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Life is transition.

Some changes unfold slowly, spanning years or even decades. Other transitions quickly pivot, forcing us into new circumstances that can be profoundly scary and stressful.

One turn that can be swift or slow is when our health declines, either from serious illness or because our bodies wear down from the many years of living. We all know this is a part of being human, but it can still be difficult to accept and manage.

On the other side of this transition, new forms of care wait for us. And these days, care services come with many different options and variables which can be confusing and overwhelming.

This article clarifies two forms of care that are frequently confusing to people: one is Hospice and the other is Assisted Living,


First, let’s talk about hospice. This form of care is for people at any age who face a life shortening illness. The expectation is to live up to another six months. The focus of hospice care is mostly to provide high quality relief for pain, compassionate nurturing for emotional needs and giving authoritative support for spiritual matters.  Hospice care helps people finish their lives with comfort and dignity.

Hospice care is often provided at the person’s home and is also available at long-term care facilities like hospitals, nursing homes and even dedicated hospice centers.

The fees for hospice can be covered in full or partly by private insurance plans, Medicaid and/or Medicare.

Hospice care uses a team-oriented approach to deliver the best expertise for the different areas of need: medical, emotional, and spiritual. The team might include doctors, nurses, therapists, counselors and clergy who are available around the clock, seven days a week, so professional help is always there when needed.

A family member will usually be the point person on that hospice team and all decisions funnel through that family leader to support their loved one. Family caregivers also receive support and coaching on how to care for their loved one (and themselves) because that role can be tremendously draining and often overwhelming.

A specific list of hospice care services include:

  • Relief of pain and discomfort from illness symptoms
  • Support for feelings around dying
  • Quality council on spiritual beliefs about life and the afterlife
  • Help with medication dosing and schedules
  • Nurse services
  • Support and information for family in their caring tasks and transition
  • Therapy for movement, speech, memory and more
  • If at home, help with easy access to advanced care facilities as needed

Assisted Living

Assisted living shares many of the same bundle of services as hospice, but is designed for fairly healthy elders whose independence is in decline. This is for when we need a hand with certain life tasks that have become difficult to manage on our own. The broad service categories for assisted living may include help with meals, hygiene, medicine, transportation and socializing.

Like hospice care, assisted living can be provided in the home or at dedicated facilities where residents can live alone or with up to hundreds of peers in a community.

The costs for assisted living care are also much lower than hospice, due to the need for different levels of medical support.

The options to pay for assisted care might be a bit more limited, so families sometimes cover the costs by cashing out family savings, investments, and real estate sales. But Medicaid often pays some expenses, as will some state-run programs, and certain life insurance plans. Also, veterans benefits are often great for helping to manage these costs.

A list of specific assisted living assistance might include:

  • Preparing meals
  • Giving correct medications
  • Hygiene tasks
  • Getting dressed
  • Moving around the home
  • Transportation outside the home
  • Running errands
  • Making appointments
  • Physical exercises
  • Social activities
  • Housekeeping & laundry
  • Memory loss care
  • Professional security
  • Emergency call system
  • Pet care

Here is a chart to easily compare the two forms of care a glance:

Assisted Living Hospice
Health Status fairly healthy elder terminally ill
Help with Hygiene yes yes
Support with Getting Dressed yes yes
Preparing Meals yes yes
Mobility Help (In and Out of Home) yes yes
Social Activities yes few
Housekeeping likely no
Advanced Medical Care no yes
Physical and/or Memory Therapy extra yes
Pets Allowed likely varies
Average Ratio of Caregiver to Residents 15 to 1 5 to 1
Cost at Facility – National Monthly Average 2018 $2000 – $5000 $7000 – $7700
Cost at Home – National Monthly Average 2018 $4000 – $7000 $4500 – $25,000

In conclusion, one simple way to think about the differences between hospice and assisted living is that hospice service is mostly for comfort in the final transition, while assisted living is the care needed when there's a few more transitions on the road ahead.

Here’s to you and your loved ones getting the absolute best care possible, wherever they are on their journey.

Reviewed By

Scott Witt

Elder Home Care Expert

Scott founded Select Home Care Portland in 2009 and has been helping seniors live their best life at home or in their local senior community ever since. As an advocate for seniors, the primary philosophy has been to listen, educate and provide… Learn More About Scott Witt

Written By

Jeff Hoyt

Editor in Chief

Since graduating from Harvard with an honors degree in Statistics, Jeff has been creating content in print, online, and on television. Much of his work has been dedicated to informing seniors on how to live better lives. As Editor-in-Chief of the personal… Learn More About Jeff Hoyt

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