I’m 83: What Are the Alternatives to a Nursing Home If I Can’t Live Alone?
At 83, needing help with daily life doesn’t automatically mean you need a nursing home. The right choice depends on how much assistance you need, whether you need 24-hour supervision, your finances, and how safely you can remain in the community.
1. 🏠 Stay at home with support
You may be able to remain in your own home with a combination of:
- A home-care aide for bathing, dressing and meals
- Family, friends or a paid caregiver
- Home-delivered meals
- Transportation services
- Medication assistance
- Housekeeping
- A medical-alert/emergency-response system
- Grab bars, improved lighting, a walk-in shower and other home modifications
A combination of services can sometimes provide considerably more support than relying on one caregiver.
2. 🏢 Assisted living
Assisted living can be a good middle ground if you can’t safely manage everything yourself but don’t require 24-hour nursing care. Typically, you have your own apartment or room while receiving help with things such as bathing, dressing, meals, medications and transportation.
3. ☀️ Adult day care or adult day health
You can live at home while spending part of the day at a supervised center. This can provide meals, activities, social interaction and, in some programs, health services—while giving family caregivers time to work or rest.
4. 🏘️ Board-and-care or residential care homes
These are smaller residential settings that can provide assistance with everyday activities. They may feel more home-like than a large facility, although the services and regulations vary considerably by state.
5. 🩺 PACE
If you’re in the U.S., ask whether Program of All-Inclusive Care for the Elderly (PACE) operates in your area. PACE coordinates medical, social and long-term-care services for eligible older adults who meet nursing-home-level criteria but can remain safely in the community. Availability varies by location.
6. 👨👩👧 Living with family
Moving into an adult child’s or other relative’s home—or having a relative move in with you—can work when combined with professional caregiving and appropriate modifications.
Which option might fit?
| If you need… | Options to investigate |
|---|---|
| Occasional help | Home-care services |
| Help with bathing, dressing, meals | Home care or assisted living |
| Supervision during the daytime | Adult day services |
| Significant daily assistance but not 24-hour nursing | Assisted living/residential care |
| Nursing care and continuous supervision | Nursing home or specialized care |
| Nursing-home-level needs but desire to remain in the community | PACE, where available |
💰 Don’t assume you have to pay for everything yourself
In the U.S., Medicaid may cover certain home- and community-based services, depending on your state and eligibility. Medicare generally doesn’t function as comprehensive long-term-care insurance, so it’s important to investigate state and local programs.
The Eldercare Locator can connect you with your local Area Agency on Aging and services such as home care, meals, transportation and caregiver support.
Find local aging services through Eldercare Locator
❤️ A good first step
Before deciding where to live, ask a doctor, occupational therapist, social worker or aging-services professional to help assess what you actually need help with—bathing, cooking, medications, mobility, toileting, nighttime supervision, memory, etc.
That assessment can reveal that you need more support, not necessarily a nursing home. Person-centered planning is specifically designed to match an older adult’s preferences and needs with appropriate community services.
