The short answer: for most people with Alzheimer’s, home care is the best fit in the early and middle stages, because it keeps them in familiar surroundings with one-to-one attention. Assisted living suits people in the early stage who want a community but can still manage much on their own. Memory care becomes the better option when safety can no longer be ensured at home, for example with frequent wandering. A nursing home is for people who need continuous medical care.
Choosing where a parent or spouse with Alzheimer’s should live is one of the hardest decisions a family makes. The options have confusing names, very different costs, and each one fits a different stage of the disease. This guide compares them side by side, with Pennsylvania prices, so you can decide with clear information.
The Four Options at a Glance
| Option | What it is | Best suited to | Typical cost in Pennsylvania |
|---|---|---|---|
| Home care | Caregivers come to your loved one’s home, from a few hours a week to 24/7 | Early and middle stages; later stages with 24-hour care | About $34 per hour |
| Assisted living | A residence with private apartments, meals, activities and help with daily tasks | Early stage, when the person can still manage much independently | About $6,350 per month |
| Memory care | A secured unit or community designed for people with dementia | Middle and late stages when wandering or safety risks are high | Usually more than standard assisted living |
| Nursing home | A licensed facility with 24-hour nursing and medical care | Late stage with complex medical needs | About $11,950 to $13,700 per month |
Pennsylvania costs: CareScout Cost of Care Survey 2025, converted from annual medians.
Alzheimer’s Home Care
With home care, a trained caregiver comes to your loved one’s home to help with supervision, bathing and dressing, meals, medication reminders and companionship. Care can start with a few hours a week and grow to 24-hour care as the disease progresses.
Advantages – Familiar surroundings, routines and belongings, which often reduce confusion and agitation – One-to-one attention from consistent caregivers – Flexible: you pay only for the hours needed, and adjust as needs change – Family stays closely involved in daily life – Couples can stay together
Limits – Round-the-clock care at home costs more than most residential options – Social contact with peers can be limited, though outings, adult day programs and companion care help – The home may need safety changes, such as grab bars, locks and alarms
For a full picture of what home care includes, read our guide to dementia care at home.
Assisted Living: Can Someone With Alzheimer’s Live There?
Assisted living communities offer private or shared apartments, meals, housekeeping, social activities and help with daily tasks such as bathing and medication. They are not medical facilities: staff help with daily living, but there is no continuous nursing care.
Can someone with dementia live in assisted living? Often yes, in the early stage. Many people with mild Alzheimer’s do well with the structure and social life. As the disease progresses, standard assisted living may no longer be enough: residents who wander, become disoriented at night or need a lot of hands-on help usually have to move to a memory care unit. Ask any community upfront what happens when needs increase.
Advantages: built-in social life and activities, meals and housekeeping handled, staff on site day and night. Limits: a move to an unfamiliar place, shared staff rather than one-to-one care, and often a second move later to memory care.
Memory Care
Memory care is a secured unit, often inside an assisted living community, designed for people with dementia. It has locked or alarmed exits to prevent wandering, staff trained in dementia care, and structured daily activities. In Pennsylvania, these units in personal care homes and assisted living residences are licensed as secured dementia care units.
Memory care vs. home care: memory care offers a secured environment and staff around the clock, which matters when wandering puts your loved one at risk. Home care offers one-to-one attention in familiar surroundings, which many people with Alzheimer’s cope with better. With 24-hour care, home care can also provide constant supervision. The deciding questions are usually safety, cost and what your loved one would want.
Nursing Homes
Nursing homes provide 24-hour care by licensed nurses, along with help with all daily activities. They are designed for people with complex medical needs, such as those who are bedbound, need frequent skilled nursing, or have several serious conditions alongside Alzheimer’s. They are the most expensive option, and Medicaid is the main payer for long-term nursing home stays.
Cost Comparison in Pennsylvania
Based on the CareScout Cost of Care Survey 2025 for Pennsylvania:
| Type of care | Annual median | Approximate monthly cost |
|---|---|---|
| Home care (non-medical, 44 hours a week) | $77,792 | $6,480 |
| Assisted living | $76,218 | $6,350 |
| Nursing home, semi-private room | $143,445 | $11,950 |
| Nursing home, private room | $164,250 | $13,690 |
| Adult day health care (5 days a week) | $30,420 | $2,535 |
What these numbers mean in practice:
- Part-time home care is the least expensive option. Four hours a day, every day, costs about $4,100 a month, well below assisted living.
- Full-time home care is roughly comparable to assisted living, without the move.
- 24-hour home care costs more than a nursing home, which is why families often combine home care with family help or adult day programs.
- Medicare does not pay for assisted living, memory care or long-term custodial care, at home or in a facility. Medicaid in Pennsylvania (Community HealthChoices) can pay for care at home and in nursing homes for eligible people, and can even pay a family member as caregiver (learn more). Veterans’ benefits and long-term care insurance can also help.
Which Option Fits Each Stage of Alzheimer’s?
Mild (early) stage. Your loved one forgets recent events and struggles with complex tasks but remains largely independent. Best fit: a few hours a week of home care, or assisted living for someone who wants a community.
Moderate (middle) stage. Confusion grows, personal care becomes harder, and wandering or sundowning may appear. This is usually the longest stage. Best fit: daily personal care at home, with overnight care if nights are difficult, or memory care if safety at home can’t be ensured.
Severe (late) stage. Your loved one needs help with almost everything, including eating and moving. Best fit: 24-hour home care, memory care, or a nursing home if medical needs are complex. Hospice can support any of these settings at the end of life.
Questions to Help You Decide
- Safety: can your loved one be left alone? Do they wander or leave the stove on?
- Needs: do they need supervision and help with daily tasks, or skilled medical care?
- Their wishes: what has your loved one said about staying at home or moving?
- Family capacity: who can help, and for how long, without burning out?
- Budget: what can you afford over several years, and which programs could help?
- Transitions: how would your loved one cope with one move, or two?
You don’t have to answer these alone. A free in-home assessment can help you see which option fits today, and what may be needed later.
Frequently Asked Questions
Do Alzheimer's patients do better at home?
Is assisted living good for dementia patients?
What is the difference between assisted living and memory care?
When should someone with Alzheimer's move to a nursing home?
Is home care cheaper than assisted living?
Talk Through Your Options With Aurora Home Care
Aurora Home Care helps families across Greater Philadelphia and Bucks, Delaware, Chester, Lancaster and Berks counties keep loved ones with Alzheimer’s safe at home. Our Alzheimer’s and dementia home care services range from a few hours a week to 24/7, with consistent caregivers and respite care for family caregivers.
Not sure which option is right? Book a free consultation. We’ll come to you, assess your loved one’s needs, and give you an honest view of whether home care is the right fit, with no obligation.
Request your free consultation → or call 215-354-4444 (Philadelphia), 610-375-1800 (Reading) or 717-200-1414 (Lancaster).
