Guide
Types of senior care in the U.S.: which one your loved one needs
Updated October 15, 2026 · Reviewed against official sources
Many Latino families start looking for "a nursing home" when mom or dad might do fine with less: a few hours of help at home or an adult day center. Other times, it's the opposite: the person needs nursing care all day, and a small care home can't give them that level of care. This guide explains each option in plain words, so you know what to look for and what to ask.
If the names confuse you (senior living, nursing home, retirement home, care home), also read what each term means.
First: how much help does your loved one need?
Before you compare places, think about what your loved one can do on their own and what they can't. Professionals look at two groups of activities:
- Basic activities of daily living: bathing, dressing, eating, using the toilet, getting from the bed to a chair, and bladder control.
- Instrumental activities of daily living: cooking, taking medications on time, managing money, shopping, using the phone.
You can get an idea in a few minutes with our Katz and Lawton scales. They're a guide, not a diagnosis: the doctor is the one who evaluates. If there are also memory problems or confusion, or the person gets lost, keep that very much in mind, because it changes the type of place that makes sense. If you're not sure whether your loved one can still live alone, these signs in daily life can help you think it through.
The types of care, one by one
Nursing home
It's the highest level of care outside a hospital. Nurses and aides are there 24 hours a day, along with medication management, therapy, and medical oversight. When it provides rehab after a hospital stay, Medicare calls it a skilled nursing facility (SNF). Many nursing homes have both: a short-term rehab unit and a section for long-term residents.
It's for people who need medical or nursing care every day, or full help to move, eat, or use the bathroom. All nursing homes have a state license, and almost all are certified by Medicare and Medicaid, so their inspections are public. In our state-by-state directory, each listing shows the official Medicare data: the star ratings, the abuse icon, and whether the place is in the Special Focus Facility program. These are tools for information; in how to read Medicare star ratings, we explain what each one tells you and what to ask the facility.
Assisted living
It's a residence with a private apartment or room, meals, housekeeping, activities, and help with bathing, dressing, and medications. It does not provide continuous nursing care. It's for people who can no longer live alone safely but don't need constant medical care.
There's no federal standard: each state issues the licenses and uses different names. Texas has Type A and Type B licenses; in California, it's called an RCFE (Residential Care Facility for the Elderly). Read more in what is assisted living.
Residential care home (board and care)
It's a regular house, adapted for care, where a few residents live and a staff takes care of them. The setting feels more like a family home, and it sometimes costs less. In California, many are small RCFEs; in Florida, there are Adult Family Care Homes, with a maximum of 5 residents. Some accept people who get SSI (Supplemental Security Income). In California, the SSI/SSP rate for "nonmedical out-of-home care" is $1,626.07 a month in 2026, and many homes that accept SSI charge that amount as full payment. Always ask what that payment includes.
Memory care
It's a special unit or residence for people with Alzheimer's or another type of dementia. It has secure doors, trained staff, and activities designed for people with memory loss. It can be inside an assisted living community or a nursing home. See our memory care guide and, if you're worried about the move, how to prepare a loved one with dementia.
Adult day care
Your loved one goes during the day, several times a week, and comes home to sleep. They get meals, activities, and company, and at adult day health centers, nursing and therapy too. It's a big help for families who work and a way to give the caregiver a break. Read our guide to adult day care for seniors or search the adult day center directory.
Home care and home health
There are two types that are easy to mix up:
- Non-medical home care: a caregiver helps with bathing, meals, housekeeping, and companionship. The family pays for it or, in some states, Medicaid does.
- Home health: nursing or therapy visits ordered by a doctor. Medicare pays for it if the person is homebound and meets the other requirements. See home health agencies.
Read the complete guide to home care for seniors. If the family needs a few days of rest, there's respite care.
PACE program
PACE (Programs of All-Inclusive Care for the Elderly) coordinates almost all of a person's care so they can keep living at home: doctor, adult day center, therapy, transportation, and help at home. According to Medicare, it's for people 55 or older who live in the service area of a PACE program, who are certified by the state as needing a nursing home level of care, and who can live safely in the community with that help. It isn't available everywhere. With Medicaid, there's no monthly premium. Read our guide to the PACE program.
Hospice
It's comfort care for a person with a terminal illness and a prognosis of 6 months or less. It controls pain and symptoms and supports the family. It's almost always provided at home or wherever the person lives, including a nursing home. Medicare covers it, but it doesn't pay for room and board in a facility. Read hospice and palliative care or search for hospice providers.
Continuing care retirement community (CCRC)
It's a campus with several stages: independent living, assisted living, and a nursing home. The person moves in while still independent and changes levels if needed. These communities usually charge a large entrance fee on top of the monthly fee. There's no official national cost figure. Ask for the full contract and read it carefully. Because of the amount of money involved, it's a good idea to have a lawyer review it before you sign.
Comparison chart
Costs are 2025 national medians from the CareScout (Genworth) survey. They can be very different in your state: see how much senior care costs.
| Type | Who it's for | Typical cost (2025 national median) | Who usually pays |
|---|---|---|---|
| Nursing home, semi-private room | Needs nursing care or full help 24 hours a day | $315 a day (about $9,581 a month) | Medicaid, personal savings; Medicare only for a short rehab stay |
| Nursing home, private room | Same, with a private room | $355 a day (about $10,798 a month) | Same as above |
| Assisted living | Needs daily help, without constant nursing care | $6,200 a month | Personal savings; in some states, Medicaid pays for services (not rent) |
| Residential care home | Same as assisted living, in a small setting | No published national median | Personal savings, SSI with a state supplement in some states |
| Memory care | Alzheimer's or dementia with a risk of wandering | No published national median; usually costs more than assisted living | Personal savings; Medicaid in some states |
| Adult day center | Lives at home, needs supervision during the day | $95 a day | Family, Medicaid (state programs), VA |
| In-home caregiver (non-medical) | Needs help for a few hours or all day | $35 an hour (about $6,673 a month at 44 hours a week) | Family; Medicaid in programs like IHSS or STAR+PLUS |
| Home health | Needs nursing or therapy visits | Per visit | Medicare, if the person meets the requirements |
| Hospice | Terminal illness, 6 months or less | Usually $0 with Medicare | Medicare, Medicaid, insurance |
Medicare does not pay for long-term custodial care (daily help with bathing, dressing, or eating) or for assisted living. For that, most families use their own savings or Medicaid. Read what Medicare covers and whether Medicaid pays for a nursing home. If your loved one is a veteran, also look into Aid and Attendance benefits.
How to decide as a family
- Measure the need. Use the scales and ask for the doctor's opinion.
- Ask what your loved one wants. If they can share an opinion, their voice matters most. This guide can help you talk with mom or dad about moving.
- Start with the least restrictive option that's safe. If your loved one is doing well with help at home or an adult day center, they may not need to move yet.
- Look at the money. Figure out what a caregiver would cost with our home care calculator and compare it with the cost of a residential facility.
- Talk with your siblings. Sharing tasks and costs from the start helps avoid tension. See how to talk with your siblings.
- Search and compare. Use the guided search, places near you, and the compare tool.
- Visit. Bring our visit checklist and read how to choose a nursing home.
If your loved one is in the hospital and will be discharged soon, go straight to our hospital discharge page and ask the hospital social worker for help. The terms you'll see in letters and forms are explained in our glossary.
Frequently asked questions
What's the difference between a nursing home and assisted living?
A nursing home provides nursing care 24 hours a day and is regulated by the federal government as well as the state. Assisted living helps with daily life (bathing, dressing, meals, medications), but it doesn't have continuous nursing care, and each state sets its own rules.
Can you switch to a different type of care later?
Yes. It's very common to start with help at home or an adult day center and later move to assisted living or a nursing home as needs grow. Ask each place what happens if your loved one needs more help over time.
Rules and license names vary from state to state. This guide is for information only and doesn't replace medical or legal advice.
Sources
- Medicare.gov, Long-term care: https://www.medicare.gov/coverage/long-term-care (accessed October 15, 2026)
- Medicare.gov, Skilled nursing facility care: https://www.medicare.gov/coverage/skilled-nursing-facility-care (accessed October 15, 2026)
- Medicare.gov, Hospice care: https://www.medicare.gov/coverage/hospice-care (accessed October 15, 2026)
- Medicare.gov, Home health services: https://www.medicare.gov/coverage/home-health-services (accessed October 15, 2026)
- Medicare.gov, PACE: https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE (accessed October 15, 2026)
- CareScout, Cost of Care Survey 2025, median cost tables: https://assets.carescout.com/x/8fcb50422f/282102.pdf (accessed October 15, 2026)
- California Department of Social Services, senior care licensing (RCFE): https://www.cdss.ca.gov/inforesources/senior-care-licensing/resources-for-residents-and-families (accessed October 15, 2026)
- California DHCS, SSI/SSP payment standards effective January 1, 2026 (ACWDL 25-29): https://www.dhcs.ca.gov/services/medi-cal-resources/medi-cal-eligibility-division/all-county-welfare-directors-medi-cal-eligibility-division-information-letters/ssi-ssp-payment-standards-effective-january-1-2026/ (accessed October 15, 2026)
- Texas Administrative Code, 26 TAC §553.5 (Type A and Type B assisted living): https://www.law.cornell.edu/regulations/texas/26-Tex-Admin-Code-SS-553-5 (accessed October 15, 2026)
- Florida AHCA, Adult Family Care Home: https://ahca.myflorida.com/health-quality-assurance/bureau-of-health-facility-regulation/assisted-living-unit/adult-family-care-home.html (accessed October 15, 2026)
This is general information, not medical, legal or financial advice. Rules vary by state and by year: confirm with the official agency that applies to you.
Keep reading
How much care costs
Nursing home, assisted living, adult day care, and home care prices by state (CareScout 2025). What the rate includes, what's extra, and how to pay.
What is assisted living
What assisted living is, who regulates it in each state (RCFEs in California, Type A and B in Texas), what it costs, and when Medicaid pays for services.
Choosing a place for care
How to choose a nursing home: assess the need, check the license, star ratings and inspections, visit, what to ask and how to read the contract.
Board and care homes
What a board and care home is, who it's right for, how it's licensed in California, Washington and Florida, how to pay for it and what to ask.
