If your mother fell last month and discharge is coming, ask the social worker for the written care needs, then price assisted living against the home care hours those needs require. Guiding Souls Home Care does not provide assisted living. Guiding Souls Home Care does not provide home health or a nursing home.
How do home care and assisted living differ day to day?
In assisted living, your relative moves into a room or small apartment in a community. Staff are on site around the clock. Meals are served in a dining room. Help with bathing and dressing is part of a care plan, and the monthly fee usually rises as needs grow.
At home, your relative keeps the same bed, the same kitchen and the same neighbors. A caregiver comes for the hours you set. That might be two visits a day, morning and bedtime, or a few hours on weekdays.
- Nights: assisted living has staff awake on site, shared among many residents. At home, nobody is there overnight unless you arrange overnight or live-in care.
- Meals: assisted living serves set meals. A home caregiver cooks what your relative likes, in their own kitchen.
- One-on-one time: at home, the caregiver's attention is on one person. In a community, it is shared.
- Cost as needs grow: home care cost follows the hours. Assisted living cost follows the level of care, and extra help is often added to the monthly bill.
- The move: assisted living means leaving the house. Home care means no move.
Neither is better in every case. A person who is lonely and safe may do well in a community. A person who is confused by change often does better at home.
When is home care the right fit, and when is it not?
Home care tends to fit when your relative needs help with bathing, dressing, meals, reminders to take medication, errands and company, and wants to stay in the house. It also fits when you need a break. Start with hours you can name, such as four hours a day, and add hours only if the need grows.
Home care costs more than a community once you need help most of the day and night. At 24 hours of care, hourly pay adds up fast, and a shared setting is often cheaper.
Wound care, injections and therapy belong to a home health agency, a different kind of provider. Ask the hospital discharge planner who covers it.
Assisted living is the better fit when the house is unsafe and cannot be fixed, when your relative wants the company of a dining room and activities, or when no family member can arrange and supervise daily care. Tour at least two homes. Visit at mealtime and in the evening, and ask how the fee changes if needs grow.
You can look up any assisted living home, and any home care agency's license status, on the California Care Facility Search.
What does it cost in Sacramento, and who helps pay?
The CareScout 2025 survey, taken from July to November 2025, puts the Sacramento-Roseville-Folsom area at $7,750 a month for assisted living. The same survey shows a private nursing home room at $19,771 a month there. Nationally, the median caregiver rate is $35 an hour, so the local $40 is a bit higher.
Because an hourly rate drives home care cost, the number to ask each agency for is the rate, the minimum visit length and whether nights cost more. Get all three in writing from at least three agencies. Then call the county about IHSS or Medi-Cal, ask whether a VA pension applies, and read any long-term care policy before you accept a community fee.
Several programs can lower the bill:
- Medi-Cal Assisted Living Waiver. The Assisted Living Waiver pays for care in participating assisted living homes for people who would otherwise need a nursing home. Enrollment is capped and there is a waitlist, so apply early.
- Medi-Cal asset limit. The state's asset limit rules allow $130,000 for one person, plus $65,000 for each extra person, through June 30, 2027. From July 1, 2027, the limit is $21,000 for one person and $31,000 for two. The home, one car and household items do not count.
- In-Home Supportive Services. IHSS pays a provider, often a relative, for in-home help for Medi-Cal recipients who are aged, blind or disabled. You apply through the county, and a social worker visits the home to decide the hours.
- VA benefits. VA Aid and Attendance adds money to a VA pension for a veteran or surviving spouse who needs help with daily activities. The VA's Homemaker and Home Health Aide program can send an aide when VA finds a clinical need; services vary by location.
- Long-term care insurance. Read the policy for the daily benefit and the waiting period. A CalPERS policy, for example, needs an itemized invoice and daily visit notes from the provider, as the CalPERS newsletter explains (Spring 2025).
For free, unbiased help sorting these out, the Sacramento County Area Agency on Aging can point you to caregiver support, respite and HICAP counseling.
What happens if you call Guiding Souls Home Care?
A person answers (916) 229-8120 at any hour, weekends and holidays included. The first visit to the house is free and carries no obligation. Mereani Blanton, who founded the agency, does that visit herself on most new cases, then puts a plan and a clear cost in writing before anything begins. There is no contract. You can read about all home care services or see where we serve across the Sacramento region. Prefer not to call? Use the free assessment form.
