How do I decide between home care and assisted living for a parent in Memphis?
Start with how many hours of help are needed and whether anyone must be awake at night: a few hours a day of help with bathing, meals and errands usually favors home care, while needs that span the day and night usually favor an ACLF.
Isolation is the other deciding factor. A parent who lives alone in Whitehaven or Arlington and no longer drives may be safe with a morning aide but alone for 20 hours a day. Assisted living bundles meals, activities and company with the care, which home care hours cannot replicate.
Which costs less in Tennessee?
Home care costs less for part-time help and more for full-time help: at Tennessee's 2025 median of about $31 an hour, home care passes the $5,595 assisted living median at roughly 42 hours a week.
Compare the full cost of staying home, including housing, food, utilities and upkeep, with the full ACLF quote. See the hour-by-hour table.
Can TennCare pay for either option?
Yes, for eligible members: TennCare CHOICES Groups 2 and 3 can pay for personal care visits at home (up to 2,580 hours a year) or for ACLF services in a participating facility, with the member paying room and board in an ACLF.
For families who do not qualify financially for TennCare, OPTIONS for Community Living offers homemaker and personal care hours on a sliding fee with no income limit, depending on funding. Call the Aging Commission of the Mid-South at (901) 222-4111.
What signs suggest home care is no longer enough?
Repeated falls, missed medications despite reminders, wandering, a caregiver who cannot keep up, or needs that arise at unpredictable hours of the night usually mean that paid hours at home are no longer the safest option.
Track incidents for a few weeks before deciding. If the incidents cluster at night, an ACLF's awake overnight staff, or a secured unit for wandering, addresses the risk directly in a way that adding daytime hours cannot.
Can someone use home care inside assisted living?
Yes. Tennessee lets ACLF residents receive services from a licensed home care organization or other licensed provider, so families sometimes add private-duty or home health visits to an ACLF stay instead of moving to a nursing home.
Check the admission agreement for rules about outside caregivers and who coordinates with facility staff.
At a glance
| Home care | Assisted living (ACLF) | |
|---|---|---|
| Best for | Part-day help, strong family support, a safe house | All-day needs, night-time safety, isolation |
| Cost driver | Hours per week (about $31/hour median) | Monthly rate plus care level (about $5,595 median) |
| Licensing | Home health agencies are HFC-licensed | HFC ACLF license |
| TennCare | CHOICES personal care visits | CHOICES ACLF services; room and board extra |
Sources include Tenn. Comp. R. & Regs. chapters 0720-26, 0720-21 and 0720-18, Health Facilities Commission and TennCare pages, CareScout and VA rate tables as cited above; see our editorial standards.
