The Choice Between In Home Care vs Out of Home Care

ageormoveI recently attended a session hosted at my Mom’s Continuing Care Retirement Community (CCRC). My parents made this choice more than 15 years ago, however, it’s not like you don’t wonder what it would have been like if they had opted to age-in-place.

“Aging-in-place” is a hot topic now, and in reality there are many “aging” options. In addition to a CCRC, there are local adult care options, many offered by local government and non-profits; in-home care and group home care. As a society, we seemed to have moved away from living with children, but I’m feeling a little guilt about that now. My Mom seems terribly lonely, but I know the move would be difficult on her cognitively.

Had my parent’s opted to “age in place”, we would most likely have had to take my parents to court to gain guardianship. Because they both moved into dementia together, they really didn’t recognize how much difficulty they were having managing on a day-to-day basisI’m thankful we never had to pursue this option. My parents would have recognized and been very hurt by this process.

This session I attended was focused on caring for a loved with dementia. The speaker shared that those that have a loved one in a CCRC feel guilt while those that care for a parent in their home are exhausted.

I know I’m lucky my parent’s made this choice and can afford it. The support of my parents over the past two years has been overwhelming at times. Now, it’s comforting to know that I’m not responsible for my mother’s care 24/7.

It has me wondering how my husband and I will manage this decision. Nothing is perfect, but given the wave of aging loved ones that is going to build in the coming years, I want to start having this conversation now. Discussed.

Please share with me what you are planning to do

8 thoughts on “The Choice Between In Home Care vs Out of Home Care

  1. It was very important they made their own decision to move out of their home – my Father regardless of his condition would have never made the decision to leave – by the time I got involved this past year my Mother had very advanced dementia and couldn’t make any decisions – my Father made all of the big decisions in their 60 years together anyway. I thank the re-hab facility that my father was in 3 years ago after his heart attack/failure – to advise me and my sister-in-law to get Power of Attorneys signed by both parents. I was then able to move forward – move their $$’s into an account so that I could move my mother to the adult residential home – very expensive – $4500 a month. It did not turn out well with my father – he was moved as an involuntary commit to remove him from the house – he was filthy, not paying bills, and physically detiorating. All very sad – they both hated me because they did not understand why they were forced to move. What a very sad situation.

    Vickie – parents from Seattle – I live in Maryland – no living siblings.

  2. There is definitely truth in the statement the speaker made about the guilt of children placing their loved one in a CCRC vs. the exhaustion of those caring for their parent with dementia at home. This type of decision needs to be made, but clearly isn’t an easy one. I think the best thing to consider is the level of care at the CCRC or any other facility. A number of factors have to be considered from 24 hour nursing care, to other amenities related to physical activities. In early next year, I plan to have a monthly theme of my blog focus on this issue, as I studied aging in place as an urban planner. I’d love to have your voice as a guest blogger. Please visit:

  3. I think we all have to ask ourselves as adult children, “What is the trigger that will require us to start making the decisions for or caring for our parents?” Is it after they fall for the 3rd time? Is it when they no longer keep themselves clean [define that?]? Is it when they are diagnosed with dementia or ALZ? Is it when you can no longer manage 2 out of 5 ADLs? etc. etc. I think families have to have that conversation ahead of time–early and often.

    1. Agreed! My parents thought they had it figured out. My siblings and I had 2 different “interventions” with my parents who refused to or where unable to believe and accept the examples we provided illustrating that it was time to move into their pre-selected retirement community. Sometimes, all the planning in the world goes awry. I have written letters to myself that my husband and children know how to access and give to me. I hope that will help me should I end up repeating history.

  4. Related– for elders who want to age in place: Advance Directives are so important for aging parents to have and share with their children. That said, it’s important to know:

    When Advance Directives include DoNotRresuscitate, should 911 be called because of an emergency, those responders–unless the DNR is visible to them–must do everything possible to maintain life until they get us to the hospital, whereupon the advanced directives “kick in.” For specifics check my Help! Aging Parents post, “DNR, 911 and Hospitals” (shortlink: It may help with the decision to age in place or elsewhere.

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