Home vs. a Facility: What the Research Actually Shows
When families start thinking about care for an aging parent, one of the biggest questions comes up quickly: should they stay home, or would a facility be better?
It's an emotional question — and an important one. Here's what the research actually shows.
Most Older Adults Want to Stay Home
According to AARP's Home and Community Preferences Survey (2021), 77% of adults age 50 and older want to remain in their own home and community as they age. That's not a small majority. It's a near-universal preference.
But wanting to stay home and being able to stay home safely are two different things — and that gap is exactly where in-home care becomes relevant.
What Happens to Wellbeing in a Facility?
The data here is consistent across decades of research.
The Health and Retirement Study — one of the largest longitudinal studies of aging in the U.S., run by the University of Michigan and funded by the National Institute on Aging — has repeatedly found that community-dwelling older adults report higher levels of wellbeing and autonomy than institutionalized counterparts, even when controlling for health status.
Depression rates in nursing homes, measured through the Centers for Medicare & Medicaid Services Minimum Data Set — which assesses every nursing home resident in the U.S. — range from 25% to over 50%, depending on the measure used. Research published in The Gerontologist identified loss of autonomy and social isolation as significant independent predictors of depression in facility settings, separate from underlying health conditions.
This doesn't mean facilities are wrong for everyone. For people with serious, complex medical needs, skilled nursing care is often necessary and appropriate. But for older adults who are reasonably healthy and primarily need help with daily activities — the research strongly favors home-based support.
What About Assisted Living?
Assisted living was designed to feel less institutional than nursing homes and preserve more autonomy. In many cases it succeeds. But research from the Collaborative Studies of Long-Term Care (CS-LTC) at the University of North Carolina found that outcomes varied significantly depending on the size and culture of the facility — with smaller, more homelike settings consistently outperforming larger institutional ones on quality of life measures.
The pattern holds: the closer the environment is to home, the better people tend to do.
The PACE Evidence
The Program of All-Inclusive Care for the Elderly (PACE) — a federal program designed specifically to help frail older adults remain at home — has been extensively evaluated by CMS and independent researchers. Findings consistently show that PACE participants had fewer nursing home admissions, comparable or better functional outcomes, and higher satisfaction than similar populations in nursing facilities.
In other words: with the right support in place, staying home is not just a preference — it's often the better outcome.
What "The Right Support" Looks Like
For older adults who don't require intensive medical care, in-home support typically includes:
- Companion care — regular visits, conversation, and social connection
- Homemaker services — meal prep, housekeeping, errands
None of these require medical training. They require consistency, reliability, and genuine care — which is exactly what GSA Home Care provides.
The Bottom Line
If your loved one is reasonably healthy and wants to stay home, the evidence supports making that possible. A facility isn't inevitable. With the right in-home care in place, staying home is often the safer, healthier, and happier choice.
Sources: AARP Home and Community Preferences Survey, 2021; University of Michigan / NIA Health and Retirement Study (ongoing); CMS Minimum Data Set; Zimmerman et al., The Gerontologist, 2003; CMS PACE Program evaluations.
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