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The Differences Between a Nursing Home and Assisted Living

Lisa Belluck  — June 28, 2019

Often used interchangeably, nursing homes and assisted living facilities are actually two totally different things. While they overlap in several ways, it’s important to know which services each provides, as well as how much they cost and what standard of care to expect. If you or a loved one is considering moving into one of these establishments, here are a few things to consider: 

The Similarities

Before we discuss their differences, it’s worthwhile to understand what these two facilities have in common. Residents at both facilities can expect healthy, high-quality food and a safe, secure environment. Most staff members are nurse assistants or aides, and they’ll often assist with laundry and light housekeeping. Residents tend to be 65 years of age or older, and though their specific needs vary, they either desire help with certain tasks or can’t live on their own any longer.

Level of Care

Assisted living facilities are best suited to residents who require minimal assistance with daily tasks, whereas nursing homes cater to residents with more advanced needs. In order to determine which facility is best for your situation, caregivers may offer an Activities of Daily Living (ADLs) assessment. This assessment will measure a potential resident’s ability to handle everyday tasks, such as feeding themselves, bathing themselves, and walking on their own. Generally, nursing homes will help with all of these tasks, whereas assisted living facilities assume residents are able to complete them independently and will charge a fee for assisting.

Independence and Privacy

Assisted living facilities often allow residents to keep their cars, and they may provide kitchenettes so that residents can cook meals on their own. Nursing homes tend to offer less independence, due to the resident’s advanced needs. Additionally, due to nurses providing constant medical assistance, nursing homes offer less privacy. 

Costs/Coverage

In general, nursing homes cost more than assisted living facilities. A private room at a nursing home can cost upwards of $8,000 a month, while assisted living facilities tend to cost between $3,000 and $6,000 monthly. However, there is often more financial aid available for nursing homes. For instance, Medicare and Medicaid will often cover nursing homes, but it’s rare that they’ll pay for assisted living facilities. If you’re considering an assisted living facility, look into waivers and long-term care insurance to help with costs. Veterans are also eligible for certain benefits. 

Activities

Both facilities offer plenty of activities for residents, but at a nursing home, most of those activities are confined to the building. For instance, a nursing home resident can enjoy movie nights, arts and crafts, visiting musicians, and fitness classes. Assisted living facilities usually provide these activities as well, along with trips outside the facility to doctor’s appointments and religious services, or fun places such as museums and gardens. Nursing homes are less likely to provide transportation outside the building.

Living Situation

Aesthetically, nursing homes tend to resemble hospitals or institutions while assisted living facilities resemble condos or apartments. In assisted living facilities, residents can live alone or with their spouses, and they can even bring their own furniture; nursing homes are less likely to provide private rooms, and residents are often paired with a roommate. Number of residents vary greatly, but nursing homes tend to be larger and care for more residents simultaneously. On average, an assisted living facility will house 50 residents, while a nursing home houses 100.  

Pets

Unfortunately, if you have a dog or cat, chances are you can’t bring it with you to a nursing home. The level of care required is too steep, and few nursing homes are equipped to take care of them. Conversely, assisted living homes often allow your furry friends to accompany you, though you’ll be tasked as their primary caregiver or be charged an extra fee for the facility’s assistance.

Specialized Medical Care

It can be difficult to determine whether an assisted living facility can provide adequate care for a specific illness or injury. However, in cases where the resident has multiple medical concerns and/or requires 24-hour surveillance, a nursing home is the better fit. Many nursing homes offer specialized care for conditions such as Alzheimer’s, dementia, congestive heart failure, and diabetes. While assisted living facilities can also assist with these health issues, their resources are often more limited and targeted toward less severe cases.

Duration of Stay

While some seniors may spend the remainder of their lives in nursing care, many residents leave after a few months. In these cases, the nursing home functions as rehabilitative care, and the goal is to get the resident ready to return to their previous housing situation. In assisted living facilities, residents may stay several years before requiring advanced assistance and transitioning to a nursing home; others never require such advanced care and choose to remain in assisted living throughout their golden years.   

Other Options

If neither of these homes sound like the right fit, it’s worth looking into other housing choices. Senior apartments are one such option, as they provide age-restricted housing for adults over 55 who are able to care for themselves. In-home care is another possibility; this service allows seniors to remain in their own apartment or house and sends caregivers directly to them. Lastly, continuing care retirement communities provide multiple levels of care and housing, allowing residents to transition from independent living to assisted living, then if needed, a nursing home, all while living in the same community.   

Regardless of your specific care requirements, it’s worth calling individual nursing homes and assisted living facilities to ensure their offerings meet the needs of you or your loved one. Both facilities are concerned with the care and well-being of their residents, and a good fit can make all the difference in a resident’s continued health and happiness.