Nursing Home vs. Home Care in San Francisco: The Pros and Cons for Aging Adults

Nursing Home vs. Home Care in San FranciscoI’ll never forget the day my grandpa fell in the shower and couldn’t get up. Thankfully, the cordless phone was close enough to reach, so he called my mom. Without saying a single word, she got in her car and drove an hour to my grandpa’s home to help him up. He was pretty injured from the fall, and my mom was devastated. That’s when she decided to help him move into a nursing home.

Fortunately, the nursing home he moved into was much closer to our family home, so visiting him was something we did regularly. But even my 10-year-old self knew that the move and his loss of independence were hard for him. Almost overnight, the little twinkle in his eyes vanished and the lines on his face deepened.  

“Thank goodness he’s getting the care he needs,” my mom would say every time we left the home after a visit. It was true, my grandpa seemed to be very well looked after and my mom no longer had to worry about him alone in his home, but I could tell it was painful to her see his spark disappear. She always regretted not getting home care for him instead so that he could live out his last years happily in his home.

Deciding between a nursing home and home care for your aging loved one can be difficult. Many people think that nursing homes are the safest and easiest option for their aging loved one, and in some cases, they might be. San Francisco, however, has plenty of programs and services that make living independently much more possible for aging adults. Let’s look at the pros and cons of nursing homes and home care in San Francisco so that, together, you and your aging loved one can make an informed decision about what is best.

The Benefits of Nursing Homes

Caregiving for my grandpa and constantly worrying about his well-being was very overwhelming for my mom—and this isn’t uncommon. When your aging loved one’s needs start to exceed his or her resources, a nursing home may seem like the best option. Having access to daily, full-spectrum care—from bathing to dressing to activities, and even help with running errands—can definitely be beneficial, and it certainly relieves a lot of stress for you as a caregiver.

Another advantage is that nursing homes have the potential to be very social places where many friendships form. There are typically plenty of organized activities for aging adults to engage in, keeping them active and stimulated.

Homes also have trained staff members that are capable of dealing with a spectrum of medical conditions, so your aging loved one would be safe in case of emergency. And when it comes to safety, nursing homes have protocols to make sure that residents are safe, and special safety measure for residents with dementia.

Why Nursing Homes May Not Be Right for Your Aging Loved One

While there are many good reasons to consider a nursing home for your aging loved one, there are also a lot of drawbacks. Perhaps the most obvious downside to nursing homes is the huge expense. In California, the average nursing home costs around $260 a day, unless it is a home that is certified by Medi-Cal, in which a portion of the costs may be covered. Of course, for the costs to be covered, your aging loved one must meet the eligibility requirements for Medi-Cal.

Inconsistent quality of care is another big drawback. Many nursing homes are understaffed, which means it may be difficult for your aging loved one to receive the quality of care they deserve. In 2014, the Inspector General released a document revealing that 33% of a sample of Medicare recipients experienced “adverse events” during the initial 35 days of their stay. These adverse events, which were all deemed preventable, resulted in harm or death due to poor treatment, less than optimal monitoring, or delayed care. It is important to keep in mind that conditions will vary from home to home, so you will want to make sure you do your research and compare prospective homes.

The other thing to consider is that many aging adults are resistant to the idea of living in a nursing home. If this is the case, making the move might be very hard on them physically and mentally. While some aging adults thrive in the social environment, others can become isolated and experience a decline in mental health. In fact, depression in older adults is much more prevalent among aging adults living in nursing homes than it is in adults living independently. While only 1 to 4% of people over the age of 60 suffer from depression, more than 20% of those living in nursing homes are affected.

While there are pros and cons to nursing homes, it all comes down to yours and your aging loved one’s particular situation, the quality the individual nursing home, and what is best for the aging individual.

The Many Benefits of Home Care in San Francisco

Thankfully, nursing homes aren’t the only option for aging adults in need of care. Continuing to live independently is a desire that many aging adults have, but it can be viewed as a challenge for family members, especially when they become the primary caregivers and take on all the responsibilities of their aging loved one themselves. It can seem especially difficult if aging loved ones have mobility issues or are living with dementia. In such cases, there are certain dangers that come with aging adults living independently. Fortunately, however, there are many programs and services that seek to make living at home safer and easier.

Home care and support services are readily available in San Francisco, offering aging adults personalized, at-home care. In-home care costs in the city typically range from $18 to $25 an hour and can encompass basic care needs or more personalized medical attention.

Home safety evaluations, free home repairs and maintenance, and meal prep and planning services are available as well through the city’s many nonprofits and senior’s service organizations, including the Institute on Aging.

While isolation is also a common concern for families to have about their aging loved one living independently, the city boasts day programs for aging adults that provide community, mental stimulation, wholesome meals, exercise, personalized care, and transportation to and from senior facilities. There are also a number of mental health services available to older adults to help them cope with the many challenges that come with aging, from cognitive behavioral therapy to bereavement therapy.  

If your aging loved one’s health is a concern, On Lok Lifeways offers a Program of All-Inclusive Care for the Elderly (PACE) that provides full-service medical care, making it possible for ill or disabled aging adults to continue living in their homes. In addition to medical services, home care assistance, meals, community engagement, and transportation are provided regardless of one’s financial situation.

As a family member supporting an aging loved one living independently, there are also tools available for you that make life easier when it comes to managing your aging loved one’s affairs and coping with the challenges you face. Apps like the Senior’s Care Manager App can make it easy for you to keep track of your loved one’s appointments, keep track of their medications, or store emergency contacts. If you are caregiving for your loved one, there are a number of in-person caregiver support groups in San Francisco that can help you meet others facing similar challenges, and find a supportive community of your own.

It’s been years since my grandpa passed away, but I know my mom still regrets that he didn’t live out his last years in the comfort of his own home. At the end of the day, it’s important that you talk to your aging loved one about his or her desires so that you can come to a decision about their care together. Whether it’s home care or a nursing home, your aging loved one needs care that empowers him or her to age with dignity.

At Institute on Aging, we help connect aging adults and their families with the resources they need to live independently, including offering a range of home care services. To find out more about our offerings, contact us today.

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Institute on Aging

Committed to offering thoughtful discussions and resources to older adults, their families, and their caregivers.

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