El Paso Senior AdvisorWhen is home care a better fit than assisted living in El Paso?
Home care fits when needs are predictable and fit into scheduled hours, the home is safe or can be made safe, family can cover nights and weekends, and the person strongly wants to stay; El Paso's many licensed agencies and adult day centers make that common here.
El Paso County has 108 agencies licensed for personal assistance services alone, more than the number of assisted living and nursing facilities combined. Many El Paso families combine a weekday adult day center with evening attendant care and family support, a pattern much less common in other Texas metros.
When is assisted living the better choice?
Assisted living is usually better when help is needed unpredictably around the clock, nights are unsafe, the person is isolated, or family caregivers are exhausted; at the Texas medians, paid home care costs more than assisted living beyond about 44 hours a week.
| Paid home care hours per week | Monthly cost at $30/hour | Compared with the $5,666 assisted living median |
|---|---|---|
| 8 | $1,040 | below |
| 16 | $2,080 | below |
| 24 | $3,120 | below |
| 32 | $4,160 | below |
| 40 | $5,200 | below |
| 44 | $5,720 | above |
| 56 | $7,280 | above |
| 84 | $10,920 | above |
| 168 | $21,840 | above |
Can Medicaid pay for care at home in El Paso?
Yes. STAR+PLUS HCBS, Community Attendant Services and Primary Home Care can pay licensed agencies for attendant hours for eligible people, and PACE covers home care for its members.
Medicare pays only for intermittent skilled home health, not hourly care. VA pension with Aid and Attendance can help pay either.
How do we make home care safe in El Paso?
Start with a home safety check for falls, a medication system, an emergency response button, a plan for heat and power outages, and backup coverage when a caregiver cannot come.
El Paso summers make cooling a safety issue; check that air conditioning or evaporative cooling works and that someone checks in during heat waves.
How do we decide between the two?
List the hardest hours of the day and who covers them, add up the paid hours needed, compare that cost with written assisted living quotes, and ask the person what matters most to them.
Revisit the decision every few months; needs change. An advisor can help compare options at no cost.
Side by side
| Home care | Assisted living | |
|---|---|---|
| Setting | The person's own home | A licensed facility |
| Hours | Scheduled hours | Staff on site around the clock |
| Cost | Cheaper below about 44 hours a week | More predictable at high need |
| Programs | STAR+PLUS, CAS, PHC, PACE | STAR+PLUS care services only |
Sources: Texas Health and Safety Code chapters 142, 242 and 247; 26 Texas Administrative Code chapters 553, 554, 558 and 559; HHSC program handbooks; CareScout, CMS and VA rate tables, as cited above. See our editorial standards.
