Getting an elderly person into a care home involves several concrete steps: assessing their care needs, choosing the right type of facility, handling the financial and legal logistics, and managing the move itself. The process can take anywhere from a few days (in an urgent hospital discharge) to several months if you’re planning ahead. Here’s how to work through it.
Assess What Level of Care They Need
Before looking at facilities, get clear on what your family member can and can’t do on their own. Professionals evaluate this through two categories of daily tasks. Basic activities of daily living cover the fundamentals: bathing, dressing, eating, using the toilet, and moving around. Instrumental activities of daily living are more complex: managing finances, paying bills, preparing meals, taking medications correctly, keeping up with housework, and arranging transportation.
Someone who struggles mainly with instrumental tasks (forgetting to pay bills, not cooking for themselves, missing medications) may do well in assisted living. Someone who needs help with basic tasks like bathing or eating, or who has serious medical conditions requiring ongoing nursing care, likely needs a skilled nursing facility. If dementia is the primary concern, memory care units offer secured environments with specialized staff. Start by honestly listing which tasks your family member can handle independently and which they can’t. This list will guide every decision that follows.
You can request a formal needs assessment through your family member’s doctor or through your local Area Agency on Aging. These assessments create a documented picture of care needs that facilities will ask about during the admissions process.
Understand the Types of Facilities
The terms “care home,” “nursing home,” and “assisted living” often get used interchangeably, but they’re quite different in what they provide and what they cost.
- Assisted living is for people who need help with daily care but not round-the-clock medical attention. Residents typically get up to three meals a day, help with personal care and medications, housekeeping, and access to social activities. Staff are on-site 24 hours, but the medical capabilities are limited compared to a nursing home.
- Skilled nursing facilities (nursing homes) provide a much higher level of medical care, including nursing staff around the clock, rehabilitation therapies like physical and occupational therapy, and management of complex health conditions. These are appropriate when someone needs daily medical oversight.
- Memory care units are specialized programs, sometimes within assisted living or nursing homes, designed specifically for people with Alzheimer’s or other forms of dementia. They feature secured entrances and staff trained in dementia care.
- Board and care homes are smaller residential settings that provide personal care and meals with around-the-clock staff, but generally don’t offer nursing or medical services on-site.
Handle the Legal Side
If your elderly family member can make their own decisions and agrees to move, the legal process is straightforward. They sign the admissions paperwork themselves. The complexity comes when they can’t or won’t make that decision.
A health care power of attorney lets someone (the “principal”) designate another person (the “agent”) to make health care decisions on their behalf if they become unable to do so. This document must be set up while the person still has the mental capacity to sign it, so acting early matters. The designated agent cannot be the person’s doctor or any of their health care providers.
If no power of attorney exists and the person can no longer make decisions, a health care surrogate can be appointed. This requires two doctors to certify that the person lacks decision-making capacity. Surrogates follow a legal priority order: a court-appointed guardian comes first, then a spouse, adult children, parents, adult siblings, adult grandchildren, or a close friend.
Capacity is assessed as a two-stage process. First, there must be an impairment or disturbance in the functioning of the brain or mind. Second, that impairment must prevent the person from understanding, retaining, or weighing the information relevant to the specific decision at hand, or from communicating a choice. Capacity is always assessed in relation to a particular decision, so someone might have capacity to choose what to eat but lack capacity to make complex housing decisions.
If your family member actively refuses care and there’s no existing power of attorney, you may need to pursue legal guardianship through the courts. This is a more involved process that typically requires an attorney.
Research and Compare Facilities
Once you know the level of care needed, start identifying specific facilities. Visit in person whenever possible, ideally more than once and at different times of day.
For skilled nursing facilities, Medicare’s Care Compare tool provides inspection results and quality ratings. Every nursing home must meet federal standards covering staffing levels, medication management, food safety, and protection from abuse. State inspection teams review clinical records, observe how staff interact with residents, and interview both residents and family members. When a facility fails to meet a standard, inspectors issue a citation. The overall health inspection score factors in the current inspection, prior inspections, complaint investigations from the past three years, and infection control inspections. Citations are weighted by how severe and widespread the issue is, and facilities that fail to fix previously identified problems receive additional penalty points.
During visits, pay attention to how staff talk to residents, whether the environment is clean and well-maintained, how the food looks and smells, and whether residents seem engaged or isolated. Ask about staff-to-resident ratios, turnover rates, and how they handle medical emergencies.
Figure Out How to Pay
Cost is often the biggest barrier. Nursing homes average over $90,000 per year for a semi-private room in many parts of the country, and assisted living costs vary widely by location and level of care.
Medicare
Medicare covers skilled nursing facility care only after a qualifying hospital stay, and only for a limited time. In 2026, you pay nothing for the first 20 days after meeting a $1,736 deductible. Days 21 through 100 cost $217 per day out of pocket. After day 100, Medicare pays nothing. This coverage is designed for short-term rehabilitation, not long-term residence.
Medicaid
Medicaid is the primary payer for long-term nursing home care for people who have limited income and assets. Eligibility for people 65 and older generally follows the income and asset rules of the SSI program, though some states apply more restrictive criteria. Many people become eligible by “spending down” their assets on care until they fall below the threshold. One critical rule: if someone transfers assets for less than fair market value (such as gifting money to family members) within five years before applying for Medicaid, their coverage for long-term care will be denied for a penalty period. This five-year lookback period is strictly enforced.
States also offer medically needy programs for people whose income is too high for standard Medicaid but who have significant health needs. These programs allow people to qualify by spending down income above the state’s threshold on medical expenses.
Veterans Benefits
Veterans who served during wartime and need help with daily activities may qualify for the Aid and Attendance pension benefit. For 2026, the maximum annual benefit is $29,093 for a veteran with no dependents and $34,488 for a veteran with at least one dependent. For two married veterans where both qualify, the maximum reaches $46,143 per year. The actual payment is calculated as the difference between the veteran’s countable income and these maximum rates.
Long-term care insurance, personal savings, and the sale of a home are other common funding sources. A financial planner who specializes in elder care can help you map out a strategy that preserves as many assets as possible while meeting eligibility requirements.
Moving From the Hospital to a Facility
If the move is happening after a hospitalization, the timeline is compressed. Hospitals have discharge planners or social workers who help coordinate the transition to a skilled nursing facility. Key things to make sure happen before discharge: all medications should have specific instructions (not vague directions like “use as directed”), the discharge summary should include accurate diagnoses and a clear care plan, and follow-up appointments should be scheduled before the person leaves the hospital.
Ask for all discharge documents to be printed and sent with the patient to the facility. If your family member is on controlled medications, make sure prescriptions are sent to the facility’s pharmacy rather than their usual outpatient pharmacy. Errors during this handoff are common, so being actively involved in reviewing the paperwork reduces the risk of medication mix-ups or missed follow-up care.
Having the Conversation
For many families, the hardest part isn’t the logistics. It’s the conversation. Framing the move as something being done “to” someone rarely goes well. When possible, involve the elderly person in the decision. Bring them to tour facilities, let them ask questions, and let them voice concerns. Focus on what they’ll gain (social interaction, safety, meals they don’t have to prepare) rather than what they’re losing.
If they’re resistant, it helps to have their doctor or another trusted person outside the family reinforce why the move is necessary. Sometimes a short-term stay for rehabilitation after a hospital visit becomes the bridge that helps someone adjust to facility life before committing to a permanent move.
Plan the move itself carefully. Bring familiar items like photos, a favorite blanket, or personal toiletries to make the new space feel less institutional. Visit frequently in the first few weeks, as the adjustment period is typically the hardest. Staff at good facilities expect this transition to be emotional and can offer guidance on helping your family member settle in.