Assisted Living or Nursing Home

How is a nursing home different from assisted living for residents, community and services?

In this article, we dive into assisted living & nursing homes consideration, which place 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 long-term care, serving as a place where people have access to health care and a place to call home.

We had questions as 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.

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In assisted living, seniors have full-time housing and close access to 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 these home or apartment living styles, 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. For example, high-end communities have private apartments with kitchenettes, spacious, safety-focused bathrooms, inviting common areas, chef-prepared meals, and a fitness center.

The local market, state regulations, and typical costs influence services and amenities. First, consider how you typically choose the neighborhood and city you want to live near. This is important because assisted living is intended to be a social experience.

If you want to check 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.” Daily living activities include walking or moving, bathing, grooming, and feeding themselves.

Assisted living communities are secure, but residents can come and go. However, 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 (state, region, locale)
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 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 have a variety of consultation ranges.

We want to point out another core determinant for residents to be comfortable in assisted living is that they need to be in a stable medical condition. Assisted living communities are a bridge between independent living and nursing care centers.

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 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.
• 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.
• Care.com: Need help at your current home while you work out the next, next? Find senior care providers near you.
• Elder Care Solutions: How do we pay for aging or continuing care is one of the most demanding challenges families face. Eldercare solutions knows how to help you get the team and resources to make the best decision possible.

What is a nursing home?

Nursing homes are also called skilled nursing or long-term care facilities, where aging 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 or others 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 needs a nursing home?

Nursing homes have 24/7 medical, services and general care. This is a great choice for aging adults who need significant medical care and want companionship.

If a person has memory care or high care needs for and chronic condition or stroke, then there are additional considerations to find an appropriate option. If your loved ones require supervised medical care, a skilled nursing facility can restore dignity, confidence and may be just 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.

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 and 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 social and independently inded, 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 dementia or debilitating health concerns that need daily skilled support.

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 soft and professional skills, and they do their best to care for 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.