It is commonplace for people to use the terms “assisted living community” and “nursing home” interchangeably when referring to a place that provides care for the elderly or disabled. In fact, an assisted living facility is different from a nursing home in a number of ways.

How Assisted Living is different from Nursing Home Care

There are two major differences between assisted living communities and nursing home care. With assisted living, you will have your own private apartment, and there will be limited interaction with a nurse/staff member each day. In a nursing home, you may share a room with someone or live in a more medical setting, and there will be around-the-clock care available. Assisted living is different because the resident lives by themselves and requires limited assistance in their daily routine. Some of the care that is provided in an assisted living community may include:

• Help with meal preparations
• Help with personal hygiene
• Help with personal grooming or getting dressed
• Help with cleaning or doing laundry
• Medication management

In the assisted living community, the resident will have their own furniture and decor in their apartment. They will have a handicap-equipped bathroom and a full-size kitchenette. There will be emergency pull cords located throughout the apartment for emergency assistance. Another differentiation is that the residents can dine in the dining room for a more social setting or cook for themselves in their apartment with family or friends. They can join any or all of the classes and activities offered at the community for enjoyment and socialization, and they can come and go as they please. Assisted living is ideal for those looking for a safe place in a residential setting who may need some level of care and oversight but remain independent. Couples often live together and some may continue to drive.  A nursing home is more appropriate for someone who needs a level of care beyond what an assisted living could provide.

Care Given At A Nursing Home

Nursing homes are designed to provide extensive care to the residents. A person may be in a nursing home for after-surgery care, for continual care as the age, or for memory care. Some patients that are suffering from different forms of dementia often live in a nursing home so that they can have around the clock care and monitoring. People who require mobility assistance, have a hard time moving, or require specialty medications may require the services of a nursing home. Nursing homes do not provide as much privacy as a private apartment, and you do not have as much freedom to move about as you would in assisted living. Nursing homes are an important part of the care spectrum, providing vital services to those who need a high level of care. Nursing homes tend to be more clinical whereas assisted living communities tend to feel more residential.

Which One Do You Choose?

Assisted living is different from nursing home care. To determine which type of living situation is more appropriate for your needs, you should answer the following questions.

1. Eating. Can you eat your food without assistance? Can you go to the dining area without help at mealtimes? If you can eat by yourself or get to the dining room for each meal, living in an assisted living facility is appropriate. If you have medical issues that affect your ability to chew and swallow food safely and require supervision then a nursing home is appropriate.
2. Mobility. Can you get around without assistance? Most people in assisted living can walk on their own or with the assistance of a cane, walker or wheelchair. Wheelchairs are allowed in an assisted living facility if the person has the capability to move in and out of the wheelchair without aid.
3. Hygiene. Assisted living will provide you with some assistance for showering, grooming, and dressing each day. A nursing home would be appropriate if the individual is unable to do any of these without full support and supervision.
4. Continence. Some issues with incontinence can be easily managed with assisted living. Most assisted living communities keep products on hand to help with this and are available to residents. However, if the issue becomes extensive, you may require more hands-on care in a nursing home.
5. Medications. In an assisted living community, you will have some help managing your medications. A medication management program at an assisted living can help coordinate a resident’s prescriptions as well as reminders to take the medication. Nursing homes will provide around-the-clock care and can provide more complex support for those that need it.

Assisted Living vs. Nursing Home Costs

In 2022, the median monthly cost for assisted living was $4,640. Although comprehensive statistics on nursing home expenses for 2022 are yet to be published, the median monthly cost for a semi-private room in a nursing home was $7,908 in 2021, while a private room was $9,034. Considering historical cost trends, assuming a slight increase in nursing home pricing for 2022 is reasonable. Nursing homes generally prove more expensive than assisted living, except for memory care in an assisted living facility. This higher cost is attributed to the continuous provision of medical care in nursing homes, necessitating more medically trained staff and a higher overall staff requirement. It is essential to note that the costs for nursing homes and assisted living can vary based on the community, location, and services provided. The notable cost disparity arises because assisted living communities do not provide full-time medical care. Various funding sources are available for families to cover each type of care. Seniors often utilize private funds, savings, and personal assets to cover most assisted living costs. At the same time, government assistance may be accessible to assist lower-income residents in meeting the expenses associated with nursing home care.

How Do You Pay For Assisted Living or Nursing Home Care?

There are distinct differences in how you pay for assisted living and nursing home care. In most cases, assisted living is a self-pay residence. Medicare and Medicaid do not cover assisted living communities. There are some programs available to help pay for assisted living if you do not have a long-term care insurance policy. These programs often have income and asset limitations. They may also not be available to every community. Some of the programs available to help cover assisted living costs include:

1. GAFC or PACE – which are Medicaid payment assistance programs
2. Veterans benefits
3. Tax credit programs, when available

Residing at an assisted living community can also be used as a tax deduction at the end of each year. Nursing homes are generally covered by Medicaid. Medicare will cover nursing home care for a specific number of days based on your medical condition. If you have Medicare Advantage, they will help supplement the cost of the care in a nursing home. You should be aware that if you have any assets available, the costs of nursing home care will come from those assets first. Once you have depleted those assets, Medicare and Medicaid will take over the payments for nursing home care. If you have any questions or concerns about paying for assisted living or nursing home care, it is advisable to speak directly with the community. They will know exactly what your costs will be and if there are any programs available that can provide assistance with these costs in your area.

When to Move From Assisted Living to a Nursing Home

The decision to transition to a nursing home is highly personal and varies for each individual. It often involves grappling with the perceived loss of independence, a sentiment that many understandably meet with resistance. Numerous factors contribute to this decision, encompassing emotional preparedness, proximity, available services, and associated costs. However, safety frequently emerges as a primary concern. Keep an eye out for these indicators that may suggest it’s time to consider the next level of care:

1. Terminal or chronic illness necessitating round-the-clock supervision or care.
2. Deteriorating emotional disorders or conditions linked to dementia.
3. Presence of multiple simultaneous medical conditions or worsening health conditions.
4. Increased incidents of falling, sprains, or broken bones.
5. Challenges in managing finances, including misplacing money, overspending, or feeling overwhelmed by financial responsibilities.
6. Struggles with house cleaning and personal hygiene maintenance.
7. Diminished mental acuity, heightened memory loss, confusion, or disorientation.