Assisted Living vs Nursing Homes

Choosing the right long-term care facility for an aging parent or loved one is a significant decision. It involves understanding different types of care, assessing needs, and navigating financial considerations.

This guide will help you distinguish between assisted living facilities and nursing homes, and guide you through the process of finding the best fit.

What Are Long-Term Care Options?

Long-term care provides support for people who can no longer perform everyday tasks on their own.

This can include help with:

• Dressing
• Eating
• Bathing
• Managing medications

Care is delivered in a range of settings, from in-home assistance to residential facilities.

Common Types of Residential Facilities

There are different types of residential care environments with varying levels of support:

• Board and care homes — Small, private residences offering supervision and personal care
• Assisted living facilities — Support with daily activities in a semi-independent setting
• Nursing homes — 24-hour medical care by licensed professionals
• Continuing care retirement communities (CCRCs) — A campus offering multiple levels of care

Key Differences Between Assisted Living and Nursing Homes

The main difference lies in medical care: nursing homes provide skilled care, while assisted living focuses more on support with daily life.

What to Expect in Assisted Living

Assisted living facilities are best suited for individuals who need help with daily tasks but not intensive medical care.

“Assisted living is for people who need help with daily care, but not as much help as a nursing home provides.” — National Institute on Aging¹

Residents usually live in private or semi-private apartments within a larger complex.

Typical services include:

• Meals and dining services
• Assistance with bathing, dressing, grooming
• Medication reminders
• Housekeeping and laundry
• Planned social and recreational activities

“Most people pay the full costs of assisted living themselves. Medicare does not pay for assisted living.” — National Institute on Aging¹

Coverage options vary by state. Medicaid may help if the facility accepts it.

Learn more about Assisted Living Costs and What Assisted Living Includes.

What Nursing Homes Provide

Nursing homes, or skilled nursing facilities, offer the highest level of care outside of a hospital.

“Nursing homes... provide a wide range of health and personal care services. Their services focus more on medical care than most assisted living facilities.” — National Institute on Aging¹

They offer:

• 24/7 supervision by licensed nurses
• Assistance with all Activities of Daily Living (ADLs)
• Skilled therapy: physical, speech, and occupational
• Management of complex medical conditions

“Medicare generally doesn’t cover long-term stays in a nursing home, but it may pay for some related costs.” — National Institute on Aging¹

Long-term care through Medicaid is available to qualifying individuals.

For more details, see Medicare Coverage Guide and Medicaid and Long-Term Care.

How to Choose a Facility That Fits Best

Choosing between assisted living and a nursing home should be based on both medical need and personal preference.

“Choosing a place to live for long-term care is a big decision. It can be hard to know where to start.” — National Institute on Aging²

Identify Needs and Preferences

Begin with a clear understanding of what your loved one needs:

• [ ] Help with basic tasks like eating or bathing
• [ ] Routine medical supervision
• [ ] Memory care for dementia
• [ ] Social interaction and structured activities

Also factor in preferences:

• Privacy and room size
• Meal options and dietary needs
• Community setting vs. clinical environment

Touring and Comparing Options

Seek referrals from doctors, friends, or local agencies. Then contact facilities to gather detailed information.

Key questions to ask:

• [ ] What is the staff-to-resident ratio?
• [ ] Are staff trained in specific areas like dementia care?
• [ ] What medical services are offered on-site?
• [ ] What activities are available?
• [ ] What’s included in the monthly fee?

See Questions to Ask on Tours for a detailed checklist.

Always visit a facility more than once, including during meals and busy times, to assess atmosphere and care practices.

Evaluating Costs and Contracts

Long-term care can be expensive. Get a complete breakdown of costs and understand what is included.

• [ ] Are there extra charges for medication or personal care?
• [ ] How is billing handled monthly?
• [ ] What happens if care needs increase?
• [ ] Can the contract be terminated without fees?

Helpful guidance available in Understanding Assisted Living Contracts.

Special Considerations for Dementia and Alzheimer’s Care

If your loved one has dementia, choose a facility that specializes in memory support.

“Some assisted living facilities have special Alzheimer’s units with staff who check and care for people with dementia.” — National Institute on Aging³

These units often provide:

• Secure environments to prevent wandering
• Daily routines suited to cognitive needs
• Staff trained in dementia care
• Enhanced sensory and memory-supportive activities

Explore in-depth comparisons at Memory Care and Memory Care vs Assisted Living.

Preparing for the Transition

“Moving an older adult to an assisted living facility, group home, or nursing home can be stressful and is a big change for both the person and their caregivers.” — National Institute on Aging⁴

Steps to support the transition:

• Involve your loved one in decision-making
• Tour the facility together
• Pack personally meaningful items to ease the move
• Get to know key staff members
• Be present, especially in the first few weeks

Support tools can be found in Assisted Living Checklist.

Trusted Resources for Help

Get extra support from trustworthy programs and tools:

• Eldercare Locator (eldercare.acl.gov) — Connects families to local aging resources
• LongTermCare.gov — Offers planning tools and information
• Area Agencies on Aging — Regional sources for guidance and advocacy
• Medicare's Care Compare — Compare nursing homes at Medicare.gov

Also explore caregiver resources like Dealing with Parents and Caregiving with Siblings.

Final Thoughts

Your loved one's care journey should honor their dignity, preferences, and medical needs.

Assisted living is fitting for those who desire some support but want to maintain independence. Nursing homes cater to individuals with serious health needs requiring 24-hour skilled care.

Take time to research, tour, and compare options. And remember, you don’t have to do it alone — help is available every step of the way.

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Explore Related Topics:

• How to Find Senior Living Facilities