If you’re in the market for long term care for an elderly or disabled adult who needs medical monitoring and assistance with personal care, hygiene, and other daily living activities, the odds are that you’re considering both nursing home care and at-home care. These two options are the most poplar solutions when a loved one’s medical needs have progressed beyond what the patient can do for themselves or what the patient’s family can provide. Choosing the best option can be a challenge. Both offer benefits and drawbacks, and in the end, it’s a question of which one better serves more of the patient’s needs. Understanding the positives and negatives of each long term care option can help make the decision easier.

One of the big benefits that nursing homes provide is the opportunity for structured and unstructured activities and socialization. In many nursing home settings, residents who are able to participate will find themselves able to participate in everything from field trips to resident council meetings. Larger nursing homes usually employ activities directors that arrange outings and transportation, club meetings, games, and social affairs for the residents. In addition to socializing with other residents, it’s not unusual for residents and staff members to develop friendly attachments. Speaking of staff, nursing homes employ enough staff to cover patient care and medical needs 24 hours a day and 7 days a week. Even if several people call in sick or inclement weather prevents people from driving, you can be assured that at a nursing home, there is a full staff to see to your loved one’s needs.

The primary drawback of nursing home care is the loss of familiar surroundings that residents will experience. It is not at all uncommon for normally alert and oriented patients to become confused while transitioning to nursing home care, though this typically does not last long. Residents are usually assigned a roommate, or will have to pay extra for a private rooms. Private rooms are often scarce even for those willing to pay extra. Because space is limited, nursing home residents are only allowed to bring a limited number of possessions from home. If the most adequate nursing home for a patient is located far from their home, they may even lose the comfort of familiar faces, as family and friends may find it difficult or inconvenient to visit. Patients may feel abandoned, may be distressed about the loss of privacy and possessions, and may be intimidated by the many strangers that work and live in the nursing home.

Employing an agency to provide nurses and aides for at-home care or hiring nurses or aides privately neatly addresses the problem of unfamiliar surroundings. Home care allows the patients to keep their possessions, stay in the home that they’re familiar and comfortable with, and avoid unwanted interactions with strangers. It’s common for agencies to send the same home care team to a patients home on a regular basis, and when hiring private medical caregivers, families often choose caregivers who are interested in live-in positions. That means that the patient can get to know and feel comfortable with their caregivers. There is usually a lower turnover in these positions than in nursing home positions. Being the only patient in the house also affords the patient with more privacy than an institutional setting can. Family and friends who regularly visited before the home care was needed won’t have to change their routine to keep in touch.

On the other hand, a patient who already had little interaction with family and friends can become very isolated when being cared for at home with only the caregiver for company. At-home care also carries the risk of the caregiver not showing up when needed, either through scheduling errors or in emergency situations. Depending on the physical and mental state of the patient, being left alone could be a minor inconvenience or a disaster, or anything in between. It should also be noted that, while the majority of home nurses and nurse aides are caring individuals and upstanding citizens, the risk of abuse, theft, or fraud may be higher in home care situations where there is less oversight. Families should also consider the cost. At-home care often costs more out of pocket than nursing home care, and in many cases, money must be spent to outfit the house with rails, a hospital bed, and other safety and medical accessories.

In the end, the decision is a personal one for the patient and family. Keep in mind that any patient who is able should take an active role in discussing and deciding their medical and personal care needs, and if at all possible, the final choice should rest with the patient.