If you assumed home health and home care are the same thing, you are not alone. The terms sound similar, and many people use them interchangeably. Assisted living is different from both, because your loved one moves into an assisted living community rather than remaining in their own home. This guide explores the differences between the three types of care and when each one might be appropriate.
If assisted living turns out to be the best choice for you or your loved one, the Arbors and The Ivy are vibrant assisted living communities in Massachusetts and Connecticut. Learn more about our senior living options and find the location nearest you.
What is home health?
Home health is medical care delivered where a person lives. Also known as skilled care, home health services are ordered by a physician and provided by licensed clinicians. Examples include:
- Skilled nursing services such as wound care, catheter and colostomy care, diabetes education
- Therapy toward rehabilitation, including physical, occupational, and speech therapy
- Medical tests and vitals monitoring
- Social work services, such as care coordination and help finding community resources
A home health aide (HHA) supports clinical plans under nurse or therapist supervision. You may also see the terms nursing assistant, certified nursing assistant (CNA), or geriatric aide.
What is home care?
Home care is nonmedical support delivered at home. It helps older adults remain safe and independent in a familiar and comfortable environment. Also known as private services, in-home care focuses on daily tasks and routines, not skilled medical care. Typical services include:
- Companion care and community engagement
- Personal care, including bathing, dressing, grooming, and toileting
- Meal preparation, grocery shopping, and hydration prompts
- Light cleaning, laundry, and household organizing
- Transportation services to appointments and errands
- Memory support, cueing, and safety oversight for only a few hours or for longer blocks
Home care is also referred to as personal care, attendant care, non-medical care, and companion care.
What is assisted living?
Assisted living is a type of housing with supportive services for older adults who need help with activities of daily living, such as bathing, dressing, eating, and mobility. Assisted living facilities typically offer private apartments or suites in a community setting that encourages social connection.
Common services assisted living facilities offer include:
- Help with activities of daily living
- Medication management and health monitoring
- Meals and basic amenities, including dining, housekeeping, and laundry
- Scheduled transportation
- 24-hour on-site staff and emergency response
- Events, fitness programs, and classes that support mental stimulation
Assisted living communities emphasize maintenance-free living and personalized assistance so seniors maintain their independence as much as possible.
What is included in different types of care
| Services Typically Offered | Home Health | Home Care | Assisted Living |
| Skilled care | Yes | No | Yes |
| Therapy toward rehabilitation | Yes | No | Yes |
| Administers medications | Yes | No | Yes |
| Changes or adjusts medications as needed | Yes | No | Yes |
| Gives medication reminders | Yes | Yes | Yes |
| Performs medical tests | Yes | No | Yes |
| Performs wound care | Yes | No | Yes |
| Formally monitors health status | Yes | No | Yes |
| Helps with activities of daily living | Yes | Yes | Yes |
| Offers overnight supervision | No | Yes | Yes |
| Prepares and/or delivers meals | No | Yes | Yes |
| Performs light housekeeping | No | Yes | Yes |
| Helps with personal grooming and hygiene | No | Yes | Yes |
| Helps with transferring | No | Yes | Yes |
| Helps with toileting or incontinence | No | Yes | Yes |
| Provides transportation | No | Yes | Yes |
| Provides companionship | No | Yes | Yes |
| Provides respite care | No | Yes | Yes |
Home health care vs. assisted living
Both options support older adults, yet they serve different needs, timelines, and settings. The right fit often depends on medical care requirements, safety, social goals, and the number of hours of care needed each day.
When to use home health
Home health is often prescribed after a hospitalization, surgery, or a change in medical status. For example, following a hip replacement, a nurse may visit to check the incision and a therapist may guide exercises at home. Because home health is skilled medical care, it may be covered by Medicare or other medical insurance when criteria are met.
Home health can also help when medications change, a wound needs care, or a physician wants vitals tracked closely at home. A home health aide can reinforce safety skills under a clinician’s plan.
When to use home care
In-home care helps with daily living, not clinical treatment. It is useful when a loved one is mostly independent but needs assistance with meal preparation, personal hygiene, dressing, bathing, or transportation. It is also helpful when a family member lives far away or needs respite from caregiving.
Because home care is considered nonclinical, it is usually paid privately or through long-term-care insurance. Coverage can vary by policy.
When to use assisted living
Assisted living is often the best choice when someone cannot live safely in their own home even with support. It offers a secure environment, daily living assistance, medication management, and a community environment without the intensity of skilled nursing care.
If your parent needs supervision throughout the day, has fallen repeatedly, forgets medications, appears isolated, or struggles with housekeeping, an assisted living setting can balance safety with independence. Many Massachusetts families find that the median monthly cost of assisted living aligns with their needs when the person would otherwise require many hours of home care each day.
Signs to choose assisted living vs. home care
Caregivers often notice patterns that signal it is time to consider assisted living and home options together or to transition fully to assisted living:
- Recurrent falls or near misses at home
- Difficulty with bathing, dressing, and grooming
- Missed medications or duplicate doses
- Food spoiling in the refrigerator or weight loss
- Unpaid bills, clutter, or unsafe home conditions
- Withdrawing from friends and activities, or loneliness
- Increasing caregiver strain for a family member
If several signs are present, consider exploring assisted living options.
When to combine services
Many families blend supports. A home care aide might help your mom remember to take daily medications while a home health nurse might adjust or change her medications as needed. A home health physical therapist can work with your dad’s doctor to adjust his physical therapy if it’s not working, while a home care aide might encourage your dad to do their physical therapy exercises, watch for problems, and let the PT know how the daily exercises are going. Often, seniors and their families find a team approach of using home care services to supplement home health services provides the best solution.
Where services are provided
Home health and home care most often take place in a person’s residence. Care can also be delivered in an assisted living community, a short-term rental, or while traveling. Assisted living is provided in a licensed community that offers apartments or a unit in an assisted living setting with shared spaces for dining and activities.
Cost of assisted living vs. in-home care in Massachusetts
Families frequently ask, is assisted living cheaper than home care? The answer depends on how many hours of care are required and whether the person needs clinical or custodial help.
In Massachusetts, the 2024 annual median cost for assisted living communities was $108,696, which is about $9,058 per month. The annual median cost of home health was $86,944.
However, home health and home care are typically billed hourly, so total cost can range substantially. Local rates vary across Massachusetts, and the total depends on the number of hours, weekend or overnight needs, and specialized skills. If someone needs only 6 to 8 hours of care per week, in-home care is often the most economical option. If someone needs 12 to 24 hours of care daily, the monthly total can approach or exceed the median monthly cost of assisted living, sometimes reaching $5,000 to $9,000 per month or more depending on location and needs.
Relationship cost of ongoing family caregiving
Caregiving takes time and energy. Family caregivers spend an average of 23.7 hours per week providing care, and about 21% provide 41 or more hours weekly. That time often includes housekeeping, meal preparation, grocery shopping, laundry, medication reminders, and coordinating appointments. While caregiving can be deeply rewarding, it can also be stressful, overwhelming, and a strain on family relationships.
Assisted living costs
Generally assisted living costs cover room, meals, and basic amenities, plus services like activities, housekeeping, laundry, and medication management. A unit in an assisted living community is typically private, with shared dining and programming spaces that support community engagement and mental stimulation.
Some factors that influence your total assisted living costs include location, apartment size, level of assistance needed, staff-to-resident ratio, and add-ons such as salon services, physical therapy, or scheduled transportation.
Key aspects of assisted living vs. home care
When comparing assisted living vs home care, consider these points:
- Safety: Assisted living facilities provide a safe and secure environment with staff on site; in-home care maintains a familiar environment with supports brought into the home.
- Social life: Assisted living facilities typically offer events, fitness programs, and classes; in-home care can include community outings with a companion.
- Clinical needs: Home health can deliver skilled medical care such as therapy and wound care for a limited time; assisted living can coordinate with medical facilities if higher levels of care are needed.
- Budget: In-home care scales with the number of hours. Assisted living has a base fee, and assisted living costs may rise with care levels.
- Independence: Assisted living and home care both aim to help seniors maintain their independence through personalized assistance and reliable routines.
Learn more about the pros and cons of in-home care vs assisted living.
Expert assisted living care in MA and CT
Families choose The Arbors and The Ivy assisted living communities because we provide maintenance-free living, personalized care, and a vibrant community environment. Find a location near you in Connecticut or Massachusetts and schedule a tour to meet us and learn why our residents love it here.
Frequently asked questions
Is assisted living cheaper than home care?
It depends on the number of hours. For a few hours per week, in-home care is less expensive than assisted living. If someone needs many hours daily, full-time in-home care can be more expensive than assisted living.
Do people live longer at home or in assisted living?
Research does not give a single answer because outcomes depend on health conditions, safety, social supports, and timely medical care. The best setting is one that meets medical care needs, supports daily living, and reduces risks like falls or medication errors.
What is the difference between a care home and assisted living?
Terminology varies by state. Some states use terms like residential care facility, adult care home, and assisted living interchangeably. Regulations, staffing, and services differ by state.
Is a home care aide the same as a home health aide?
No. A home care aide provides nonmedical personal care and companionship. A home health aide works within a clinical plan and supports skilled nursing or therapy services.