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In-Home Care vs. Assisted Living

North Carolina's 2025 CareScout medians put home care around $5,720/month for a 44-hour week versus $6,496/month for assisted living -- the crossover point that decides which one costs less.

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Short answer

NC's 2025 CareScout medians put non-medical home care around $5,720/month for a typical 44-hour week, versus $6,496/month for assisted living. Home care usually wins at low weekly hours; a community usually wins once care needs pass roughly 40-50 hours a week.

When home usually wins

A few hours a day, medication reminders, help with errands and light housekeeping -- home care lets someone stay in a familiar house for meaningfully less than a community's flat monthly rate.

When a community usually wins

Once overnight supervision or near-continuous care is needed, hourly home care costs compound past what a flat-rate community charges, and staffing continuity becomes harder to guarantee with a home agency than with a community's own staff.

Questions families ask

My mother is on hospice at home in Clayton — does that mean we've given up on her getting better?

No — electing hospice means her care team has shifted focus from curative treatment to comfort and quality of life, typically because a physician has certified a life expectancy of six months or less if the illness runs its normal course, but she can still receive symptom management, emotional support, and can revoke hospice at any time if her situation or family's wishes change. Hospice in the Johnston County area is typically provided by a Medicare-certified agency coordinating with her primary physician, delivering visits at home rather than requiring a move to a facility. If you're unsure whether hospice or palliative care (which can be paired with ongoing treatment) is the better fit, ask her physician to walk through both options before committing.

What Area Agency on Aging serves Wake County, and what services do they offer families in Raleigh and Cary?

Wake County is served by the Central Pines Regional Council (formerly Triangle J Council of Governments), reachable at 1-800-310-9777, which operates the region's Long-Term Care Ombudsman Program, information and referral services, and private-pay options counseling for families across Raleigh, Cary, and the rest of Wake County. The Ombudsman program specifically investigates and helps resolve complaints for residents of nursing homes, adult care homes, and family care homes. For suspected abuse or neglect of an older or disabled adult in Wake County, contact Wake County Human Services Adult Protective Services directly at 919-212-7264.

What's the main hospital system for seniors in Wake County, and who do I contact if I suspect abuse or neglect?

Wake County's senior population is primarily served by WakeMed (with campuses in Raleigh and Cary) and UNC REX Healthcare, both offering emergency, inpatient, and geriatric specialty care across the county, plus Duke Raleigh Hospital for Duke Health-affiliated care. To report suspected abuse, neglect, or exploitation of an older or disabled adult in Wake County, contact Wake County Human Services Adult Protective Services at 919-212-7264 (fax 919-212-7354) during business hours, or call 911 if someone is in immediate danger.

Is Durham County covered by the same Area Agency on Aging as Wake, and what's the main hospital system there?

Yes — Durham County is covered by the same Central Pines Regional Council (Triangle J) Area Agency on Aging as Wake County, reachable at 1-800-310-9777, which provides the regional Long-Term Care Ombudsman Program and options counseling for Durham families. Durham's dominant hospital system is Duke Health, anchored by Duke University Hospital and Duke Regional Hospital, including Duke's geriatrics and memory-care specialty programs. For suspected abuse or neglect of an older adult in Durham County, contact Durham County DSS Adult Services directly, since Adult Protective Services is administered at the county level rather than through a single statewide number.

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