Comparison

Adult Family Home Alternatives: What Are Your Options?

Published January 29, 2026 · Seattle Nurse Delegation

If you've been researching senior care in Washington, you've probably run across adult family homes — and wondered what else is out there. The good news: there are several solid options, and the right one depends on your parent's needs, budget, and personality.

Here's a practical look at the main choices, plus when each makes sense.

Adult family home (AFH)

A licensed home for up to 6 residents, with caregivers who provide daily support and, through RN delegation, medication administration and other clinical tasks.

  • Best for: seniors who need hands-on help and supervision but not 24-hour skilled nursing.
  • Cost: roughly $5,000–$10,000/month.
  • Catch: in Washington, a licensed RN must complete a pre-placement assessment before move-in.

Assisted living

A larger, community-style facility with apartments or private rooms, shared dining and activities, and care available on demand.

  • Best for: seniors who want social connection and some independence with support close by.
  • Cost: roughly $4,500–$8,500/month.
  • Note: memory care units within assisted living run higher.

Memory care

Specialized care for people living with Alzheimer's or other dementias — secure environments, structured routines, and staff trained in dementia care.

  • Best for: seniors who wander, get confused, or need specialized behavioral support.
  • Often delivered within an assisted living facility or dedicated memory care residence.

Skilled nursing facility (nursing home)

A medical facility with licensed nurses around the clock.

  • Best for: complex, unstable medical conditions, rehabilitation, or round-the-clock nursing care.
  • Cost: commonly $9,000–$14,000+/month.

In-home care

Caregivers come to the family home to provide support and (with RN delegation) clinical tasks while the senior stays put.

  • Best for: seniors who can safely remain at home with part- or full-time help.
  • Cost: varies widely with hours; can be comparable to a facility for full-time care.
  • Note: in-home care also relies on nurse delegation for medication administration.

How to choose

Start with level of care, not cost:

  1. Does your parent need round-the-clock nursing? → skilled nursing facility
  2. Does your parent have significant dementia behaviors? → memory care
  3. Can your parent manage at home with help? → in-home care
  4. Does your parent need daily support but want to stay in a homelike setting? → adult family home
  5. Does your parent want a community with more independence? → assisted living

For a deeper comparison of the two most common choices, see AFH vs Nursing Home and AFH vs Assisted Living.

If you choose an adult family home

The last step before move-in is the mandatory RN assessment, which confirms the home can safely meet your parent's needs. Seattle Nurse Delegation provides the pre-placement assessment at a flat $450 with a written report within 48 hours — so the process doesn't stall your move-in timeline.

Ready to get started?

Call Seattle Nurse Delegation at or book online today.

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