Nursing homes aren’t your only option when it comes to long-term care. Many older adults find that other solutions meet their needs better than the highly clinical environment you typically find in skilled nursing facilities. There’s a whole world of care choices that can help you maintain independence while getting the support you need.

Whether you’re planning ahead or facing immediate care decisions, these alternatives often cost less than traditional nursing home care and let you stay closer to home.

Home Care: Professional Support in Your Own Space

You can expect a national median cost of home care in 2025 of $33 an hour. Median state costs range from $24 an hour to $43 an hour. That might sound steep, but consider this: the national annual median cost of 24/7 nursing home care is $104,025 a year for a semi-private room and $116,800 for a private one. Even part-time home care can be significantly more affordable.

Home care allows you to age in place with services like help with bathing and dressing, meal preparation, medication reminders, transportation to appointments, and companionship. The flexibility means you can start with just a few hours per week and adjust as your needs change.

Finding Financial Help for Home Care

Medicaid-funded in-home care is one alternative to nursing home care for those who qualify. Medicaid is a government program that provides health coverage for low-income individuals, people with disabilities, and some seniors. With this type of long-term care, Medicaid beneficiaries receive care services (and benefits) to promote independent living in their own home or the home of a friend or family member.

For veterans, the VA Aid and Attendance program can be a game-changer. Aid and Attendance is a monthly monetary benefit paid to veterans, dependent spouses and surviving spouses who need home or facility care. The benefit is tax-free and does not need to be paid back. In 2025, qualified married veterans can receive up to $2,795 monthly to help cover care costs.

Assisted Living: Community with Independence

According to Genworth Financial, you can expect an average price tag of about $5,350 per month for assisted living. That’s still considerably less than nursing home care, and you get your own apartment plus access to common areas, dining halls, and social activities.

Assisted living works well for those who need help with daily activities but don’t require round-the-clock medical supervision. You’ll maintain your independence while having 24-hour emergency assistance, scheduled transportation, housekeeping services, and engaging social programs.

Adult Day Care: Daytime Support and Socialization

Adult day care provides a space for seniors with assistance needs to have a safe, comfortable, and engaging space during the day. This is a way for family caregivers to ensure that their loved one is cared for while they are at work, or otherwise busy.

This option works beautifully if you’re still living independently but need supervision during certain hours, or if a family caregiver works full-time. Adult day programs typically cost between $75-$150 per day, making them much more affordable than full-time care.

Medicare PACE Programs: Comprehensive Community Care

Medicare’s Program of All-Inclusive Care for the Elderly (PACE) provides services to qualified individuals who need skilled care but want to remain living in their community. This program can be a game-changer for those who qualify.

To be eligible for PACE, you must be 55 or older, live in a PACE service area, need nursing home-level care as certified by your state, and be able to live safely in the community with PACE services. PACE covers everything from medical care to home services, often with little to no out-of-pocket cost for those who qualify for both Medicare and Medicaid.

Adult Foster Care: Small-Scale, Personal Attention

Adult foster homes can be a more individualized alternative to a nursing home, as they provide some similar benefits including 24/7 supervision. These homes typically house only 3-5 residents, creating a family-like atmosphere with personalized one-on-one care.

This option offers more individualized attention than larger facilities while providing the security of round-the-clock supervision. It’s particularly suitable for those who prefer smaller, more intimate living arrangements.

Making Your Home Safer and More Accessible

Sometimes the best alternative is staying right where you are with some modifications. Simple changes can make a huge difference in your ability to age in place safely: installing grab bars in bathrooms, adding ramps for wheelchair or walker access, improving lighting throughout the house, and getting a medical alert system for emergencies.

Recent technological advances in the devices provide seniors with freedom inside and outside the home. There are high-tech devices such as smartwatch systems, smart speakers, and on-the-go pendants. Modern medical alert systems include fall detection, GPS tracking, and 24-hour monitoring to provide peace of mind.

Money Follows the Person Programs

Money Follows the Person (MFP) Programs assist Medicaid-eligible seniors currently residing in an institutionalized setting, such as a nursing home, to transition back home, to the home of a loved one, or a group home with up to 4 unrelated residents. These programs help cover moving expenses, security deposits, and essential furniture, plus provide ongoing support services.

Finding Help and Resources

Start by contacting your local Area Agency on Aging. These agencies can connect you with services in your area and help you understand what financial assistance might be available.

Your local Area Agency on Aging may offer more services in your area. Health-care providers and social workers may also have suggestions for ways to support your loved one other than sending them to an assisted living facility.

For veterans and their families, contact the VA benefits office to learn about Aid and Attendance benefits that can help cover home care, assisted living, or adult day care costs.

Key Takeaways

• Home care averages $33/hour nationally but can be more affordable than nursing homes for part-time needs
• Assisted living costs about $5,350/month versus $10,000+ for nursing homes
• Medicare PACE programs offer comprehensive care for qualified seniors at little cost
• Adult day care and foster homes provide community-based alternatives with personal attention
• Veterans may qualify for up to $2,795/month through VA Aid and Attendance benefits
• Your local Area Agency on Aging is your best first stop for exploring all available options