Alternatives to Nursing Homes: Options for Senior Care

A senior couple sitting on a couch in their home, talking with a nurse in blue scrubs who is taking notes during a visit.There are many reasons that people seek alternatives to nursing homes for their senior parents or loved ones, including the cost of services or the fact that your loved one might need more specialized, individual care that a nursing home cannot provide. Additionally, it’s important to note that cases of negligence in nursing homes are unfortunately not uncommon.

Finding a safe, comfortable environment with adequate care and clear protections for your aging family members can be challenging. Other options for senior care could include any of the following explored further below.

Home Care

Aging in place typically describes seniors who opt to live in their own home, rather than moving to a new facility. Aging in place is a popular preference among seniors: if given the option to stay home instead of moving to a nursing home, most seniors would stay home. Those who have specialized healthcare needs may opt for home care services, whereby they are visited by a nurse or other caregiver on a regular basis.

In-home care is used for a wide array of services. Some seniors just use home care for transportation to and from medical appointments, while others need help with hygiene, taking meds, and food.

Home care is a great alternative to nursing homes because you can choose the services you need based on what your local home care provider offers. Home care is perfect for seniors who have a higher level of independence. Family members will still have to provide some level of care for their seniors, but full-time monitoring or access to hospital-grade facilities isn’t necessary.

The cost of home care depends on how reliant you are on their services. The average cost for home care in the United States is about $4,290 per month. This cost is for seniors who are getting consistent and regular care; costs for more limited services may be less.

You may be able to get help for home care using either the Medicaid HCBS (which we’ll talk more about below) or Medicare PACE programs.

Assisted Living

People often get confused about the difference between a nursing home and an assisted living facility.

Assisted living facilities will usually take healthier, more independent seniors who need general assistance in their day-to-day lives. Nursing homes, on the other hand, are usually more ideal for people who are critically ill or those who need constant medical attention throughout the day.

Assisted living facilities are great for extroverted seniors who want to live on their own but want a community to be a part of. In most assisted living places, they have the privacy of their own apartment or suite and they can join others for dinner and activities as they please.

These facilities vary greatly in size and so does the number of residents. On average, you can expect an assisted living space to have at least 20 other residents, and sometimes as many as 100+.

The cost for assisted living varies, though the national average is about $4,300 per month.

Medicare Programs

Medicare offers a few different programs for long-term care alternatives to nursing homes.

One program that we mentioned earlier is called Medicare PACE, which is the “Program of All-Inclusive Care for the Elderly.” This program offers a combination of services to families who are thinking about alternatives for nursing homes.

There are also other home-based alternative care options such as hospice, subsidized senior housing, and Medicaid Home and Community Based Services.

The cost varies based on the particular program you choose. These are all great options for seniors who wish to remain at home but need daily help.

You can find a full list of Medicare programs for long-term care options on their website.

Adult Foster Care

Adult foster care programs are similar to boarding homes and offer a family environment with specialized care options. These homes typically have about 1-5 other residents.

This option works for caregivers that don’t have much extra time to dedicate to caring for an ailing loved one. There is no level of care needed from you when your senior is in adult foster care.

If your loved one prefers a quieter environment with a homey feel, adult foster care may be good for them. They’ll enjoy the family-oriented space, sharing meals with the other residents, and doing activities together.

Most of the time, adult foster care costs less than a nursing home or home care. On average, families pay about $2,000-$4,000 a month. Medicaid may be able to help with your costs.

Adult Daycare

Adult daycare is a great option for caregivers who are in need of a break. But it’s also a great option for your senior. In this stimulating social environment, your senior will enjoy a day of planned activities in a group setting. Health services are also provided at adult daycare facilities.

With this option, caregivers can set up a predetermined schedule for when your senior will attend the facility — or you can simply use the option when you need it. You will still need to provide a certain level of care while your senior is home with you.

The average daily cost for adult daycare in the U.S. is $72 per day. It ranges from $35 in some states to over $100 in other states.

Reasons for Finding Alternatives to Nursing Homes

With adequate research and footwork to find the best nursing home, you may be able to avoid or mitigate some of these risks, though depending on your situation a nursing home may ultimately be the appropriate option.

Neglect or Abuse

There is always some risk of abuse and neglect at nursing homes, or nursing homes purposely withholding healthcare from their seniors.

At a nursing home, your senior is just one of many patients being cared for. Often the staff at nursing homes are overwhelmed and unable to provide the level of care they are required to. This can lead to bed sore injuries, dehydration, and even sexual assault and harassment.

If you suspect your loved one has been abused or neglected at their nursing home facility, it’s important to take legal action against them.


Nursing homes can be expensive. On average in the United States, nursing homes cost over $8,000 a month for a private room. Most families cannot afford that on top of their own mortgage or rent, food, transportation, and other monthly bills and expenses.

The reason that nursing homes are so expensive is that they offer a private room (or small suite/apartment) plus 24/7 healthcare services. Usually, a food plan is included in that cost as well. Nursing homes offer group activities that residents don’t have to pay for – this is also something included in the cost.

While 24/7 care is something you should expect from a care provider, there are less expensive alternatives to nursing homes that also provide this level of care.

Level of Care

There are lots of different levels of care for seniors and you may need care that a nursing home can’t provide. For example, if your senior has Alzheimer’s or dementia, they need specialized care that a nursing home may not be able to give them.

Caring for an Alzheimer’s patient requires 24-hour care and attention. In a nursing home, the staff may be overwhelmed with other patients that they can’t always provide that level of care.