Assisted Living or Nursing Home

How is a nursing home different from assisted living? In this article, we dive into the specifics of both assisted living & nursing homes, which may be a good fit for you or for a loved one, and introduce you to some partners who can lend a hand.

Ultimately, what is the difference? Assisted living facilities strive to provide a home-like environment for their residents. While a nursing home has more clinical and medical resources for its residents. Both of these types of residential care homes play a unique dual role in the long-term care, serving as a place where people have access to health care and a place to call home.

We had questions like you do, too and talked with our friends at care.com to help us understand these living options.

What Is Assisted Living?

Really, what do they assist with?

Assisted living is an excellent choice for seniors or people who can't safely live alone but still want to be active and social. These communities have a reported 93% satisfaction rate, and the move here may boost a sense of belonging and connectedness.

In assisted living, seniors have full-time housing and care. They are typically mostly independent and active but may need help with activities of daily living (ADLs), such as bathing, dressing, and using the toilet. In this home or apartment style of living, seniors get personalized care, nutritious meals, a wide range of social activities that cater to their interests, and a sense of community in a safe setting.

What Services Does Assisted Living Have

Assisted living communities have services and amenities that help seniors stay healthy and active. High-end communities have private apartments with kitchenettes, spacious, safety-focused bathrooms, inviting common areas, chef-prepared meals, and a fitness center.

If you are interested in checking out some places in your area, check out care.com, they have a robust and local search engine and have been helping caregivers for years.

Who Qualifies for Assisted Living?

In the US, state regulations set the parameters for qualifying for assisted living.

Qualifications to live in an assisted living facility are based on whether or not the person needs assistance performing at least two of what's known as “activities of daily living.” Activities of daily living include things like: walking or moving, bathing, grooming, and feeding themselves.

Assisted living communities are secure, but residents can come and go. With cognitive impairment concerns related to dementia, this may not be the right solution.

How Much Does Assisted Living Cost?

It depends. Some aspects impact the costs of assisted living based on five primary factors:

1. Community and reputation
2. Size of apartment
3. Location
4. Staffing ratios (staff to residents)
5. Services the resident needs

Generally speaking, assisted living communities have trained staff in areas such as meals, activities, skilled nursing, housekeeping, and HR. Some even have for fee concierge services. These wrap-around amenities and care services are reasons people want to live here vs. independent senior apartments.

Services are one reason assisted living communities are more expensive than independent senior apartments. So this is definitely a situation where we say get some guidance.

An aging care-focused consultant will help you turn over the stones to find what tools, organizations, and assets can help. We strongly recommend Eldercare Solutions as they will give you a free consultation.

We want to point out another core determinant for residents to be comfortable in an assisted living facility is that they need to be in a stable medical condition.

While assisted living facilities help people maintain a certain level of independence, it may not be enough support for some. Declining health or a major crisis like a debilitating stroke or serious fall may require rehabilitation or around-the-clock care from trained staff at nursing homes.

Our partners are ready to help when you have questions.

• Medical Care Alert provides the best medical alert systems for aging adults of all capacities. Medical alert devices with GPS and Fall Detection in all 50 states. Medical care alert systems are used at assisted and full-time care living facilities. Senior Living Facility staff are notified when a resident presses their button.   
• LegalZoom will help you understand how to protect your assets and afford care. If you're concerned about protecting your assets from nursing or assisted living costs, you're at an advantage if you can plan at least five years out. But there are other things you can do too.
• Care.com: Need help at your current home while you work out the next, next? Find senior care providers near you. Compare and hire the best senior care to fit your needs.  Browse the top assisted living facilities near you on Care.com, and you can compare services, reviews, and pricing for FREE. 
• Elder Care Solutions: Aging and caring are expensive endeavors.  How to pay for aging care or continuing care is one of the most demanding challenges families face. Eldercare solution will help ensure that aging and caring for an aging loved one don't financially break you.

What Is a Nursing Home?

Nursing homes are also called skilled nursing or long-term care facilities, where elderly adults and others needing more medical care can live. Nurses and experienced professionals help 24/7 with bathing, getting around, nutrition, medication management, and medically complex concerns.

Nursing homes have specific healthcare-based requirements that must be met before someone can move in. These requirements include a doctor’s prescription, a physical examination, and state approval.

Here's a general definition directly from Wikipedia:

A nursing home is a facility for the residential care of elderly or disabled people.^[1] Nursing homes may also be referred to as skilled nursing facilities (SNF), long-term care facilities, older adults' homes, assisted living facilities^[2], rest homes, convalescent homes, or convalescent care.

What Services Do Nursing Homes Provide?

Nursing homes are a place for older adults who need care 24 hours a day. In addition to the services offered by assisted living communities, nursing homes have medically related options:

• Medical care that is both palliative and preventative
• Administering prescription medications, including injections
• Rehabilitation services, such as physical, occupational, and speech therapy
• Help with incontinence issues and hygiene

Skilled nursing care is the cornerstone of many nursing homes. Meaning there are trained professionals available to help your loved one 24/7.

Who Is Suitable for a Nursing Home?

Nursing homes offer 24/7 medical and general care. This is a choice for aging adults who need significant medical care and want companionship. They will also have help with activities of daily living, plus many on-site amenities. If your loved ones require supervised medical care, a skilled nursing facility can restore dignity and may be the right fit.

• Do they need 24-hour monitoring for chronic conditions or poor health?
• Are they unable to take care of themselves without help?
• Is their safety and health in jeopardy if left alone?

How Much Do Skilled Nursing Facilities Cost?

Nursing home costs vary based on location, state funding, and the not-for-profit status of the facility.

The cost difference between assisted living and nursing home care is significant. The median monthly cost of nursing homes in the U.S. is about $7,989 for a semi-private room and $9,086 for a private room, according to Genworth.

Unlike many assisted living communities, if specific criteria are met, nursing homes can be paid for using government assistance for lower-income residents. You can learn more from people who help seniors afford the best housing with Elder Care Solutions.

Again from our LegalZoom friends: "Purchase a Medicaid-compliant annuity. A Medicaid-compliant annuity is relevant when there's a spouse who isn't institutionalized. When properly structured, it's a way to "spend down" and reduce the income Medicaid considers when deciding if you qualify for that assistance."

Which Care Facility Meets Your Needs?

Generally speaking, older adults face more complex health challenges than younger populations. In my family's case, I have a sister with special needs in her early 60s, and she needed a 24/7 skilled nursing facility to help with her complex physical and mental care.

Either care facility will help adults with age-related chronic conditions such as cardiovascular disease, as well as challenges with preparing their next meal, living safely in their home, getting enough sleep at night, and accessing medical care.

Assisted living communities benefit people who are still generally active but need assistance with daily tasks like dressing, medication reminders, or getting around. However, nursing homes are the safest and most reliable option if a loved one has chronic, progressive dementias or debilitating health concerns that need daily skilled supports.

Will I Still Be a Caregiver?

Yes, but your role will evolve. On the one hand, you will get a team of people who help with meals, cleaning, monitoring, cooking, activities, daily living help, community and available 24-hour care. These solutions are not perfect and, no, they will not be you. But that's ok.

You are still a caregiver, but your role will move to administration, management, companionship, and finances. Perhaps you will not suffer the back and physical strain from trying to help someone move around in their place. Yes, sometimes there is guilt. But you still are their caregiver.

The main point is that when there is a paid team to help you; their goals are usually aligned with yours; health, safety, and compassion. Both nursing and assisted living facilities bring both soft and professional skills to the table, and they do their best to take care of your loved one.

What are some cost comparisons?

Resources:

NCAL Report: States Continue Strengthening Assisted Living Regulations; Nearly two-thirds of states updated assisted living requirements. This report was released: on Sept 15, 2022.