Assisted living, or live-in care?

When it comes to deciding what type of care is right for you – from home care to assisted living to nursing homes and more – there are varying levels of support available to fit your exact needs without compromising on your independence. You may have read our guide on Live-In Care vs Nursing & Care Homes, but if you’re also considering Assisted Living as an option and want to weigh this up against Live-in care, we are taking a closer look at the two; what assisted living actually is, how it is different from a care home or nursing home, the pros and cons of this option compared to Live-in Care or visiting home care, and how to choose which one is right for you. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global home care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about home care, we can help.

What is Live-in Care?

Live-in Care is when a trained, professional carer lives with you in your home to provide personalised care that meets your specific needs. Often older adults prefer to stay in their own home, so this can be a more popular choice than moving into an assisted living facility, care home or nursing home. By employing Live-in Care, an older person can continue living in the home they know and love while still receiving the care they need to stay safe and well. Live-in Care can provide constant companionship, help with anything you need such as personal care, cooking or housework, and medical care so you never need to worry about travelling to stressful doctor or hospital appointments. You can read more about this in our guides to what Live-in Care is, and how Live-in Care works.Live-in Care offers 24-hour home care where you will receive the same help as someone receiving regular home care visits, but you will have access to your carer at all times of the day or night if that is what has been agreed. If you don’t feel you need 24-hour Live-in Care at this stage, you could instead opt for occasional home care visits to help only at certain times when it is needed.

What is assisted living, and how is it different from a care home or nursing home?

Assisted living may also be called extra-care housing, and it is a type of care that empowers the recipient to remain independent for as long as possible. This usually means moving into a home that is designed for someone with your needs and receiving help with some aspects of daily living such as getting washed and dressed, or weekly grocery shopping. While Live-in Care has a carer visit your existing home, and a care home or nursing home acts as a communal living space for those with more intense care needs, assisted living can be a good intermediary option between at-home care and a care home. They are mostly used by those who have additional care needs as they get older, but are not yet ready for (or not interested in) moving into a communal care or nursing home. There are many different types of assisted living facilities with differing levels of support, but typically this will look like a self-contained flat or house of your own, with a private entrance, surrounded by other houses with residents that need similar levels of care. The house will be set up to be functional for older people, making it easy to move around and live life safely and comfortably. There is usually a warden who will oversee the houses in the community, and occasional visits from carers who will support your daily care needs and be on call 24/7 with emergency care if needed. Many assisted living facilities will have community areas and optional opportunities to socialise, however, you will mostly be able to treat this house or flat as your own private home. Some of these facilities will be available to rent or buy privately, while others will be operated by your local council.

To clarify the difference between all the types of care facilities available:Live-in Care = An experienced carer lives in your current home with you to provide care Assisted living = You will move into a new house or flat designed to make life easier for you (i.e. it may contain grab rails and ramps) and is overseen by carers who live separately Care home = A communal home in which you will live in one room and make use of common areas if desired, and have help with your daily needs from experienced carers Nursing home = Similar to a care home, but with additional medical help provided by registered nurses

What are the advantages and disadvantages of Live-in Care?

Like other types of care, Live-in Care has many pros and cons. Here are the advantages and disadvantages of Live-in Care:

Advantages of Live-in Care

Opportunities to remain an active part of your community by seeing friends, attending local activities, and enjoying the place you call home.
Opportunities to establish a strong bond with carers through shared interests.
One-to-one, personalised, focused care and support at all times.
Couples can stay together in their own home with Live-in Care.
The opportunity to have control over where palliative care takes place. According to research, 71% of people would prefer to stay at home than go to a hospice.
Live-in Care can be a more affordable option, and there is no need to sell your home to finance your stay in an assisted living facility.
Better wellbeing outcomes for older adults, as studies have found patients who receive home care experience higher levels of patient satisfaction.
Familiar surroundings make people feel more comfortable. Studies show this can improve the quality of life of those with dementia, and make them less likely to experience confusion than those in care homes.
A sense of independence from staying in your own home. Research suggests interventions to maintain independent living have the potential to improve health perception and self-efficacy in older adults.
More opportunities for friends and family to visit regularly.
Flexibility to eat, socialise and sleep when you want to, rather than being bound by a daily schedule or carers coming and going.
No need to give up beloved pets, as you can stay in your own home with them.
Easy to arrange a trial period so you or your loved one can try Live-in Care first before you commit to it long-term.

Disadvantages of Live-in Care

Home administration is required when staying at home, so you may need help to pay bills, deal with home repairs and so on.
Discomfort from having a stranger move into the home.
Home alterations may be required to make the home safe as your mobility decreases. Luckily, many of these are easily installed, and studies show home assessments and tailored interventions can reduce recurrent falls of older adults by up to 38%.
A spare room is required for a Live-in carer to have their own space. You can read more of the requirements for Live-in carers here.
Palliative care can be difficult from home if family members are helping to care for an individual, as often round-the-clock care is eventually needed.

What are the advantages and disadvantages of assisted living?

At Home Instead, we believe live-in home care has more benefits than moving to an assisted living facility, however, we acknowledge there may be several advantages to assisted living that you should be aware of when making choices about the care needs of yourself or a loved one. Here are some of their pros and cons:

Advantages of assisted living

A sense of safety knowing that there are carers around if needed and that you will likely be checked on at least once a day.
An active social life and a sense of community, with potential opportunities for social contact through communal areas that can help to avoid feelings of loneliness.
The level of care can be adjusted as needed, as staff are already on-site and ready to help.
Housing is regulated and inspected by the Care Quality Commission (CQC).
Most assisted living facilities are designed to make life easy and safe for older adults, including things like ramps and grab rails, emergency pull cords, and more.
Access to 24-hour emergency help via an alarm system if needed.
Couples can move into assisted care together and avoid being separated.
Families can focus on spending quality time with their loved one instead of spending visits doing housework or chores.
Assisted living is thought to improve residents’ quality of life, as some studies suggest it could provide a stable sense of self, social belonging and a feeling of safety.
Some assisted living facilities have services on-site to make life easier, such as hairdressers, communal spaces, transport and more.
The opportunity to live in a full house or flat rather than just one room, as would be the case in a care home.
Often assisted living facilities will charge one monthly fee that includes all care costs, house rent, meals and more, making the administration easier.

Disadvantages of assisted living

In some assisted living facilities it can be a long wait to receive a place there.
Like in a care home, there may be rules and schedules to adhere to, such as specific times when carers will visit, which may not suit everyone.
Moving out of your own home and into a whole new one can cause stress and upheaval.
A new home will feel unfamiliar in the beginning and could take some adjustment.
Although assisted living facilities have emergency alarms, they lack the 24-hour support of Live-in Care, so they may not be suitable for those with more intense care needs. One study of assisted living facilities in the US found that 48% of subjects living in such facilities were hospitalised within one year.
Changes in staff are unavoidable, so you may not see the same friendly face or receive the same quality of care at all times.
There may be a feeling of having less privacy with assisted living, as carers may be entering your house throughout the day.
There could be less choice available when deciding on an assisted living facility if it is being funded by your local council.
There is usually no opportunity for a trial period, however, a visit to see the new home before moving may be arranged.
Care may not always be as personal as it would be with Live-in Care, as carers will still have several people to check in on each day.
For those with very specific medical needs, assisted living may not be able to provide the necessary care that a nursing home could.
The cost of assisted living can be extremely high in some places, and sometimes not all benefits are included within the monthly rate, such as housekeeping and laundry, meal delivery, and more – always check this with each provider.

Which is best for me?

It can be a confusing and emotional time deciding which type of facility will best cater to your changing needs. If you have narrowed this down to either Live-in Care in your own home or assisted living in a new home, the above advantages and disadvantages of each option could help you decide which is most fitting at this particular stage in your life.

Before making any big decisions, it can be useful to consider how much help is required each day; list out the tasks that would make life easier, how often they come up, and how they are currently being handled (for example, by another carer, family member or neighbour). You may want to ask yourself questions like:

What do I struggle with most, and is this likely to improve or get worse over time?
How would I manage if my carer/family member/neighbour fell ill and could not help me for some time?
What daily tasks do I still feel confident doing myself?

The aim here is to come to a long-term solution that will ensure all of your needs are taken care of without compromising on your independence. Asking yourself some prompt questions such as the above can help you reach a conclusion about when it is time to seek help, how much help you need, and whether or not you could receive that help in your own home.

What types of Live-in Care does Home Instead provide?

There are several different versions of Live-in Care available, and each agency will offer its own specific type of care. That said, most agencies (including Home Instead) will offer the below options:

24-hour Live-in Care: For those with round-the-clock needs, 24-hour Live-in Care means there is always someone (usually at least 2 carers) nearby day or night.
Companionship care: Those who do not yet require 24-hour Live-in Care may feel safer and less lonely with someone in their home at all times, and companionship care offers this.
Convalescent care/Intermediate care: This type of care is specifically for those recovering at home after a challenging surgery, injury or illness. If you are worried about post-hospital care, this type of Live-in Care can ensure you are monitored at all times until you feel better.
Complex Live-in Care: This type of care is designed for those with conditions such as dementia or Parkinson’s who require specially trained and experienced carers.
Respite care: Designed to allow other carers or family members to have a break, live-in respite care means a carer will take over caring tasks on a temporary basis.
Emergency home care: Sometimes people need expert care at the drop of a hat, but with emergency home care you can feel safe and supported with a Live-in carer moving into your home temporarily to take care of you.
Palliative care: For those with a terminal illness, staying at home where they feel comfortable is so important. In these cases, Live-in care can be extremely helpful to ensure they have absolutely everything they need during this challenging time.

At Home Instead, we can provide any of the above services as needed and include a personalised combination of bespoke services to suit your specific condition.

Our Care Professionals are highly trained to deliver the individualised services you need, so no matter what type of home care you require, we can provide a tailored service that suits you or your loved one – get in touch to learn more.

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.

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