The draw of in-home care, for elderly people who need assistance, is fairly clear: Staying in the house gives them comfort and stability that they just do not get if they move into an assisted living center. People often have no desire to leave the house, especially if they have spent decades living there.
However, the cost is very high. Some estimates put it at about $19 per hour. That may not be much for an hour or two of assistance a day, but people often need care around the clock. That can run it all the way up to around $170,000 annually. Suddenly, it moves beyond affordable for many people.
Why does it cost this much? Basically, someone who needs care 24 hours a day really needs the type of care that an assisted living center can offer, but choosing in-home care means trying to recreate that experience for one individual. In a center, things like group meals and entertainment are set up to reduce costs, and the center has numerous residents who are all paying monthly bills. At home, costs are always high and one person has to cover all of them.
On top of that, many people cannot use their insurance to pay for in-home assistance when it is needed on a long-term basis. They may be able to use insurance and other benefit options to cover costs in an assisted living center.
This is not to say that in-home care is the wrong choice. It can be great for the right individual, giving them everything they want. I've worked with people who used it and preferred it to the assisted living center experience. It's just expensive, so it is something that people need to plan for in advance.