Here it’s time to discuss the next important thing - Cost.

3. Cost

What is more cost effective, nursing home or elderly in-home care? Let’s take a look at Massachusetts rates for care in nursing home (long-term stay), home care (hourly rates), home care live-in option, and rates for a registered nurse.

Usually home care companies charge per hour, but some may also offer live –in services. Live-in home care is a special service with flat daily rate where the caregiver stays with a patient around-the-clock, with 8-hours per night of sleep.

I used The 2012 MetLife Market Survey of Long-Term Care Costs and my own market research to get the numbers.

Care Type

Nursing homes (private room)

Home Care   (Live-in option) 

Home Care round the clock (hourly rates) 

Home Care round the clock by Registered Nurse

24 hours' rate  $255-$500  $250-$350  $528 - $720 ($22-$30 per hour)  $1,900- $3,300 ($80-$140 per hour)
Monthly rate  $8,000-$15,000  $7,500-$10,500

 $16,000 - $21,500



If your parent can stay without supervision during the night, and doesn’t need the additional nurse’s help, home care services obviously will be a better option in terms of cost. 

In each case you should do the math to figure out what would be the best option for you. The Ezra Home Care team would be happy to discuss these options with you if you have any questions about long term care. Call us 617-527-9000.


Founded in 2008, Ezra Home Care offers live-in home care, 24-hour care, and hourly senior care.
All our caregivers are state-certified and provide services like personal carehousekeepingcompanionship, help with medication, and transportation assistance. We've spent 15 years refining our caregiver selection process to ensure families' peace of mind. Reach out for details and quotes.

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or call us at 617-527-9000

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