Group Home vs. Assisted Living: What’s the Difference?


Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

The term group home may have a familiar ring to it. The original development of group homes responded to the psychiatric deinstitutionalization movement of the 1960s and 1970s. As psychiatric hospitals closed, individuals needed places to live.

Group homes provided care in the least restrictive environment. The purpose of group homes was to integrate people with disabilities into the community. This type of group home still exists today through state and federal programs.

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Today, group homes have transitioned to other types of care to accommodate the growing need and desire for seniors to have alternatives to traditional assisted living. Suppose you think there are no group homes in your area. In that case, that might be because you don’t recognize them under these names: adult family homes, board and care, residential adult homes, residential assisted living, and residential care homes. 

Overview: Group Homes vs. Assisted Living

Group homes have much in common with assisted living but major differences, as well. Group homes are commonly licensed as assisted living, but this type of home tends more often to operate without a license since it’s easier to avoid detection. Many group homes operate in someone’s place of residence and can escape notice.

On the other hand, assisted living communities are typically much larger, and most operate under a corporate structure. The profit nature of the majority of assisted living companies ensures that they have proper licensing. 

We recommend exploring only group homes that are appropriately licensed so there is some degree of oversight and accountability. The concept of shared housing is growing in popularity, and in some cases, two or three older adults decide to share a home. Unless the owner provides some level of organized care, these homes are not required to be licensed. 

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Group Homes vs. Assisted Living: Who Are They For?

If you walk into any group home and then visit a large assisted living, you’ll instantly recognize the difference. Most people have a clear preference, but you never know what the experience will be like until you move and have time to adjust.

Group homes

Group homes are for all of the following: 

  • People who need some level of assistance and are ready to give up regular household chores and maintenance. 
  • People who prefer a more intimate, home-like environment. Most group homes have anywhere from 5-20 residents depending on state regulations. 
  • People who don’t feel comfortable in the large and sometimes impersonal and institutional atmosphere of assisted living. Group homes facilitate social interaction due to the lower number of residents.
  • People who are comfortable with close contact with other residents. Some group homes have shared rooms.
  • Cost-sensitive people. Group homes are generally less expensive than assisted living.
  • People who don’t mind giving up some of the amenities offered by assisted living communities.
  • People who don’t mind not having a separate apartment. They will usually have a bedroom and use a shared living space. 

Assisted living

Assisted living, on the other hand, is geared more toward the following: 

  • People who need varying degrees of assistance and assistance that can be flexible.
  • People who have the financial resources to pay for increasing levels of care.
  • People who enjoy amenities such as diverse activities, such as trips to cultural events, movie theaters, 
  • People who prefer to pick and choose when they socialize and like having the privacy of their own apartment. 
  • People who require some level of nursing care and on-site medical services.

Group Homes vs. Assisted Living: Type of Care Received

Group homes and assisted living can offer the same types of care, but group homes will vary significantly in what they offer. When deciding on a specific group home, keep in mind that your loved one may not always stay at the same level of care. If more care is needed, you might have to pay privately in addition to the group home cost. 

Not every group home will provide all of the services we list. Some group homes operate more closely to independent senior living than assisted living, so check what is offered. 

Group homes

Group homes may provide the following: 

  • All meals and snacks
  • Assistance with bathing, dressing, eating, toileting, and medication management
  • Group activities
  • Housekeeping
  • Laundry
  • Transportation to medical appointments
  • Allowance of pets in some cases
  • A staff person on-site 24/7
  • Medication management (in some homes) 
  • Nursing availability but usually not 24/7
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Assisted living

An assisted living community may offer the following: 

  • All meals and snacks
  • Significant assistance with activities of daily living, including dressing, bathing, toileting, eating, transferring, and ambulation
  • Extensive activities, with some communities having pools, theaters, and classes
  • Transportation to medical appointments
  • On-site physicians in some communities
  • Medication management and dispensing
  • Pets of a certain weight usually permitted
  • Emergency response system for each resident

Group Homes vs. Assisted Living: Costs and Paying for Care

Paying for care for either group homes or assisted living can stress the financial resources of families. Unless you qualify for state and federal programs (which require low income and few assets), group homes and assisted living will be private-pay.

Long-term care insurance covers a daily rate in assisted living, but you’ll need to check your policy to see if it covers a group home. The other benefit that can help pay for a group home is the VA Aid and Attendance program, which can provide a monthly cash benefit to offset the cost. 

We do have good data on the median cost of assisted living throughout the country through Genworth Financial. The median monthly cost of assisted living is $4,300, but that cost could be lower or much higher depending on where you live. Paying for care can put pressure on families if they don’t have the resources. Most sell the primary residence and use retirement funds or savings to pay for assisted living. 

There isn’t good data on the cost of group homes, but it is generally accepted that they cost less than assisted living. The lower overhead, limited amenities, and less staff keep costs lower. 

Group Homes vs. Assisted Living: Admissions Process

The admissions process for assisted living is more stringent than a group home, depending on the level of care that the group home provides. An assisted living community will want to ensure that it is the appropriate placement for your loved one and can provide the care necessary to keep someone safe.

Group homes 

Since group homes vary so much in terms of their services, the admissions process will differ depending on the home. Of primary concern is that the group home can care for your loved one’s medical and other needs. The owner or manager of the group home will meet with any prospective resident, then assess and develop a care plan.

If they feel that their home is not appropriate, they may recommend assisted living. If a person has significant cognitive impairment with wandering behavior, they may not be suitable for a group home. However, if memory problems don’t present a safety issue, a group home could be acceptable.

Assisted living

Most assisted living communities have standard protocols for care and have larger staff with more care than group homes. A nurse typically completes the admission with the resident. The process involves a history and physical, an assessment of daily needs, medications, dietary or eating requirements, and evaluation of cognition.

Although there are many residents in assisted living with cognitive impairment, they may be referred to memory care if someone has significant memory, judgment, and wandering problems. Also, if a prospective resident has complex medical needs beyond the scope of assisted living, they may recommend nursing home care. 

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Group Homes vs. Assisted Living: Finding Care

Finding care through a group home or assisted living will take a diligent effort. Group homes, in particular, may not be plentiful in your area, so your choices could be limited. 

Group homes

Here are the steps for finding a group home in your area: 

  • Do a search using the other terms for group home: residential care, board and care, adult residential care, residential assisted living, or adult family home. 
  • Ask a senior care specialist for recommendations. Most senior care specialists work with larger assisted living communities, but they may know of group home options.
  • Call your local area agency on aging. Their outreach specialists can usually direct you to group homes.
  • Ask friends and other healthcare professionals.

Assisted living

Finding assisted living options should be no problem. The more significant challenge might be narrowing down your choices. Here are the steps you’ll want to follow:

  • Make a list of your priorities such as location, size, amenities, meals, and cost. Ask about cost increases.
  • Work with a local senior care placement specialist. Check before working with them to make sure they have contracts with every assisted living community. If they only have agreements with a few, they are more likely to steer you towards those communities.
  • Do an online search to get reviews.
  • Call the Ombudsman program. They are the agency responsible for handling complaints about assisted living.
  • Ask your friends and healthcare providers.
  • Always visit any community under consideration.

Group Home vs. Assisted Living

It seems as though every day, there are new options for seniors looking for residential care. Having choices is good, but make sure you thoroughly vet any residential opportunity. Group homes are likely to increase, and assisted living is here to stay. Take time to discuss priorities and options with your loved one before making your decision. 

  1. “Calculate the Cost of Care in Your Area.” Genworth Financial.
  2. “VA Aid and Attendance Benefits and Household Allowance.” US Department of Veterans Affairs.
  3. Abrahms, Sally.“Group Homes an Alternative for Seniors Who Can’t Age in Place.” AARP. 12, February 2020.

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