Whats the difference between nursing homes and assisted living

When it comes to residential care facilities for seniors, “nursing home” is often the umbrella term used to describe both assisted living and nursing homes. However, these facilities are not the same.

Assisted living communities help residents with activities of daily living (ADLs) while nursing homes provide seniors with 24-hour monitoring and high-level medical care. Learning more about the various features and benefits of assisted living and nursing homes can help you determine the right fit for you or an aging loved one.

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More than 800,000 Americans reside in assisted living communities, which offer a safe, long-term residential setting for active seniors who can no longer live on their own. Residents may be able to choose from private, individual studios with kitchenettes and shared apartments for friends and couples. And while these senior residents don’t require 24/7 skilled nursing care, help with daily living tasks (such as getting dressed and using the bathroom) and medication management is available if needed.

Other typical assisted living services include:

  • 24-hour on-site staffing
  • Resident nurse/on-site health clinic
  • Housekeeping and maintenance
  • Laundry service
  • Exercise and wellness programs
  • Nutritional meals and dining services
  • Transportation to and from medical appointments

Select assisted living communities serve seniors with specific medical conditions, such as Alzheimer’s disease and other types of dementia, Parkinson’s disease or intellectual and developmental disabilities. Accommodations can include a specific wing, unit or floor designated for people with particular needs.

Who Can Benefit Most From Assisted Living?

Assisted living communities are typically designed for active, social seniors in good health who want to maintain a sense of independence. These communities foster an environment for senior wellness, consistent intellectual stimulation and meaningful social connections.

If you or your loved one can answer “yes” to the following questions, assisted living might be a great option:

  • Do you require minor nursing assistance, but not full-time medical care?
  • Do you need a little daily help with dressing and bathing?
  • Does a maintenance-free lifestyle appeal to you?
  • Would you like friends and social activities within walking distance?

What Is a Nursing Home?

Nursing homes provide high-level custodial and skilled residential care for seniors who have serious medical issues or chronic conditions that require 24-hour supervision. In contrast to the apartment-like appearance of an assisted living complex, some nursing homes can look a little institutional due to the hospital-level care provided.

“In my 30 years as a charge nurse, the notion [of nursing homes] has evolved,” says Tamara J., a registered nurse at Lee’s Summit Pointe Health & Rehabilitation in Missouri. “This is not [a place] where old people come to die. When a senior breaks a hip, they come here to mend and rehabilitate. It’s their home while they’re here. The same goes for residents who have diminished capacity and can’t do for themselves—this is their home, but with nurses. We create ‘home’ for [both] long-term care residents and rehab-to-home residents.”

There are typically two kinds of nursing home residents: people admitted for short-term rehabilitation after hospitalization, and permanent residents with ongoing physical conditions that require 24-hour care and supervision. Nursing homes can be a great choice for seniors who have chronic injuries or are wheelchair-bound. They provide the same help with daily living as assisted living communities, but offer additional services that may include:

  • Palliative care
  • Mobility assistance
  • Nutritional services
  • Speech, occupational, physical, respiratory and occupational therapy

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Who Can Benefit Most From a Nursing Home?

Nursing home care is for seniors who require 24-hour supervision, significant medical care, assistance with daily tasks, and onsite amenities. A nursing home might be ideal for a senior who is experiencing:

  • Limited mobility
  • Chronic illness
  • Diminished ability to eat independently

Assisted Living vs. Nursing Homes: Key Similarities and Differences

Both assisted living and nursing homes strive to keep their senior residents safe, healthy and happy by often offering similar supportive services:

  • Assistance with daily tasks
  • Medication management
  • Enrichment and wellness activities
  • Housekeeping, laundry and transportation
  • Balanced meals and nutritional options

The biggest differences between assisted living and nursing homes lies in the level of medical and assistive services provided. Residents in assisted living communities typically need general custodial care (assistance with cooking, cleaning and personal upkeep), whereas residents in a nursing home require 24-hour skilled nursing care and monitoring.

Care Costs

Costs related to assisted living and nursing homes vary by location, services offered and level of care needed. Nursing homes can cost almost twice as much as assisted living facilities because of the full-time medical care provided. In 2020, the national median cost for assisted living was $51,600 a year. In comparison, the national median daily rate for a semi-private nursing home room was $255 ($93,075 a year) and $290 for a private room ($105,850 a year). These charges generally include rent, meals, laundry, basic nurse supervision and generic non-prescription medication.

Families can finance assisted living community costs through personal funds or long-term care insurance policies. Medicare will cover part of a nursing home stay for a maximum of 100 days, but Medicaid will cover nursing home expenses as long as eligibility requirements are met and there is a demonstrated medical need. To get more information on eligibility requirements and specific coverage, contact your state Medicaid office.

How to Choose the Best Type of Facility for You

Once you’ve done an honest and complete assessment of your medical needs and chosen which type of facility will best serve you, you’ll need to do some research and legwork to find the perfect fit.

Consider what’s important to you. Do you care if the facility has a particular religious affiliation? Are you a foodie who needs a varied diet? Do you want to be close to family and friends? Are you a social butterfly who desires a facility with communal spaces, scheduled activities and numerous outings?

Ask around. Talk to your doctor, relatives, former colleagues and others in your social circles about facility recommendations and suggestions.

Research online. Visit the website of each place on your list of favorites. See how many answers to your immediate questions can be found online. Download or print a checklist, like The Medicare Nursing Home Checklist to prepare you for visiting your top picks.

Schedule a visit. Make an appointment with the director of the facility and take a tour. Don’t forget to bring your checklist and ask questions like:

  • Is the facility Medicare and Medicaid certified?
  • What is the ratio of residents to staff?
  • Who administers the medications?
  • How long has the director worked there? The head nurse? The dietitian? (A high turnover rate can be a red flag.)
  • What’s that smell? (Strong odors could indicate a problem and overly clean ones might be covering up a problem.)
  • Can I have a copy of the contract to review policies, procedures and costs at home?

Surprise them. Visit again, unannounced. Drop in during lunch or during a scheduled activity to talk to the residents. Take note of the following:

  • Are the residents happy and attended to?
  • Is the dining room clean? Does the food look good?
  • Is the atmosphere energetic?
  • Can you see yourself there?

The decision to move from independent living to assisted living or a nursing home isn’t an easy one, but knowing the differences and benefits of each can help you make an informed choice.

How does assisted living work in Massachusetts?

Assisted Living Residences offer housing, meals and personal care services to adults. They do not provide medical or nursing services. You can search for certified Assisted Living Residences in Massachusetts below. Please contact individual Assisted Living Residences directly to confirm wheelchair accessibility.

Does Social Security pay for assisted living in Tennessee?

The short answer is yes, in most states, Social Security (through Optional State Supplements) provides financial assistance for persons that reside in assisted living communities provided they meet the eligibility criteria.