Breaking down 5 Major Differences in types of Caregiving YOU need to know!

Maybe you are aging, or maybe you are watching a loved one age, maybe you are closer to nursing babies than nursing homes…but you are needing to think about options of supporting someone you love! Making decisions about caring for the needs of the aging can be overwhelming. Families face a range of options, from nursing homes and assisted living facilities to memory care units, group homes, and in-home caregivers. Each of these care settings offers distinct services designed to meet different needs, so it’s important to understand the differences between them to make an informed decision.

So! Today lets talk about what are the differences between the following types of care:

Nursing homes
Assisted Living Facilities
Memory Care Facilities
Group Homes
In Home Caregiving

For each category, I will give you an Overview, talk about Key Features such as Medical Care, Regulations, Rehabilitation, Social Activities, the Financial Need to know, Limitations,Who its best suited for, and finally, What I as a Social Worker want to make sure you know!

Let’s get started!

Overview: Nursing homes (also known as Skilled Nursing Facilities [SNF] OR Long Term Care [LTC]) provide the most comprehensive level of care outside of a hospital setting. These facilities are designed for individuals who have significant medical needs (read that as needing either an LPN or RN 24 hours a day), such as chronic illnesses, advanced disabilities, or conditions that require constant monitoring and assistance.

Key Features:

Medical Care: Nursing homes offer 24/7 care from registered nurses (RNs), Licensed Practical Nurses (LPNs). In addiction, they receive care from Qualified Medical Assistants (QMAs) and certified nursing assistants (CNAs). They are equipped to handle complex medical conditions, administer treatments and medications, and provide rehabilitation services.
Regulations: Nursing homes are highly regulated by both state and federal authorities if efforts to ensure quality care and safety for residents.
Rehabilitation Services: Nursing homes provide physical, occupational, and speech therapy, which can help residents regain independence or improve quality of life. Often these rehab services can be paid for by Medicare/Medicaid/Insurance IF you are continuing to return to a prior level of functioning. Once you plateau, they will discharge you either from therapy services or from your stay at the nursing home depending on your needs and payment source. Some nursing homes have a program to help pt’s exercise or have activities for them to move around and have extra movement too.
Social Activities: While medical care is the primary focus, nursing homes also offer social programs and activities to keep residents engaged. Because they are institutions, there is often a large amount of people to interact with. A Plus! Different facilities offer different support in this as success of activities can depend on range of things such as budget for this department, staffing, creativity of the staff, and even interest of other residents in participating.
Financial Need to Know: Medicare is only willing to pay for your stay in a nursing home IF you are accepted into the Rehab program. So up to a 100 days IF you continue to meet criteria to return to a prior level of functioning. Medicaid is a program for you have to apply for in your state, and each state has very specific criteria you have to qualify for. You should know that across the USA nursing homes range in cost from $8,000 a month to $16,000 a month.
Limitations:Staff to patient ratios are huge. There never seems to be enough staff to meet the needs of patients…you end up needing a significant amount of, well… PATIENCE.

Best Suited For: Individuals who need full-time MEDICAL care and monitoring due to severe illness, disability, or advanced aging conditions.

What the Social Worker in me wants you to know: While there are advantages of living in a nursing home like a community of people to interact with, specific medical care, they are institutions, and care gets missed. There are alot of regulations from the government to try to ensure things don’t get missed. But the reality is that things get missed. Even in the “good” homes. You will need to advocate and continue to communicate the needs of yourself or your family member.

A great place to compare nursing homes in your area of the United States is https://www.medicare.gov/care-compare/

2. Assisted Living

Overview: Assisted living facilities are for individuals who need some help with daily activities but do not require intensive medical care. Residents may need assistance with bathing, dressing, medication management, or mobility but are otherwise relatively independent. Most Assisted Living settings by definition from state governing agencies, have criteria for residents that include being able to do 3 of the 5 activities of daily living as named above.

Key Features:

Personal Assistance: Assisted living provides help with activities of daily living (ADLs), such as bathing, dressing, grooming, transferring, and medication reminders. Most Commonly residents are required to do a minimum of 3 out of the 5 activities of daily living just listed.
Social Activities and Amenities: These facilities often offer a wide range of social, recreational, and educational activities, as well as amenities like communal dining rooms, exercise facilities, and even housekeeping services.
Level of care: The level of medical care provided in assisted living is usually limited, and there may be visiting healthcare professionals (such as nurses or doctors), but residents generally don’t require full-time medical supervision.
Private or Shared Living Spaces: Depending on the facility, residents may live in private apartments or shared rooms with access to communal spaces.
Financial Need to Know at an Assisted Living: You need to know at most ALs start with a base price and then have an a’ la cart menu that you pay for. Most of the time you pay for them up front like if you need meds given, how many meals per day you want to have them make, or if you need help with showers 2x a week. If you need emergency help off the toilet, or have a fall, those are going to be additional cost to your monthly bill. Also in AL you bring all of your supplies. They do not provide incontinence products, laundry services or any extras for free. If they do provide that, there is a cost. Know what you are going to be paying for up front! And it is definitely ok to ask for an estimate of your bill before you commit. Know what areas might be extra when you have emergencies.
Staff to Patient Ratio: Depends on the time of day, but often 1 to 40 during daytime, and during night time whole facilities of 200 residents may have 2 staff persons on…
Limitations: It seems like its clear…but I will say it again. ASSISTED Living. So keep in mind the activities of daily living and that they expect that you can do most of living on your own. Having things like meals, meds, and a call light is their willingness to help.

Best Suited For: Seniors who need SOME help with daily tasks but can still live independently for the most part.

What the Social Worker in me wants you to know: People expect AL to provide more than they do. It is important to keep in mind that they are ASSISTED. There is not usually a nurse on duty 24 hours a day, there are assistive persons, most of Certified Medical Assistants (CNAs 8 weeks of schooling and very helpful for activities of daily living) or Qualified Medical Assistants (QMAs who can give out medications and are CNAs usually).

3. Memory Care

Overview: Memory care units are specialized sections of either assisted living or nursing homes designed to cater to individuals with Alzheimer’s disease, dementia, or other forms of memory impairment. These facilities offer a structured environment with heightened security and specialized care to meet the unique needs of individuals with cognitive decline.

Key Features:

Security and safety: Memory care units are typically secured to prevent residents from wandering or getting lost, a common concern for individuals with dementia. These facilities may have locked doors and specialized alarms to ensure residents are safe.
Specialized care: Staff members are trained to work with individuals with memory issues, offering a higher level of supervision and personalized care.
Daily routines: Memory care focuses on creating structured routines to provide comfort and minimize confusion. Therapeutic activities, such as art therapy, music therapy, and reminiscence therapy, may also be incorporated to engage residents and stimulate cognitive function.
Comfortable environments: Memory care units are often designed with sensory-friendly environments and simplified layouts to reduce confusion and stress.
Financial Need to Know at Memory Care: They usually have a higher base rate than AL and of course there are more services that are “given” in the cost, such as medications being managed, all meals included, help with ambulation, transfers, etc. They also have a range, typically, depending on how independent a person can be, versus how much caregiving they need.
Limitations: If a partner wants to reside WITH a dementia patient it is not always a great option for the well being of the alert and oriented partner. Also, know the difference between Assisted Living Dementia Unit and Nursing Home Dementia Unit and then apply it to what your loved one needs.

Best suited for: Individuals with Alzheimer’s disease, dementia, or other cognitive impairments who need a higher level of care and a secure, structured environment.

What the Social Worker in me wants you to know: Most memory care facilities are Assisted Livings. VERY FEW operate as actual nursing homes, and then are usually attached to a nursing home with a specific “wing” being memory care. It’s important to know the difference as you don’t always necessarily need medical care around the clock, however they are often perceived as such. Memory Care costs are higher.

You can also have supportive agencies come into serve you, such as home health agencies that would provide rehab services in your apartment, such as Physical Therapy, Occupational Therapy, Speech Therapy, Etc, but would have to qualify for these under Medicare if you are having them pay for it.

4. Group Homes

Overview: Group homes are small, residential settings where individuals with disabilities, chronic conditions, or aging adults can live in a more intimate, home-like environment. Group homes typically house a small number of residents (usually up to 5 residents, depending on licensure but can be up to 10 residents) and provide personal care services and social support.

Key Features:

Personalized care: Group homes offer a more individualized approach to care than larger facilities. The staff-to-resident ratio tends to be higher, allowing for more personalized attention and care.
Homelike environment: Group homes aim to replicate a family-style living situation, with a cozy, non-institutional atmosphere. Residents often have their own rooms and share common areas like kitchens and living rooms.
Services: Depending on the home, services may include help with ADLs, medication management, and social activities. Group homes service a variety of individuals. Some group homes also offer more specialized care, such as for individuals with developmental disabilities, mental health or dementia.
Regulation: Group homes can be regulated by the state if they meet certain criteria requiring them to. Some group homes are not regulated and are small, family style environments that the resident is considered to be renting a room. If they are regulated, they are typically less regulated than larger facilities like nursing homes or assisted living.
The Financial Need to Know: Group Homes have a range of costs. In 2025, group homes typically have about a $2-3000 range (at the time of writing this the range for Northern Indiana is about $6000 to $8000). Cost is dependant on what type of care is needed.
Limitations:Group homes of 5 and under are not typically regulated by any oversight agency such as the State. So family involvement and presence to any areas of concern are a MUST. Ongoing communication with Group home Owner or Manager is also a MUST!

Best suited for: People who want a more home-like environment with a smaller group of people, or those who need specialized care but don’t require the extensive services of a nursing home.

What the Social Worker in me wants you to know: Not all group homes are created or run equally!!! Group homes of 5 and under are not regulated or monitored by any government entity, so there are a bunch of questions you should be asking. Ask for family referrals from the home, and talk with the family about what they like and what their concerns are. Always go and take a tour, talk with staff and even other family members of residents. . See my future blog post specifically focussing on Group homes!

Also ask to know if extra things like incontinence products, or tissues are included. Be prepared to know what is going to the patient or family need to supply.

5. In-Home Caregivers

Overview: In-home care allows individuals to receive care in the comfort of their own home. Caregivers can help with a wide range of services, from personal care to light housekeeping to companionship, depending on the individual’s needs.

Key Features:

Flexible care: In-home care can be tailored to the individual’s needs and can range from a few hours a week to 24/7 care, depending on the level of assistance required.
Types of services: Services include help with bathing, dressing, meal preparation, medication reminders, and light housekeeping. For individuals who need medical care, home health aides or registered nurses can also provide skilled services.
Familiar environment: Many people prefer to age in place or their own residents, and in-home care allows individuals to stay in their own homes, surrounded by familiar surroundings, which can be comforting and reduce stress.
Cost: In-home care can be significantly more expensive than other options, especially for 24-hour care, but it offers a high level of flexibility and independence.
Financial Need to know about In-Home Care: There is a lot to know about in home caregiving and how its paid for. For private pay persons, it is the most expensive option for 24 hour care. Each state varies on how and if Medicaid participants can receive in home caregiving support and if so, how much they can receive. Medicare does not pay for in home caregivers, UNLESS your medicare advantage plan or supplement has that written in. Those unique plans offer options like 130 hours total for the year of in home caregiving, which can be helpful! Check out my blog post on paying for in home care and all you need to know…
Limitations: Be aware of elderly being vulnerable and so having a trusted caregiver is so important. Keep in touch with caregivers and regularly monitor goings on.

Best suited for: Individuals who want to stay in their home but need help with daily activities or supervision. It’s ideal for those with mild to moderate care needs who prefer a more private, individualized care experience.

What the Social Worker in me wants you to know: Please, never post an ad on FB or Craigslist or the newspaper asking for in home caregivers. There is a big advantage to having an agency providing staff. The staff are trained, and have background checks completed and if there is an issue with theft, abuse or misappropriation of money or things, having an agency involved adds another level of accountability and another party to concerns as the agency should have a policy for dealing with any allegations. There are also risks included if a worker is injured in your home, so ask questions about insurance coverage.

Conclusion

When choosing a care option for a loved one, it’s essential to consider their health, preferences, and financial situation. Nursing homes offer intensive medical care, while assisted living and group homes provide more independent living with varying levels of support. Memory care is tailored specifically for those with cognitive impairments, and in-home caregivers offer flexibility and comfort for those who want to remain at home. By understanding the differences between these options, families can make a decision that best meets their loved one’s needs and ensures a high quality of life.