Which Is Best? Assisted Living or Skilled Nursing?

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One of the questions most frequently asked by families of potential residents of The Arbors Assisted Living Residential Communities is: How can I tell which is best? Assisted Living or Skilled Nursing?

It’s not really a matter of which is best. What is important, is your loved one’s needs.

How to Determine If Your Parent Needs Assisted Living or Skilled Nursing

If your parent needs a little help remembering to take their medication or does not get around as much as before, they’re a prime candidate for Assisted Living.

Assisted Living communities provide assistance with the activities of daily living (ADLs). There are six categories of ADLs—eating, bathing, dressing, toileting, transferring (walking) and continence. This is assistance, not actually doing the task. For example, if your parent needs meals prepared and special utensils, that is assistance; feeding someone is not assistance.

The other category is medication management and administration. Many people choose Assisted Living because their parent either forgets to take their medicine, takes too much or does not take their medicine at the correct time. Assisted Living communities make sure your parent takes their medication on time every day to ensure their health.

Skilled nursing communities do everything Assisted Living communities do, as well as medical treatments and 24/7 nursing care.

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Take this quiz to determine if you have a good idea of the differences between Assisted Living (AL) and skilled nursing (SN).

  1. Needs a walker to get around                                                                    AL          SN
  2. Is totally incontinent                                                                                  AL          SN
  3. Uses oxygen                                                                                                  AL          SN
  4. Has an open wound                                                                                     AL          SN
  5. Gets lost easily                                                                                             AL          SN
  6. Engages in behaviors that may pose dangers to themselves or others AL          SN
  7. Frequently becomes ill                                                                                AL          SN
  8. Has few problems communicating                                                            AL          SN
  9. Refuses or fails to follow instructions                                                      AL          SN
  10. Burns food when cooking                                                                           AL          SN

Answers:

  1. Even if your loved one uses a wheelchair, they may qualify for Assisted Living if they can get in and out of the wheelchair with no help.
  2. People who are totally incontinent and unable to change their own pads need the supervision available in skilled nursing to prevent skin breakdown and other illnesses.
  3. As long as someone can handle their own oxygen, they may live in Assisted Living. If they don’t know how to administer oxygen to themselves, they should receive skilled nursing care.
  4. Open wounds should always be treated by nurses because of the danger of infection.
  5. Most Assisted Living communities offer Memory Support for people who are otherwise healthy but experiencing the beginning stages of dementia or Alzheimer’s.
  6. People who hurt themselves, refuse to eat, or yell at or attack others need more care than AL can provide.
  7. If someone becomes ill, they may temporarily need skilled nursing, but if it’s a frequent occurrence, they’re safer with skilled nursing care all the time.
  8. Even if your parent frequently becomes confused, as long as they can communicate, they will do well in Memory Support, where staff are trained in communication techniques.
  9. People who refuse or are unable to follow instructions pose a danger to themselves and others.
  10. Most Assisted Living communities offer 3 nutritious meals a day, even though many also offer a kitchen, so a senior who is having problems cooking need never cook again.

If you’re still unsure, their physician can tell you which is best. If a person lives in an Assisted Living community, they receive regular assessments to determine whether they should move to skilled nursing. In addition, if they become ill, they may temporarily receive skilled nursing care.

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Financial Differences Between Assisted Living and Skilled Nursing

Cost Differences

The average annual cost in Massachusetts for Assisted Living is $65,550 for 2016, according to the Genworth 2016 Cost of Care Survey. The cost for Memory Support is approximately 23% higher.

That’s compared to $135,050 for a semi-private room and $144,175 for a private room in a skilled nursing facility.

Genworth estimates that costs will increase to $78,270 for Assisted Living, $161,257 for a semi-private skilled nursing room, and $172,152 for a private skilled nursing room by 2022.

Payment Options

Payment for costs differs between Assisted Living and skilled nursing.

Assisted Living costs do not qualify for Medicare payment in most cases and, as a result, are primarily paid for out of pocket. Veterans pensions, long-term care insurance, and Medicaid (in some states) may cover costs. In Massachusetts, the Low Income Housing Tax Credit and HOME programs and MassHealth/Medicaid programs, such as the Group Adult Foster Care Program, the (PCA) Personal Care Attendant Program and the (PACE) Program of All-Inclusive Care for the Elderly, may be used to cover costs. Additional programs may help with Memory Support care.

Medicaid will cover the costs for skilled nursing care, but only after a person’s assets are spent down.

Other Differences Between Assisted Living and Skilled Nursing

Residential Differences

Although Assisted Living communities vary nationwide, most residents live in their own private apartments with doors that lock. For safety reasons, people who require skilled nursing live in rooms with bathrooms and easy access by nursing staff.

Programs

Although both communities offer on-campus entertainment that may include seminars, crafts, local musicians, and school groups, Assisted Living communities also provide off-campus transportation to activities and attractions.

Other Services

Both Assisted Living and Skilled Nursing offer housekeeping and laundry services.

What Does The Arbors Offer?

Here at The Arbors Assisted Living Residential Communities, we foster the independence of residents. We promote an active, engaging lifestyle with programs that enhance seniors’ well-being. Each community is customized for its residents, including food choices, programs, trips and more. If you have questions about how The Arbors can help your parent live an independent, active, fulfilling life, please contact us.

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