At-Home Alternatives for Elder Care

Is a nursing facility the only option for my mother? Her health has been in decline for a long time, and it's recently become clear that she can no longer live on her own. She doesn't want to move, and I don't like the idea of putting her in some kind of "institution." What are some alternative forms of elder care for a woman in her situation?

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Although nursing homes used to be the option of choice for housing the elderly, they may not represent the most appropriate or most cost-effective plan for seniors who need less care. Depending on the severity of your mother’s health issues, you may want to take a look at some of the in-home and community-based long-term-care services that are becoming increasingly available.

These alternatives can be particularly attractive when you consider that most seniors prefer to grow old at home. Many of them were raised on the principles of self-sufficiency and hard work, and for a person who cherishes such values it can be devastating to lose their independence and their beloved home. It’s not surprising, then, that almost 95 percent of the elderly live in some form of independent household. According to Census Bureau figures, 83.8 percent of people ages 70 to 74 are homeowners, as are 77.7 percent of Americans age 75 and older.

Before making a final decision, there are a number of key questions you’ll want to ask in order to determine whether it’s desirable and/or feasible for your mom to remain in her home. For example, how determined is she to stay there? If she’s absolutely opposed to making a move of any kind, you should probably do everything you can to accommodate her wishes. In that case, you’ll need to make sure that the house is safe. Are any repairs needed? Has the neighborhood deteriorated? If so, how badly? What are the public transportation options? What social supports are available? Are friends and family members willing to stop by and help when needed? Is there a supportive church nearby? Is your mother financially capable of maintaining the home? With reference to this last point, it’s worth mentioning that most states have some form of property-tax relief program to help older persons stay in their own homes.

Once these issues have been settled, you can begin to explore the possibilities for securing in-home care or community-based assistance for your mother. Today, a number of community-based services are available to make it easier for her to get her needs met while remaining at home. Among the many options on the market you may want to consider the following:

  • Case- (or Care-) Management Services help people assess what kind of help they need.
  • Multipurpose Senior Centers provide a wide range of resources and services for people age 60 and over, including recreation, education, lunch-time meals, legal and income counseling, and health-screening clinics.
  • Adult Day-Care Services offer a variety of health, social, and related support services to senior adults who need supervision in a structured, protective environment and assistance with more than one activity of daily living, such as eating, walking, toileting, bathing or dressing.
  • In-Home Services deploy care-giver substitutes who can assist your mother in the comfort of her own home either on a limited, hourly basis or, if her needs are more intensive, on a “live-in” basis, offering 24-hour supervision. Title III of the Older Americans Act provides some limited funds for in-home services through the
    National Association of Area Agencies on Aging.
  • Respite Care is designed to give primary care-givers a temporary break from the constant care of an impaired elderly person. Sometimes this care is provided in a center, hospital, group home, or nursing home; on other occasions it’s an in-home service.
  • Employer-Supported Services. A few companies are now combining day care for children and elderly people in the same building. Check with your employer’s Human Resources Department to see if they offer this kind of support.

You may need to do some homework to sort through the various services available. Each state has designed its own network of resources and institutions to provide long-term care options for the elderly, and of course not all the services listed above are available in all locales. Check with your area agency on aging or visit for more information about what is accessible in your mother’s area.

For additional help and information on this topic, we’d encourage you to consult the resources and referrals highlighted below. Or if you have relationship concerns and challenges associated with this situation, please don’t hesitate to give our Counseling department a call.


If a title is currently unavailable through Focus on the Family, we encourage you to use another retailer.

Caring for Your Aging Loved Ones

Complete Guide to Caring for Aging Loved Ones

National Association of Area Agencies on Aging

Caregiver Action Network

National Association of Professional Geriatric Care Managers


Caring for Ill or Aging Parents

When a Nursing Home Has to Be Considered

Excerpted from The Complete Guide to Caring for Aging Loved Ones, a Focus on the Family book published by Tyndale House Publishers. Copyright © 2002, Focus on the Family.

This information has been approved by the Physicians Resource Council of Focus on the Family.

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