Senior Living vs. Home Care: Consumer Preferences May Be Changing

Home care is often seen as senior housing’s biggest competitor, as surveys routinely find a strong preference among older adults to age in place. But the tide might be slowly turning, with assisted living and continuing care retirement communities (CCRCs) becoming more attractive options.

That’s according to a new paper from the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health in Baltimore. The paper, which is due to be published in an upcoming edition of academic journal The Gerontologist, examined a random sample of 1,783 adults age 65 or older who participated in the 2012 National Health and Aging Trends Study.

Those participants were asked about the best care option for someone else who is 80 years of age or older and who needs help with personal care and mobility. The results showed that equal proportions (roughly 3 in 10) of older adults saw assisted living or continuing care retirement communities (CCRC)s, care at own home with family help, and care at home with paid help as the best options for aging. Less than 10% identified a nursing home or living with an adult child as the best choice for an older adult.


How participants answered also depended on their own care setting. For example, older adults who reside in an assisted living or CCRC setting were significantly more likely to choose that option as the best care setting, according to the paper.

In general, while the research still shows aging at home is seen as the most preferred care option by older adults, it also suggests that their care preferences are evolving, according to Dr. Judith Kasper, one of the paper’s authors.

“As we have seen for many years, there’s still a strong preference for aging in place and being in your home,” Kasper told Senior Housing News. “What is new here is that about a third of people also endorsed the idea of assisted living-CCRC kind of environments. I think that’s a new development in terms of people’s preferences, and awareness in this option.”


There is evidence to suggest more older adults view senior living as a preferred care option today than they did in previous years.

For example, a 2008 paper examined data regarding older women living with disabilities in the Baltimore area in the 1990s. This paper showed that only about 10% saw assisted living and CCRCs as the preferred option for senior care. That paper was authored by Kasper, along with colleagues Dr. Jennifer Wolff and Dr. Andrew Shore.

“To now have 2012 data that suggests that about one in three older people see that as an option is a signal,” Kasper said. “Those are the kinds of things I would point to that suggest views are changing.”

Interest has grown in recent years for non-institutional care options, such as home and community-based services and assisted living and CCRCs, according to the latest Gerontologist paper.

On the senior living side, it’s not completely clear why more older adults might now see that setting as more preferred for older adults. It could be that there’s simply more consumer awareness in senior living now than there was in past decades. And many senior living communities offer a wider range of activities and more high-end amenities than they may have 20 years ago.

At the end of the day, however, only one in three older adults receiving care are in arrangements that match their preferences, the paper found. This suggests there is some difficulty aligning care preferences and older adults’ ultimate care arrangements, and that a more flexible kind of senior living community may be the key to finding a match.

“Clearly, there’s some interest in environments that will let people be in the right kind of setting depending on their needs,” Kasper said. “CCRCs that have independent living and then also have other kinds of more intensive support I think will continue to be an option that a lot of people will see as viable.”

Written by Tim Regan

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