The question that actually sorts it

Not the diagnosis. What somebody needs help doing, and whether anybody needs to be awake at night.

  • If they manage alone and just want company and no chores, that is independent living, and it is not care.
  • If they need a few hours of help a day and family are nearby, help at home is often right and usually cheaper.
  • If they are not safe alone, need hands-on help with washing, dressing or the bathroom, and need somebody there overnight, that is assisted living. It is what we do.
  • If memory loss means they wander, or need a secured setting and specialist programming, that is memory care.
  • If they need a licensed nurse on site around the clock, are medically complex, or are permanently confined to bed, that is skilled nursing.
Round-the-clock supervision takes three shifts. That is usually what decides it.

Families rarely move somebody because of a diagnosis. They move because the nights stopped being safe, or because one person was doing the work of three.

The four options side by side

The rows that matter most are the overnight one and the Medicare one, because those are where families are most often surprised.

Swipe the table sideways to see every column →
Comparison of home care, assisted living, memory care and skilled nursing
Option Who it suits Someone awake overnight Licensed nurse on site Typical monthly cost Medicare pays
Help at homePaid caregiver in their own house A few hours of help a day, with family nearby Only if you pay for every hour No ~$5,720 at 44 hrs/week~$21,800 for round the clock NoLimited skilled home health only
Assisted livingA small residential care home. This is us Not safe alone, needs hands-on daily help Yes, awake and on duty at Daraan Not around the clock $4,900 – $6,500Our published all-in rates No
Memory careA secured specialist setting Wandering, or needing a secured specialist setting Yes Varies by provider Usually more than assisted living No
Skilled nursingA nursing home Medically complex, or permanently bedfast Yes Yes, 24 hours Usually the most expensive SometimesShort-term rehab after a qualifying hospital stay

Where these figures come from. The home-care rate is the Texas median for a home health aide at roughly 44 hours a week, from the CareScout Cost of Care Survey, 2025; the round-the-clock figure applies that same published hourly rate to a full week and is arithmetic rather than a quote. Our own rates are the ones published on the pricing page. We have deliberately not invented dollar figures for memory care or skilled nursing, because they vary too much locally to state honestly. Get a written quote from any provider you are considering, and compare the totals rather than the headline rates.

When the answer is not us

We are one option of four, and there are people we should not be looking after. Knowing that early saves a family weeks.

Round-the-clock nursing
If somebody needs a licensed nurse on site 24 hours, or is permanently confined to bed, that is skilled nursing and it is outside what we provide. This is the most common reason we say no.
Specialised memory care
We support residents living with short-term memory loss, confusion or forgetfulness. We do not provide specialised Alzheimer's care and we do not operate a memory care unit. Where needs progress past what we can safely support, we say so early and help you plan.
Medicaid as the only route
We are private pay. Texas runs a programme that can help with assisted living services, the STAR+PLUS waiver, but interest lists are long and not every home participates. We do not. Call us anyway and we will point you at providers who do.
Home is still working
Plenty of people are better off at home for now, particularly where family live nearby and the help needed is a few hours a day. It stops being the cheaper answer at the point where somebody needs a person there overnight, and that is usually when families start calling us.

Two things families get wrong

Medicare
It does not pay for assisted living room, board or ongoing personal care, anywhere. It covers short-term skilled nursing or rehabilitation after a qualifying hospital stay, plus medical services like doctor visits and home health. This is the single most common misunderstanding in senior care, and it catches people at the worst possible moment. There is more on the paying for care page.
Small homes are the lighter option
Nationally it is the other way round. Residential care homes of 4 to 25 beds look after residents with higher needs than communities of 50 or more: 51% living with dementia against 39%, and 38% needing help eating against 17%, with no difference in hospital or emergency use over 90 days. The figures and their sources are on the about page.

Still not sure? Describe the situation on the phone and we will tell you which of the four it sounds like, including when it is not us. It takes about ten minutes and costs nothing, and we would rather do that than have you tour four places in the wrong category.

Describe the situation and we will tell you.

The diagnosis, what happened last week, what the nights are like. Ten minutes on the phone will usually sort the category, which is the part families waste the most time on.

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