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In-home care vs. assisted living for dementia

In-home care vs assisted living for someone with dementia: a Florida-specific look at costs, license types and which option fits your loved one's stage.

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Updated October 12, 2026

In Florida, in-home care is usually cheaper and calmer for someone with dementia who needs fewer than about 35 hours of help a week. Assisted living, at a 2025 Florida median of about $5,610 a month, is usually better value above that, or when isolation and poor nutrition are the main problems. A standard ALF is not the right fit for someone who wanders.

Why this comparison is different from memory care

Many Florida families picture assisted living as the natural next step after home. For someone with dementia, that can be true, but it depends on which kind of assisted living facility (ALF) and which stage of dementia.

A standard ALF is built for older adults who need help with bathing, dressing and medications but can still find their way around, follow a dining schedule and stay inside without locked doors. Many people with mild dementia do well there. People who wander, become frightened in crowds or need constant cueing often don’t.

Florida’s AHCA licenses ALFs under Chapter 429 of state law. Every ALF holds a standard license, and some add a specialty license. Under s. 429.07, an extended congregate care license lets a facility provide extra nursing and support so residents can stay as they become more impaired, though even these facilities can’t keep residents who need 24-hour nursing supervision. A limited nursing services license allows certain nursing tasks beyond the standard license. A limited mental health license covers facilities that serve residents receiving mental health services.

Residents sharing a meal in a dining room, the assisted living side of in-home care vs assisted living — Photo: Robin Noguier / Unsplash

Side-by-side: in-home care vs. assisted living

	In-home care	Assisted living (standard ALF)
Florida cost (2025)	Non-medical home help median about $32/hr (CareScout). Dementia Companions: $35/hour for 40+ hours a week (40 hrs/week ≈ $6,070/mo); call us about shorter schedules.	Median about $5,610/mo, or $67,320/yr (CareScout). Many ALFs add fees for higher care levels and medication help.
What’s included	Help with the tasks you choose, during the hours you book. Housing, food and utilities stay as they are.	Private or shared apartment, meals, housekeeping, activities, help with daily tasks, staff on site day and night.
Staffing and consistency	One person (or a small team) who knows your loved one well.	Shared staff on shifts. Residents often see many different aides each week.
Supervision	Only during visits.	Staff on site round-the-clock, but exits are usually not secured in a standard ALF.
Florida regulation	Companion/homemaker registration or home health agency license with AHCA; Level 2 screening and dementia training for staff.	ALF license under Ch. 429; specialty licenses ECC, LNS, LMH. Staff must complete dementia training under s. 430.5025. Inspected by AHCA.
Who pays	Private pay; some long-term care insurance policies reimburse home care. Florida Medicaid LTC can fund some in-home services.	Private pay; Florida Medicaid LTC covers assisted living services for eligible residents, often with a waitlist.

Cost sources: CareScout 2025 Florida data. Monthly in-home estimates use 52 weeks a year at $35 an hour.

The break-even point

Our rate is $35/hour for 40+ hours a week; call us about shorter schedules. At 40 hours a week that comes to about $6,070 a month, already above Florida’s median assisted living cost. Part-time help at home is usually cheaper, especially if your loved one owns their home outright. Once you need full-time hours, assisted living usually costs less, because the ALF spreads overnight staff across many residents. Remember to compare the full picture: an ALF bill includes food and housing, while home costs include the mortgage or rent, insurance, utilities and repairs, hurricane preparation included.

Who each option is for

In-home care

Home suits people whose identity is tied to their house, garden, pets or neighborhood, and those who become more confused after any change of surroundings. It works best when there is a spouse or relative in the home, or when your loved one is still safe alone for stretches of the day.

Best for: mild to moderate dementia, needs under about 35 hours of help a week, and families who can cover nights.

Assisted living

A standard ALF suits someone with mild dementia who is lonely at home, follows simple routines with cueing, and doesn’t try to leave. Meals, activities and people nearby can be a real lift. For someone who wanders, look specifically at memory care instead.

Best for: early-stage dementia with isolation or nutrition problems, no wandering, and care needs above about 35 hours a week.

In-home care vs assisted living: our pick by scenario

Widowed parent, early stage, isolated and eating poorly: assisted living often wins. Daily meals and company solve the actual problem. A few companion visits a week can bridge the months while you tour and decide.
Married couple, one with dementia, the other healthy: stay home with part-time help. Moving both spouses to an ALF is an option later, but in-home respite protects the healthy spouse now. See our page for spouse caregivers.
Moderate dementia with any wandering: skip standard assisted living. Choose in-home care if nights are calm, or a secured memory care unit if they aren’t.
Recently widowed, deeply attached to the home and a pet: stay home. The disruption of a move can cost more in confusion than the help it buys.

Warning signs that home, or a standard ALF, is no longer enough

At home: unopened mail, spoiled food, missed doses, unpaid bills, new dents on the car.
At home: phone calls at odd hours, signs of scam contact, or strangers doing “repairs.” Our guide to protecting a loved one from scams can help.
In an ALF: staff calling about exit-seeking, entering other residents’ rooms, or refusing care.
In an ALF: notice that your loved one no longer meets the facility’s continued-residency criteria.
Anywhere: more falls, weight loss, or rising agitation in the late afternoon.

Questions to ask before choosing an ALF for someone with dementia

Does the facility advertise dementia care, and does it meet the s. 429.178 requirements for awake overnight staff and dementia training?
Which license does it hold: standard only, or also extended congregate care or limited nursing services?
What behaviors or care needs would require a move out, and how much notice would you get?
How are residents with memory loss guided to meals and activities each day?
You can also look up inspection history through AHCA before you sign anything.

How families combine the two

Several patterns work well in Florida. Some families hire a companion for a few afternoons a week after an ALF move, to take a parent on walks, to church or to the hairdresser, which shared ALF staff rarely have time for. Others keep a parent home through the hot summer months with more companion hours, then plan a move before hurricane season peaks so they aren’t evacuating someone with dementia on short notice. And some use in-home care to stretch savings for a year or two before an ALF becomes necessary.

Where Dementia Companions fits, and where it doesn’t

We send one consistent companion, at $35 an hour for 40+ hours a week with no contracts; call us about shorter schedules. That covers the in-home side of this comparison and works as an add-on inside an ALF where the community allows private companions. We are not a residence, and our companions don’t give medications or do nursing tasks.

Our companions don’t provide hands-on personal care such as bathing or toileting. If your loved one needs it, a licensed home health agency or aide can add it at home, and our companion can work alongside them.

Round-the-clock care at home costs more than most assisted living: live-in care starts at $375 a day (about $11,250 for 30 days). For a full budget, see our Florida cost guide or the long-term care insurance page.

Weighing home against assisted living?

Try a few weeks of companion visits while you tour. We’ll send 3-5 matched profiles within 48 hours, with no contract.

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FAQ

Frequently asked questions

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Screened for dementia care experience
Florida ADRD training before the first visit

How much does assisted living cost in Florida?

CareScout’s 2025 survey put Florida’s median at about $67,320 a year, or roughly $5,610 a month. Prices vary by region and by care level, and memory care units usually cost more.

Can someone with dementia live in a regular assisted living facility?

Often yes in the early stage, if they don’t wander and can follow routines with cueing. Facilities that advertise dementia care in Florida must meet the extra requirements in s. 429.178.

What is an ECC license in Florida?

Extended congregate care is a specialty ALF license that lets a facility provide additional nursing and support services so residents can stay as they become more impaired. It does not allow care for residents who need 24-hour nursing supervision.

Does Medicaid pay for assisted living in Florida?

Florida’s Statewide Medicaid Managed Care Long-Term Care program covers assisted living services for eligible people who need nursing-home level of care. Contact your local ADRC or the Elder Helpline at 1-800-96-ELDER about the waitlist. See Florida Medicaid.

Can we hire a companion for a parent who already lives in assisted living?

Many Florida ALFs allow private companions. It’s a common way to add one-on-one time for walks, outings and conversation. Check the facility’s policy first.

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