Differences Between Assisted Living and Nursing Homes
Paul Williamson – October 23rd, 2020
Paul Williamson – October 23rd, 2020
The growing United States senior population continues to seek viable, affordable living options. Two of the most popular choices are nursing homes and assisted living communities. Many older adults are mostly mobile but need some help with activities of daily living (ADLs).
These seniors often choose to reside in assisted living facilities.Other older adults require ongoing skilled medical care. This can be due to reduced physical capabilities or a need for management of specific medical conditions. These seniors may find that a nursing home is a good fit.
As you can see, both assisted living and nursing home facilities address seniors’ care needs but with slightly different approaches. When it comes to assisted living vs nursing homes, it’s best to learn about the characteristics of each senior living option. Wondering about the differences between the two? Keep reading to learn the similarities and differences, and compare their care levels and costs. Afterward, you can determine if an assisted living community or a nursing home is right for your or your loved one’s care needs.
Some older adults may be generally mobile but need help with their activities of daily living (ADLs). Examples include personal care, continence support, medication management, and meal consumption. This type of care is found in an assisted living community.
Assisted living communities are a good option for seniors who would otherwise need some in-home care. These residential care facilities offer numerous amenities, enabling assisted living residents to enjoy a rich, vibrant lifestyle. In many aspects, the complexes resemble independent living enclaves.
Assisted living residents often have a choice of senior housing venues. Examples include private or shared rooms or perhaps a senior apartment. Cottages and condominiums offer a sense of autonomy and independence. A couple’s residence enables two spouses to stay together, even if one partner requires assistance with ADLs.
Most assisted living residents are somewhat mobile, so they can generally navigate around their home (and perhaps around the complex) on their own. Although residents generally need assistance with activities of daily living, it may not impact their quality of life.
Outside their lodgings, residents enjoy spacious common areas and nicely landscaped gathering spots. An inviting schedule of recreational activities encourages residents to remain physically and mentally active.
If they don’t have their own vehicle, the complex provides transportation to appointments and errands.
These multifaceted senior living communities provide residents with a veritable feast of social and cultural happenings. Facilities frequently offer onsite college and personal enrichment courses.
Community groups often deliver spirited performances on holidays and other special occasions.
Residents enjoy outings to shopping destinations and cultural venues. Some senior living facilities may offer a dedicated onsite worship space.
Assisted living communities are among the highest-priced senior care options. The Genworth 2019 Cost of Care Survey noted that assisted living facility residents typically pay between $3,000 and $6,000 monthly.
It’s wishful thinking to assume that Medicare will cover assisted living expenses. Medicare does not cover any residency or custodial care fees, including assisted living charges. This lack of coverage applies to Medicare Parts A, B, and C.
However, a resident’s Medicare Beneficiary Agreement may dictate coverage of some “medically necessary” health services available through their assisted living complex. A recognized Medicare healthcare provider must deliver each service.
In addition, most United States health insurance plans do not cover long-term care services, including assisted living services.
To generate income for long-term care costs, residents often sell their homes and the contents within.
Here’s where an estate sale company can help. Within a short period of time, the estate liquidation company can organize a multi-day sale that will net some income for the homeowner. For a firsthand look at how estate sales work, visit an estate sale near you.
To produce additional revenue, residents may wish to sell stocks and/or bonds. They can also ask loved ones for help, or they can liquidate fine art, higher-end jewelry, and other exclusive items at an estate auction.
So, what is a nursing home? A nursing home serves older adults who require skilled nursing care, medical care, and perhaps other medical services. In addition to needing help with their ADLs, these seniors often need a higher level of care due to declining physical capacity or need for chronic disease management.
Many skilled nursing facilities also include a memory care and/or Alzheimer’s wing that provides full-time care services tailored to residents’ health care needs.
Most nursing home residents have limited mobility and ongoing health problems. These factors make it unlikely that they’ll be able to participate in a robust menu of social and recreational activities. As a result, the facility tailors its resident offerings accordingly.
A skilled nursing facility’s layout enables efficient medical care. Residents typically live in a shared or private room off a central hallway. A nursing station is usually located just a short distance away. Because of residents’ limited mobility, common areas and outdoor spaces are smaller than those in an assisted living facility.
Nursing home residents typically require a higher level of care than assisted living residents. In addition to assistance with multiple ADLs, residents may need skilled nursing help with various medical conditions. Although nursing assistants can perform many tasks, registered nurses often provide the type of care residents require.
Residents may need round-the-clock care for chronic health conditions and other medical needs. Some residents may be resistant to help because of their declining cognitive health. However, skilled nursing personnel are trained to work with these residents.
Recently discharged hospital patients often receive nursing home care while they benefit from short-term rehabilitative services. Patients may receive speech therapy, occupational therapy, or physical therapy.
Residents’ restricted mobility limits outings and essentially dictates that social and recreational activities take place onsite. Throughout the year, community groups deliver lively performances designed to engage the residents.
Some nursing homes invite friendly pets and their owners to visit residents on an ongoing basis.
Churches often conduct onsite worship services to help residents meet their spiritual needs.
Nursing home care is the most expensive long-term care option. On average, a resident might pay $5,000 to $10,000 per month. The only plus side: This cost likely includes most (if not all) ADL expenses, along with other services.
Unfortunately, Medicare doesn’t pay for these long-term care costs. Most health insurance plans won’t cover long-term care, including nursing home care. However, your health insurance plan may cover the expenses if you or your loved one must go to a nursing home for short-term care or rehabilitative services.
However, the federal Medicaid program covers long-term nursing home expenses for people with lower incomes and very few assets besides their home. For those who qualify, Medicaid covers the entire cost of the nursing facility room and board.
In addition, Medicaid pays for therapies that are included in the facility’s standard resident care. Note that some nursing homes may limit the number of Medicaid-covered beds.
Assisted living and nursing homes have several similarities along with a few important differences. By objectively presenting each facility’s attributes, prospective residents and family members can make a more informed decision about the best senior care option. This is the heart of the assisted living vs nursing home comparison.
Both entities present viable senior care and housing options, and each is well-equipped to deliver long-term care to residents with varied needs. Both facilities maintain a secure environment, and staff provides home care and maintenance services.
On a personal level, assisted living facilities and nursing homes provide residents with ADL services.
However, nursing home residents are more likely to need extensive assistance. Staff members in both facilities assist with medication management.
Life-enriching activities are available in each complex. However, assisted living residents’ increased mobility and better health certainly broadens their choices.
It’s useful to establish criteria for assisted living vs nursing home comparisons. There are several key differences between assisted living communities and nursing homes. These apply to the facilities’ attributes along with resident-related variables. View the table below to see a side-by-side comparison of their differences.
|Assisted Living Community||Nursing Home|
|Facility Layout||Attractively landscaped campus with separate buildings for residency and services. Emphasis on outdoor recreation areas and social venues.||Self-contained facility with residents’ rooms situated near central nursing stations. Small common areas and outdoor spaces. Facility often includes memory care and/or Alzheimer’s wing.|
|Types of Residents||Older adults who would otherwise need some home care but want to live in a cohesive community.||Residents require constant skilled nursing care because of diminished physical capabilities and/or specific medical needs.|
|Types of Services||Residents need some ADL assistance and may request home care services.||Residents need help with multiple ADLs. In addition, they frequently require medical care for chronic and acute health problems.|
|Social & Recreational Activities||Many onsite and offsite activities promote residents’ physical and mental well-being. Examples include outings to shopping venues and cultural events.||Reduced social and recreational activities on nursing home premises. Community groups may give onsite performances, and local churches may conduct worship services at the facility.|
|Cost and Payment Options||Fewer ADLs included in monthly fee and more itemized services. Residents and/or their family members pay for facility costs. Long-term care insurance or other financial resources may help.||Most ADLs are included in a monthly fee. Because nursing home care is medically necessary, Medicaid typically pays for these services.|
In terms of senior care options and corresponding costs, assisted living facilities and nursing homes assess each resident’s needs. The determining factor is how much ADL assistance the resident requires every day. If the resident requires help with multiple ADLs, they will pay more.
In an assisted living facility, a resident’s base monthly fee includes minimal ADLs. If the resident requires assistance with additional tasks, such as medication reminders and laundry or cleaning services, they will be charged an additional fee. Family members often help lower ADL costs by doing their loved one’s laundry or providing housekeeping services.
In contrast, a resident’s nursing home care includes more ADLs in their monthly fee. Because residents typically need assistance with multiple ADLs, this is a more palatable approach than assessing line-item charges for each individual service.
In deciding between an assisted living community and a nursing home, consider two equally important variables. First, identify the type of care that’s most appropriate for you or your loved one. Next, objectively evaluate your financial situation. Determine which level of care you can comfortably afford.
Once you’ve reconciled your preferred facility with your budget, list the senior living options within driving distance. Contact each facility’s admissions director, and schedule a tour of the complexes that interest you. Be sure to bring facility evaluation forms along with your smartphone or a digital camera.
Afterward, note each facility’s pros and cons, and develop a shortlist of top contenders. If necessary, revisit those complexes before making your final decision. Remember to take your time deciding which senior living option is right for you or your loved one. Long-term care is a long-term decision, and you want to make sure you choose wisely.