9 Alternatives to Nursing Homes (and How to Pay for Them)

Header image for article about alternatives to nursing homes and how to pay for them. Shows a collage of elderly people

Many people think that nursing homes are the only types of senior housing available for their loved ones. But that simply isn’t true!

Nursing homes, also called skilled nursing facilities (SNFs), are just one kind of senior living community. They’re great for older people who require around-the-clock skilled nursing care services. However, they won’t be the best fit for every senior.

There are plenty of alternatives to nursing homes—one of them could even be the perfect fit for your aging loved one.

9 Alternatives to Nursing Homes

There are plenty of housing options for older adults available. Which one is best depends on the senior in question. After all, some older adults can live independently and need little to no help with day-to-day activities. Others will need more extensive care; fortunately, they can receive this care in locations other than SNFs. In some cases, they can receive that care in the comfort of their own home!

1. Independent Living

Also called:

  • Retirement living communities
  • Senior apartments
  • Retirement communities

For social butterflies, independent living communities could be even better than living alone!

This type of senior housing is unique in that residents need little to no help with activities of daily living (ADLs). These activities are so named because they are activities people need to complete on a daily basis in order to live comfortably.

These activities include:

  • Ambulating: Walking independently from one spot to another
  • Dressing: Selecting appropriate clothing and putting them on
  • Feeding: The ability to feed oneself
  • Bathing: Maintaining personal hygiene (e.g. showering)
  • Toileting: Going to and from the toilet and cleaning oneself after use
  • Continence: Control of bladder and bowel function

These residences don’t offer much help with ADLs, but they may offer other attractive services, such as laundering services, appliance maintenance, and lawn care. All in all, independent living communities are perfect for active seniors who want to live in a vibrant community with other active seniors.

2. Assisted Living

Also called:

  • Assisted living facilities
  • ALFs

Sometimes seniors require enough help that they will not be able to live in an independent living community. That said, a nursing home may not be the right fit for them. In these cases, an assisted living arrangement could be ideal.

Assisted living facilities, or ALFs, are designed for people who need some help with ADLs but still do not require the level of care that SNFs offer. ALFs are therefore ideal for people who only need some medical attention and slight assistance with day-to-day activities, like meal preparation or laundering.

3. Memory Care

Also called:

  • Memory care facilities
  • Dementia care
  • Alzheimer’s care

Memory care can refer to either a special unit inside an ALF or SNF, or it can refer to an entire facility dedicated to treating and housing people with memory loss or other memory problems.

Memory care, as the name suggests, is for people with severe memory issues who need 24/7 monitoring. The goal of these facilities is to make life easier and safer for their residents. Staff members are trained specifically to care for individuals with memory loss, so residents will be treated with respect and receive top-notch care at these locations.

4. Home Health Care

Also called:

  • In-home care
  • Homecare
  • Social care
  • Domiciliary care

The name says it all: home health care is for older people who need the aid of caregivers but want their services delivered within the comfort of their own home. Many different kinds of licensed professionals—such as geriatric care managers, social workers, and registered nurses—can deliver in-home services to address their clients’ personal care needs.

Home health care services can include, but are not limited to, the following:

  • Meal preparation
  • Laundering
  • Medication management
  • Help with household chores
  • Financial assistance, such as help paying bills

5. Adult Foster Care

Also called:

  • Adult family homes
  • Adult family care
  • Elderly foster care

Adult foster care programs are for any adult who needs personal care services, provided within the comfort of the adult’s own home. Enrollees of these programs typically receive in-home help with activities of daily living.

6. Adult Day Care Services

Also called:

  • Adult day health care
  • ADHC

Adult day care services are not to be confused with adult foster care services, although there is some overlap between the two medical care options. Adult day care services, as the name implies, are day care services where adults, not children, are the enrollees.

These programs are great for family members-turned-caregivers who cannot watch over their aging relatives 24/7. For example, an adult child caregiver might enroll their elderly parent in an adult day care program so they can have peace of mind that their parent is well-cared for while they are at work.

People interested in finding an adult day care center can use the official government Eldercare Locator to discover locations in their area.

7. Respite Care

Also called:

  • Residential respite care
  • Short-term assisted living

Caregiving can be exhausting. It can drain not just physically and mentally, but also cut into personal resources like time and money. This exhaustion has serious consequences for caregivers.

According to the CDC, unpaid caregiving is associated with higher risks of many conditions, including the following:

  • Mental health problems
  • Compromised immunity
  • Early death

While it’s obviously important to care for elderly loved ones, caregivers need to take their needs into consideration as well. That’s where respite care comes into the picture. Respite care provides caregivers the opportunity to take a step back, rest, and recover. Respite care can come in many forms, including:

  • In-home care services
  • Adult day centers
  • Short-term stays in residential facilities

8. Continuing Care Retirement Communities

Also called:

  • Life plan communities
  • CCRCs

The level of care people need can change as they age. Rather than shuffling about from facility to facility as these needs change, wouldn’t it be nice to stay in one community that adjusts the level of care it provides to its residents? This concept guides continuing care retirement communities (CCRCs).

CCRCs offer various personal care and senior living options, such as independent living, assisted living, and memory care programs. Since CCRCs offer all these services in one community, residents will not need to move to a new location when their needs change.

9. Convalescent Homes

Also called:

  • Inpatient rehabilitation facility
  • IRF
  • Acute care facility

The term “convalescent” refers to a recovering person. Convalescent facilities offer short-term rehabilitation services for people recovering from illnesses, injuries, and surgeries. The goal of convalescent care is to help patients recover properly. This way, they can leave the facilities and be fully independent.


According to Genworth’s 2020 “Cost of Care Survey,” the average monthly fees for senior care services in the United States are:

  • Adult day health care – $1,603
  • In-home homemaker services – $4,481
  • In-home health aide – $4,576
  • Assisted living – $4,300
  • Nursing home facility, semi-private room – $7,756
  • Nursing home facility, private room – $8,821

Additional fees associated with senior housing include:

  • Independent living – $2,750/month
  • CCRCs – entrance fee + $500/month to $3,000/month

Financial Assistance Programs

There is no sugarcoating the fact that senior care is expensive. There are fortunately plenty of ways to ease the financial burden associated with eldercare services, including the following.

Long-term Care Insurance

15% of the adult population (roughly 44 million people) in the United States are enrolled in the Medicare program, making it one of the single-largest federal public health programs in the country. Basic Medicare, unfortunately, does not cover long-term care costs. Doubly unfortunate is the fact that someone’s chance of needing long-term care increases to 50% by the time they turn 65. What this all means is that millions of Americans will require long-term care at some point in their life, and that one of the largest health programs in the country will likely not offer them financial assistance for these services.

And that’s a big deal.

According to Genworth’s 2020 “Cost of Care Survey,” the average annual cost of a semi-private room in a nursing home in the United States is $93,075. Since most people can’t pay these out-of-pocket costs, investing in a long-term care plan is one of the most reliable ways to financially prepare for the future.


Medicare is a government-sponsored healthcare program for senior citizens. Enrollment is optional, and participants have the ability to add different plans or “parts.”

Original Medicare (Medicare Parts A and B) will pay for short-term stays in SNFs only. Specifically, Medicare will cover costs associated with stays less than 100 days in SNFs. The program will pay for the full amount for the first 20 days. For the next 80 days, Medicare will pay for 80% of the costs. All costs after 100 days are the responsibility of the individual.


Medicaid is a federal and state health insurance program for low-income, disabled people in the United States. What this program covers depends on several factors, such as the individual’s income and where they live.


In some states, Medicaid offers waivers to extend coverage in situations where the individual would otherwise bear the brunt of a healthcare bill. For example, Texas offers a STAR + PLUS waiver for citizens to apply for financial assistance with assisted living facilities and services, which otherwise are not covered by Medicaid in the Lone Star State.

People should visit their state’s official Medicaid site to learn more about what financial assistance waivers are available to them.

Program of All-inclusive Care for the Elderly

PACE is the Program of All-inclusive Care for Elderly. It is a Medicare program/Medicaid service. It helps seniors access services they may need in most locations, including within their own homes.

Who is Eligible?

According to the official Medicaid website, people are eligible for PACE if they meet the following requirements:

  • “Age 55 or older
  • Live in the service area of a PACE organization
  • Eligible for nursing home care
  • Be able to live safely in the community”

What States Offer PACE Programs?

As of July 2020, the following 32 states offered some form of PACE services:

  1. Alabama
  2. Arkansas
  3. California
  4. Colorado
  5. Delaware
  6. Florida
  7. Indiana
  8. Iowa
  9. Kansas
  10. Louisiana
  11. Maryland
  12. Massachusetts
  13. Michigan
  14. Missouri
  15. Nebraska
  16. New Jersey
  17. New Mexico
  18. New York
  19. North Carolina
  20. North Dakota
  21. Ohio
  22. Oklahoma
  23. Oregon
  24. Pennsylvania
  25. Rhode Island
  26. South Carolina
  27. Tennessee
  28. Texas
  29. Virginia
  30. Washington
  31. Wisconsin
  32. Wyoming

Final Thoughts

There may come a time when an elderly loved one needs help with their daily activities. This fact doesn’t mean they have to enter a nursing home, though. There are plenty of eldercare services and programs available that can fit the needs of a wide range of seniors, from independent living communities to in-home care services.

If you believe your loved one would thrive best in a community setting, we can help. Our directory can show you thousands of senior living locations all across the United States. That means your loved one can live life to the fullest at a place near you.