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Assisted Living vs. Nursing Homes: What’s the Difference?

By Claire SamuelsMay 18, 2021
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Senior living communities come in many shapes and sizes, and there’s no universal approach for aging loved ones. Many people think of “senior living” and “nursing home” as synonymous, but over the past 30 years the terms have grown apart, and “nursing home” isn’t the senior care catch-all it used to be.

In fact, A Place for Mom surveyed 100 families who contacted us seeking “nursing homes” for their relatives. After consulting with our Senior Living Advisors, 89 of those families determined that a nursing home wasn’t the right choice for their aging family member, and they selected a more social, communal senior living environment.

So what’s the difference between assisted living and nursing homes, and which fits your loved one’s needs? Learn more about the services, features, and costs of assisted living versus nursing homes to help find the best community for your aging relative.

What is assisted living?

Assisted living is a great housing choice for seniors who are no longer capable of living alone, but want to maintain a social, active lifestyle. Considering these communities’ 93% satisfaction rate, it’s safe to say that assisted living isn’t what your aging loved one is picturing when they say they don’t want to move into “a home.”

Assisted living provides long-term housing and care for seniors. People in these communities are generally active, but may need support with activities of daily living (ADLs), such as bathing, dressing, and using the toilet. Seniors in assisted living can expect personalized care, nutritious meals, a wide range of social activities to cater to a variety of interests, and a sense of community in a safe, residential setting.

As you consider housing options for your aging loved one, know that assisted living communities often have health standards for admitting new residents. For instance, your relative may have to be able to eat independently or transfer between a bed and a wheelchair without assistance.

What services do assisted living communities provide?

Assisted living communities offer services and amenities that focus on encouraging important aspects of senior wellness, including physical health, intellectual stimulation, and social connection. Assisted living communities may offer some of the following:

  • Restaurant-style dining, happy hours, and activities based on resident interest
  • Outings and transportation to local stores, theaters, and museums
  • Help with laundry, housekeeping, and maintenance
  • Assistance with ADLs, including medication management, bathing, and grooming
  • Suites with mini-kitchens or larger apartments that allow couples to age together
  • Accessible spaces and widened doorways for residents with wheelchairs or walkers

Who can benefit from assisted living?

Assisted living communities are designed for seniors who wish to maintain independence as long as possible in a secure setting designed to fit their needs. Assisted living may be a good option for your aging loved one who fits the following descriptions:

  • Needs minor nursing assistance or medication but doesn’t require full-time medical care
  • Needs help with daily activities like dressing and bathing
  • Is interested in a maintenance-free lifestyle without lawn care or home repairs
  • Desires an active life but doesn’t have access to transportation
  • Is looking for new friends or social activities
  • Wants to pursue their passions, like golf, art, or religious studies, in a specially focused lifestyle community
  • Is currently in good health but knows they’ll need more help soon

How much do assisted living communities cost?

Assisted living costs vary by community, location, and services offered. Generally, assisted living — which provides additional amenities and care services — costs more than independent senior apartments. However, the difference between assisted living and nursing home costs is significant, since assisted living communities don’t offer full-time medical care.

The median cost of assisted living in the United States in 2020 was $4,300 per month, according to Genworth’s most recent Cost of Care Survey.

What is a nursing home?

Nursing homes — also called skilled nursing facilities or convalescent homes — are designed for seniors who require full-time monitoring and medical assistance. These facilities offer the highest level of care for seniors who don’t require hospitalization, but do need day-to-day medical care in addition to help with ADLs.

Elderly adults who need long-term care at a nursing home often suffer from severe, debilitating physical or cognitive health conditions that require 24-hour nursing and personal care. They may be bedridden,  be wheelchair users without the ability to maneuver themselves independently, or require daily skilled nursing care.

Nursing homes often have entry requirements, which include a physician’s prescription, physical examination, and state approval. If your loved one doesn’t meet these requirements, assisted living or another type of more moderate care setting may be more appropriate for their needs.

Talk with a Senior Living Advisor

Our advisors help 300,000 families each year find the right senior care for their loved ones.

What services do nursing homes provide?

The goal of a nursing home is to ensure the safety and comfort of older adults who need round-the-clock care. In addition to the services provided by assisted living communities, nursing homes offer a variety of medically related options:

  • Ongoing palliative and preventative long-term care
  • Prescription medication administration, including injections
  • Specialized rehabilitative services, such as speech, occupational, physical, respiratory, cognitive, and vocational therapy
  • Emergency and routine dental services
  • Meal options that must meet the daily nutritional requirements and the unique dietary needs of each resident, including pureed and liquid diets
  • Increased safety features and security benefits, including grab bars, ADA-accessible spaces, and alarmed doorways

Skilled nursing care is a key feature of many nursing homes. That means trained medical professionals are available at all times to assist your loved one. If your family member is gravely ill or has a serious, progressive medical condition, they may need specialized care from the licensed health care professionals at a skilled nursing facility, versus assisted living’s senior care aides, who are highly trained but may not be medically certified.

Who can benefit from nursing home care?

The higher level of care offered in a skilled nursing facility versus an assisted living community makes nursing homes an ideal choice for seniors who require significant medical care in addition to companionship, assistance with ADLs, and on-site amenities. A nursing home may fit the needs of elderly loved ones who require a greater level of care. These seniors may:

  • Require constant care due to chronic conditions or deteriorating health
  • Be unable to feed themselves independently
  • Have significant mobility concerns
  • Have experienced an injury or fall and need significant rehabilitation
  • Have progressive conditions, like Parkinson’s disease or MS
  • Require regular injections for diabetes or other conditions

How much do skilled nursing facilities cost?

Nursing home costs vary by location, state funding, and not-for-profit status. Skilled nursing facilities are generally more expensive than other senior living communities, since residents require more help with medical needs and personal care.

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, nursing homes can often be paid for using government assistance for lower-income residents.

How do you decide which care type is best for your loved one?

In the past several decades, senior living choices have expanded as the needs and expectations of older adults have changed. Finding the right option that meets your loved one’s needs is an important part of keeping them healthy, active, and safe. The best way to decide which care type is best for your loved one is by talking to those with experience with these care types. At no cost, a Place for Mom’s Senior Living Advisors can guide you through the many senior living options to help you find the best fit for your family.

Claire Samuels

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