Many families may not think about assisted living or nursing homes until a crisis.
“No one sits around and says, ‘OK, I’m ready for a nursing home.’ It’s normally that broken hip or stroke that comes out of nowhere that throws our life into a black hole,” says Roxanne Sorensen, an aging life care specialist and owner of Elder Care Solutions of WNY in Buffalo, New York.
Decision-making when the stakes are low and everyone is less emotional is the best option for your loved one. Sorensen encourages you and your loved one to at least take a tour of senior living options while they’re healthy enough to see what’s available.
But the unique care needs of your older loved one may not fit neatly into a box, and it can be hard to parse the differences among facilities, including the levels of care provided. Explore when to consider assisted living versus a nursing home and what the differences are.
Nursing Homes vs. Assisted Living
Nursing homes and assisted living communities both provide essential care for seniors, but they cater to different levels of need, says Jude Tenorio, RISE program manager at Foundation for Senior Living in Phoenix.
“Nursing homes typically serve individuals with more complex medical conditions who require round-the-clock medical supervision, while assisted living communities focus on providing a more independent lifestyle with support for daily activities like bathing, dressing and medication management,” Tenorio explains.
Assisted living
Assisted living is a long-term care option for seniors who may need some assistance with:
— Activities of daily living, such as dressing, bathing or grooming
— Cooking
— Day-to-day housekeeping duties and chores
— Laundry
— Social enrichment activities
— Medication management
— Transportation to medical appointments or stores
[READ: When Is It Time to Move From Independent to Assisted Living?]
Nursing homes
On the other hand, nursing homes accommodate residents with more advanced care needs.
Nursing care facilities offer:
— A higher level of daily physical care, security and supervision than assisted living
— More staff support than assisted living, especially nurses and nursing assistants
— Increased ability to offer skilled nursing tasks, such as managing wounds, catheters or IV lines
— A mix of care levels, from short-term post-hospital stays to long-term custodial care and skilled nursing needs
Some older adults may just need a short-term stay after a hospital discharge. For example, after having a stroke, some seniors may need a few days of intensive therapy but then are safe to go back to independent living. In these cases, many nursing homes or skilled nursing facilities accommodate these short-term skilled nursing stays. Frequently, moves to an SNF occur after a hospital discharge and are recommended by a physician.
Differences Between Assisted Living and Nursing Homes
The differences between assisted living and nursing homes will vary depending on each individual community.
“Even after many years, the lines are hazy. You often find residents in assisted living that should be in a nursing home, and vice versa,” says Anthony Cirillo, a North Carolina-based health, aging and caregiving expert and president of The Aging Experience, a company that provides consulting, keynote speaking and products for the senior living industry and older adults.
Seven key differences between assisted living and nursing homes may include:
1. Level of medical staff and security
Nursing homes offer a higher level of care, so more nurses, therapists and specialists will be on the premises. Physicians might also round more often than they would at an assisted living community.
[READ What Are the Levels of Senior Living?]
2. Cost
Because nursing home residents require more extensive care, the cost of nursing homes
is usually higher and can be expensive.
Sorensen says a fee-for-service structure is more common in assisted living facilities, and nursing homes are more often a flat rate.
According to Genworth Financial’s 2023 Cost of Care survey, average monthly costs in an assisted living facility are $5,350, whereas a private room in a nursing home averages $9,733 per month. Sorensen says in New York state, a nursing home can cost $18,000 a month.
[READ: How to Pay for a Nursing Home With No Money.]
3. Insurance coverage
Medicare, the federal health insurance program primarily for those age 65 and older, will pay for certain types of short-term nursing care, like rehabilitation after a knee replacement. But Medicare does not cover long-term nursing home or assisted living care.
Medicaid, a joint federal and state public health insurance program administered by individual states, covers nursing home care. However, Medicaid coverage for assisted living services varies depending on facility policies and the state residents live in.
4. Social atmosphere
All senior care homes will have some type of social scene. However, as assisted living residents require less direct care than nursing homes, the social atmosphere is often elevated. Activities, such as senior fitness or music classes, are geared toward individuals who are able to move around on their own and communicate.
“Assisted living tends to offer more social activities and private apartments, which can help your loved one stay independent longer if that is what they desire,” says Joe Williams, owner and managing partner at 10 Wilmington Place, a family-owned senior living community in Dayton, Ohio.
5. Federal regulations
Nursing homes are subject to more government oversight by both the state and federal governments to ensure quality. The federal Centers for Medicare & Medicaid Services oversees nursing homes. Assisted living communities are subject to state regulations.
“Assisted living is less regulated so there are fewer data points to check to validate objectively. Skilled nursing, on the other hand, is under a star rating from Medicare,” Cirillo says.
6. Independence offered to residents
Assisted living communities allow their residents more independence than nursing homes. Because assisted living residents don’t have as many medical conditions, they will have more freedom to leave the facility to go to community events or visit with family outside the premises. Nursing home residents are also allowed to leave, but they may require more assistance and planning to do so.
Similarities Between Nursing Homes and Assisted Living
Despite some differences, there are a few key similarities between assisted living and nursing homes.
Three similarities between nursing homes and assisted living include:
1. Use of the same building
Although a facility may refer to its senior care home as a nursing home, it may offer various levels of care. The facility could have a mix of nursing home care, assisted living or even memory care offered in the same location.
2. Round-the-clock on-site medical staff
Unlike independent senior living communities, nursing homes and assisted living communities each have medical staff on-site at all times.
3. Availability of community areas
Even nursing care facilities with residents who require a lot of care have common areas for them to dine, visit with family or even just to offer a change of scenery. This differs from a hospital, where patients typically cannot access spaces outside their rooms.
Assisted Living vs. Nursing Home: Which Is the Best Fit?
Choosing nursing homes versus assisted living can feel daunting.
Here are a few circumstances to keep in mind:
— Changing needs. Do you anticipate your or your loved one’s care needs will change quickly? If that’s the case, you may want to choose a facility that offers both nursing home care and assisted living.
— Provider recommendations. What does your medical provider have to say? A medical provider can perform something called a functional assessment, which helps determine how much care your loved one needs. They’ll also have insight regarding any chronic conditions, like how quickly they see your loved one’s chronic kidney disease progressing, for example.
— Medical care. How much medical care do you need? If you only need help with a few daily activities, like getting out of bed in the morning and having your food prepared for you, assisted living is a viable option. “If Mom and Dad require a nurse more times than not, use that as a benchmark to consider a nursing home,” Cirillo advises.
Frequently Asked Questions
Explore Top-Rated Senior Living Options With U.S. News & World Report
To find the best assisted living community or nursing home, consult U.S. News & World Report’s top-rated nursing homes
. U.S. News analyzed data from nearly 400,000 resident and family survey responses of more than 3,500 senior living communities nationwide. U.S. News also evaluated more than 15,000 assisted living communities throughout the country and rated most of them in terms of short-term rehabilitation and long-term care.
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Understanding the Differences Between Nursing Homes and Assisted Living originally appeared on usnews.com
Update 10/23/24: This story was previously published at an earlier date and has been updated with new information.
