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When Home Care Isn’t Enough: Shifting to Senior Residential Care

By U.S. News & World Report

Most seniors want to remain in their own homes for as long as possible (more than 75% of adults age 50 and older, according to a 2024 survey by AARP), and home care can often provide the extra support needed to make that happen.

As health needs change, however, there may come a point when occasional help at home no longer provides enough support. Recognizing when that shift occurs can be difficult for families, especially when changes happen gradually or loved ones live far away.

“This is often one of the most emotionally challenging decisions for families, and there’s no one-size-fits-all answer. The most important factors to consider are the level of medical care needed, safety and quality of life,” says Dr. Steve Landers, New York City-based president of Landers StratAGEy.

[Read: How to Manage Sibling Conflict Over Care of Elderly Parents]

What Are the Primary Levels of Senior Care?

The primary levels of care after home care include assisted living and nursing home care. Each step offers a higher level of support to match evolving health, safety and daily living needs.

Home care support

Home care offers flexible, non-residential support that can be adjusted over time, making it a practical option when early challenges arise but full-time supervision or medical care isn’t yet needed.

This type of care focuses on safety and help with the activities of daily living (ADLs), such as:

— Grooming

— Mobility

— Eating

— Dressing

— Toileting

Other tasks may include:

— Meal preparation

— Light housekeeping

— Medication reminders

— Transportation

— Companionship

By stepping in gradually without disrupting routines, home care can improve safety and independence while reducing stress for seniors and their families.

[READ: Understanding the Different Roles of In-Home Care Providers]

Assisted living communities

Assisted living is a residential care option designed for seniors who need support with daily tasks but do not require round-the-clock skilled medical care. These communities offer different levels of care that can be adjusted as a resident’s needs change:

— Lower levels: Residents at these levels of care require minimal support and supervision for most tasks but may need help with more complex ADLs.

— Higher levels: Moderate and advanced levels provide increased hands-on care and supervision for seniors who need more support but do not yet require a nursing home-level of care. This advanced level of care includes help with ADLs, more involved medication management, 24/7 staff availability and enhanced safety oversight.

— Memory care: Some assisted living communities offer dementia care, including structured routines and staff trained to work with people living with Alzheimer’s disease and dementia in a residential, nonclinical environment.

“Choosing the appropriate assisted living community for your loved one can make such a difference for their mental, physical and social well-being,” says LaShuan Bethea, the executive director of the National Center for Assisted Living.

[READ: Home Care vs. Assisted Living: 2026 Costs, Pros & How to Choose]

Nursing home care

A nursing home, also called a skilled nursing facility, provides continuous medical care and supervision for people with serious health conditions or significant functional limitations. It is designed for individuals who can no longer be safely cared for at home or in assisted living.

Nursing homes provide services such as:

— IV therapy

— Wound care

— Catheter management

— Oxygen therapy

— Incontinence care

Many facilities also offer specialized dementia or behavioral care or short-term rehabilitation services, with full-time nursing oversight and coordinated medical management.

[READ: Nursing Home Requirements: Who’s Eligible?]

Signs It’s Time to Transition From Home Care

If there are noticeable differences in how your loved one is able to function day-to-day, a move from home care to a higher level of care may be in order. Typical signs include the following:

Physical health and mobility signals

— Accidental falls or other balance-related issues

— Weight loss, dehydration or poor nutrition

— Recent hospitalizations or emergency room visits

— Chronic conditions or new medical issues becoming harder to manage at home

Cognitive and behavioral changes

— Episodes of confusion, memory loss or consistent forgetfulness

— Home safety concerns, such as leaving the stove on or doors unlocked

— Difficulty managing medications correctly

Emotional well-being and social life

— Isolation, depression or withdrawal from social activities

— Changes in personal hygiene or appearance

Household and daily management

— Neglected household tasks, such as laundry, cleaning or home maintenance

— Struggling with ADLs

Your loved one’s day-to-day caregivers can be a valuable resource when making this decision, as they can offer firsthand insight into current health needs and whether it’s becoming harder for your loved one to live safely at home.

“Care providers can spend meaningful time with patients and really get to know them. They see how patients live, from what’s in their refrigerator to whether there are trip hazards or how they manage their daily routines,” Landers says.

Understanding the Financial Costs of Senior Care

While caring for a loved one at home may be the most affordable option at first, increasing health needs and care demands can make it less cost-effective over time.

Keep in mind: Medicare

does not pay for long-term care. Medicaid, however, does cover long-term care and currently pays for 63% of nursing home residents, which accounts for over one-third of overall Medicaid spending, according to KFF.

There are other ways to pay for senior living facilities, such as:

— Life insurance policies

— Long-term care insurance

— Savings and investments

— Veterans benefits

While your budget is a critical part of the senior care decision-making process, knowing your loved one is receiving the care and support they need not only adds to their quality of life and longevity, but it can bring peace of mind to families as well.

More from U.S. News

Assisted Living Levels of Care: A 2026 Guide to Categories and Costs

CCRCs vs. Assisted Living: 5 Key Differences to Help You Choose

What Is a Long-Term Care Facility? Types and Costs

When Home Care Isn’t Enough: Shifting to Senior Residential Care originally appeared on usnews.com

Update 05/29/26: This story was previously published at an earlier date and has been updated with new information.

As Chicago rethinks its monuments, an artist surrounds George Washington with ‘Other Washingtons’

By CNN
Chicago (CNN) — In Chicago, a lone statue of George Washington is now surrounded by “Other Washingtons,” which take the form of blue flags bearing the faces of Black Americans who bear the same last name. They include a range of notable figures and local heroes, such as the inventor George Washington Carver, Academy Award-winner Denzel Washington, architect Roberta Washington, and South Side school band leader Benjamin Washington.Who is worthy of a monument? That question circulated across the United States six years ago as the country reckoned with racial injustice in the aftermath of the killing of George Floyd, including who is represented by, or excluded from, our public symbols. Statues of controversial figures were vandalized and taken down, with more than 160 Confederate works removed from public spaces in 2020.Chicago has offered its own answer: to commission new monuments or respond to existing ones, based on internal research that found the city had gaps in representation of gender and race. This year, its Department of Cultural Affairs and Special Events (DCASE) is unveiling a spate of new artist commissions, called the Chicago Monuments Project.“Other Washingtons,” which opened on Thursday in Washington Park, on the city’s South Side, was conceptualized by artist and architect Amanda Williams and is the second so far to be completed. It asks community members to think of the Washingtons that matter to them, with flags and accompanying banners telling their stories and that will rotate out annually for three years.The project is meant to represent “a living archive,” said Kenya K. Merritt, a commissioner from DCASE, in a statement. It “can continue to grow, reflect community memory, and make space for stories that are less widely known.”The design is modeled after the flags that surround the Washington Monument in the nation’s capital, and the colors Williams chose — blue, cream, chocolate and salmon — reference a color palette developed by George Washington Carver, that the artist has explored as part of a larger body of work on the scientist.Depicting Washington on horseback during the Revolutionary War, the original monument has been there since 1904, and is actually a replica of one gifted to France. For a long time, the statue was fenced in after it was vandalized in June 2020. Monuments to Washington and other Founding Fathers were targeted by anti-racist protestors. Washington himself had hundreds of slaves at his home and plantation in Virginia. With the statue in Chicago located in a predominately Black neighborhood, Williams believes it doesn’t fully represent the community in which it resides.“How do you make the site relevant again?” That was the question on her mind when she received the commission, she explained in an interview at the opening event. “What does it mean to not touch him, but to make something that will maybe obscure him?”A monument to manyWilliams’ idea began to take shape with census research, finding that Washington has long been one of the top surnames almost entirely associated with Black Americans. In the 2000s, it reached the top spot, with around 90% of Washingtons identifying as African American. (In the 2020 census, the surname was outranked only by Pierre, though Washington is a much more common name.)It became clear to her then that she could monumentalize many Washingtons who might be more meaningful to passersby, from musicians and athletes to politicians and local heroes. In collaboration with the educator and nearby Englewood resident Candice Washington, who is curating the project, they launched a website to ask for collective input.“It allows the community to really take ownership,” Williams said. “They need to know these are their stories.”“Other Washingtons” is one of eight commissions planned across the city as part of the Chicago Monuments Project, which has received $6.8 million from the Mellon Foundation. Last month, markers around the city were completed to commemorate the victims of the Chicago Race Riot of 1919. Other commissions include a monument to honor Native voices, a sculpture of gospel singer and Civil Rights activist Mahalia Jackson, and a site to recognize the survivors who were tortured by the Chicago Police Department during the 1970s-1990s.But the initiative is bearing the fruits of its labor during President Trump’s second term, when the federal government, in contrast, has doubled down on honoring figures traditionally exalted in US history and is funding such monuments at a breakneck pace. The White House has announced a location for its long-planned National Garden of American Heroes, added sculptures of the Founding Fathers to a newly paved Rose Garden, regilded existing mythological statues by Leo Friedlander, and is pursuing a 250-foot-tall triumphal arch that would dwarf the Lincoln Memorial.Chicago mayor Brandon Johnson, who spoke at the opening of “Other Washingtons,” hopes that the city can set an example through the Chicago Monuments Project.“Through this initiative, Chicago sets a national model for how cities can invest in public art to preserve history, strengthen communities, and inspire real dialogue,” said Mayor Brandon Johnson in his public remarks. “‘Other Washingtons’ expands our understanding of our history and honors the many Washingtons who contribute and have shaped this city, and that will continue to inspire future generations.”At the event, some of those honored and their families were present. The local band leader Benjamin Washington was there, who Williams had not yet met. She ran up to introduce herself and shake his hand before speaking at the podium. After the remarks, different Washingtons smiled and took photos beneath their banners, wearing stickers that said “I’m a Washington.”“My name is Sonya Washington,” one woman said, pointing up to a banner as she introduced herself. “You can find me up there.”The-CNN-Wire™ & © 2026 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.
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