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Penda Senior Home Care

Choosing care

Home care or assisted living: how to decide

Most agencies will tell you home care is always better, and most communities will tell you the opposite. Mildred Kiminyei, the registered nurse who owns Penda Senior Home Care, also runs Penda Homes Assisted Living, two licensed residential care homes for the elderly in Menifee. So here’s the comparison from someone who does both.

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By Mildred Kiminyei, RN · Published

Licensing and caregiver screening

  • Licensed Home Care OrganizationCDSS license #374700397

  • Caregivers on the state registryLive Scan fingerprint check (CA DOJ and FBI) and TB test

  • Owned by a registered nurseMildred Kiminyei, RN

The basic difference

Home care
A caregiver comes to your parent’s home for a set number of hours. They help with bathing, dressing, meals, and getting around, and keep them company. You pay for the hours you book, and your parent stays in their own home.
Assisted living
Your parent moves into a licensed residence where staff are on site around the clock. In California these are licensed as Residential Care Facilities for the Elderly, and range from large communities to six-bed homes, often called board and care. You pay a monthly rate that includes room, meals, and care.

What each costs, and where the math flips

Assisted living had a national median cost of $70,800 a year in 2024, about $5,900 a month, according to the Genworth and CareScout Cost of Care Survey. Prices in San Diego vary widely, and most places add care fees on top of the base rate as needs grow, so get written quotes.

Home care is billed by the hour, at $40 to $48 an hour with us. Twenty hours a week comes to about $3,440 to $4,128 a month. Round-the-clock shift care comes to about $29,200 to $35,040 a month.

The rule of thumb

At our rates, the national assisted living median buys about 29 to 34 hours of home care a week. Below that, home care usually costs less. Well above it, and especially with care needed at night, assisted living usually costs less.

Remember the costs that don’t change at home: the mortgage or rent, utilities, food, and upkeep. Assisted living includes those in its rate.

When home care is the better fit

  • Help is needed for part of the day. Mornings to get washed and dressed, or a few afternoons a week, is where home care makes the most sense.
  • Your parent sleeps through the night, or a spouse or family member is there at night.
  • The home works. A bedroom and bathroom on the main floor, or changes like grab bars and a shower chair, make a big difference.
  • Your parent is set on staying. Someone who is strongly against moving often does better at home with help than in a place they didn’t choose.
  • Recovery is short-term. After a hospital stay or surgery, a few weeks of help at home is usually all that’s needed.

When assisted living is the better fit

  • Care is needed around the clock, including at night. Paying for every hour at home gets expensive quickly.
  • Loneliness is the main problem. A caregiver for a few hours helps, but some people need people around all day.
  • Dementia is causing wandering or unsafe nights. A secured residence with staff awake at night can be safer than a house.
  • The house no longer works: stairs, a bathroom that can’t be adapted, or a long way from family.
  • The family caregiver is worn out. When a spouse or adult child is covering every hour home care doesn’t, the plan isn’t sustainable.

Signs that home isn’t working anymore

If several of these are true, it’s time to talk about a move, even if home care is already in place.

  • Falls are happening when no one is there, or more than once in a few months.
  • Your parent is awake and needs help most nights.
  • Care hours keep going up, and the family is filling the gaps.
  • Missed medicines, spoiled food, or unpaid bills keep turning up between visits.
  • Your parent seems isolated or low most of the time they’re alone.

We’ll tell you honestly if we think home care is no longer enough. That conversation is part of keeping someone safe.

It doesn’t have to be one or the other

Many families use home care first and move later. Some use home care to bridge the weeks while waiting for a room. Some keep a familiar caregiver visiting for a few hours after the move, to help with the change. The right answer can change as needs change.

Start by writing down what help your parent needs, hour by hour, across a normal day and night. That list tells you more about the right choice than any price sheet. Our free consultation can help you work it out, whichever way you go.

Common questions

Is home care cheaper than assisted living?

For a few hours a day, usually yes. At our rates, home care costs less than the national assisted living median up to about 29 to 34 hours a week. For round-the-clock care, assisted living usually costs less.

What is board and care?

Board and care homes are small assisted living residences, often six beds in a regular house, licensed in California as Residential Care Facilities for the Elderly. They usually offer more one-on-one attention than a large community.

Does Medicare pay for assisted living or home care?

No. Medicare doesn’t pay for ongoing non-medical care in either setting. Long-term care insurance, VA Aid and Attendance, and personal savings are the most common ways families pay. See our paying for care page.

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