En español | While most older adults hope or plan to age in place in their own homes or communities, changes in their health and physical abilities often bring housing alternatives into play.
As the population ages, more and more families face this issue. On average, a U.S. adult who reaches age 65 can expect to live for nearly 20 more years, according to a February 2022 report from the National Center for Health Statistics (NCHS). The federal government estimates that 7 in 10 of them will need some form of long-term care in their lifetime, and 1 in 5 will need it for more than five years.
Several types of residential communities for older people offer a range of personal and health care services. And care options are available for loved ones who can no longer live fully independent lives but do not yet need or wish to move into a specialized facility.
Long-term care can be a continuum with needs evolving as loved ones age. This list provides a brief description of common types of long-term care, with links to AARP guides and other resources so that you can learn more about each type.
With in-home care, paid caregivers come into the home to assist with activities of daily living, including grocery shopping, grooming, light housekeeping and meal preparation. Some also provide help with personal care, such as bathing and toileting.
Caregivers who provide these services usually are referred to as personal care assistants or home health aides (HHAs). They do not perform medical duties, although HHAs can do basic health care tasks such checking clients’ vital signs and monitoring their mental and physical condition.
Personal care and home health aides can be hired full time or on part-time, flexible schedules, depending on the care recipient's needs and on whether you hire them directly or through an agency. The median wage nationwide for their services is about $13 an hour, according to the U.S. Bureau of Labor Statistics.
In-home care resources
- AARP Caregiver Resource Center, in-home care guide
- AARP Caregiver Resource Center, hiring a caregiver
- AARP Caregiver Resource Center, paying a caregiver
Home health agencies
Home health agencies provide medical care in the home for people who need help with more than activities of daily living. Along with personal care, agency staff might provide skilled nursing; rehabilitative services such as occupational, physical or speech therapy; and routine medical treatment such as administering intravenous drugs, caring for wounds and managing pain.
Home health care is an option when your loved one is not ill enough to be in a hospital — or was in the hospital but has been discharged — but is not well enough to be home alone. It might be prescribed for patients recovering from an injury, serious illness or stroke, or to help compensate for declines in cognitive or physical function.
States license home health agencies, and they must also adhere to federal regulations.
Home health resources
- AARP Caregiver Checklist, home health agency
- Eldercare Locator, home health care
- Medicare Home Health Compare
Continuing care communities
Continuing care retirement communities, also known as CCRCs or life plan communities, offer a variety of housing options that support various stages of life, typically on a campus-like setting or in an urban high-rise building. About 1,900 of them are in operation across the United States, according to the National Investment Center for Seniors Housing & Care (NIC).
These communities enable residents to age in a single complex without having to change locations. Residents might start in an independent living section that caters to retirees who are still active and largely self-reliant, and then move to an affiliated assisted living community or skilled nursing wing as their needs change.
Continuing care communities are generally the most expensive option for long-term care. Most carry entry fees that can reach several hundred thousand dollars, and monthly charges average around $3,500, according to 2021 data from the NIC, which tracks CCRC costs in major U.S. markets.
Continuing care community resources
- AARP Caregiver Resource Center, continuing care communities
- myLifeSite, an online storehouse of data about CCRCs (charges a fee for premium access to data)
Assisted living facilities provide care and supervision for older adults who can no longer live on their own but do not need the level of personal or medical care found at a nursing home. The United States has about 29,000 assisted living facilities with nearly 1 million beds, according to NCHS.
Assisted living typically offers services such as exercise and wellness programs, housekeeping, laundry, meals, planned outings, social activities and transportation. Most communities offer some health care services — for example, mental health services and counseling; occupational, physical and speech therapy; and a pharmacy.
The median monthly cost for a private room is $4,500, according to a 2021 survey from insurance company Genworth, which reports annually on long-term care costs. The average stay in assisted living is 28 months, with about 60 percent of residents eventually moving into a nursing home.
Medicare does not cover assisted living, but in some states Medicaid can provide financial help for low-income residents.
Assisted living resources
- AARP Caregiver Resource Center, assisted living
- AARP Caregiving Checklist, assisted living
- National Center for Assisted Living
Memory care units are specialized residential facilities designed to serve the needs of aging adults with Alzheimer's disease, dementia and other cognitive issues. Staff members are trained to help with daily living activities and to help residents manage dementia symptoms such as combativeness, sundown syndrome and wandering.
Memory care might be provided at stand-alone facilities or in dedicated wings, sometimes called special care units, at assisted living facilities and nursing homes. They generally have a higher staff-to-resident ratio than assisted living and place a greater emphasis on security, using things such as alarmed doors, elevator codes and tracking devices to prevent wandering.
The average cost for memory care is $6,935 a month, according to 2021 NIC statistics.
Memory care resources
Nursing homes, also called skilled nursing facilities, serve people with disabilities, illnesses or mental conditions that require full-time medical care and monitoring. More than 15,500 Medicare-and Medicaid-certified nursing homes nationwide serve 1.4 million residents, according to the U.S. Department of Health and Human Services.
Skilled nursing care includes help with all meals, daily living activities such as bathing and dressing, round-the-clock supervision and a greater degree of medical attention than in assisted living. The median monthly cost for living in a nursing home is $7,908 for a semiprivate room and $9,034 for a private room, Genworth reports.
Medicaid is the primary payer for nursing home care, covering at least some costs for 62 percent of residents nationwide. While Medicare certifies nursing homes, it does not cover long-term residency. However, in some circumstances Medicare will pay for short-term stays at a skilled-nursing facility for rehabilitative purposes — after a stroke or serious injury, for example.
Editor's note: This article, originally published Jan. 13, 2020, has been updated with more recent data on long-term care options.
Nursing home resources
Learn More About Long-Term Care
These organizations and online tools can help you get more information on the different types of long-term care as well as help you research assisted living, skilled nursing and other options in your area.
Community Resource Finder. A joint project of AARP and the Alzheimer's Association that lets you search for home care, housing and other programs and services for older adults.
Eldercare Locator. You can use the U.S. Administration on Aging's resource website to contact your local Area Agency on Aging and get consumer information on housing, long-term support and other services.
Leading Age. An association representing nonprofit nursing homes, assisted living facilities and other eldercare service providers, Leading Age has a searchable directory of its members and online consumer resources on planning and paying for long-term care.