As you age, you may need extra help with daily activities. Many older adults choose to lead a simplified life by hiring at-home care or moving to a nursing home or assisted living facility. These housing options provide a number of benefits, including assistance with cleaning, bathing, shopping, and meal preparation. For those with specific medical needs, some facilities offer skilled nursing care onsite.
According to a study by the NIH, about 1.5 million Americans aged 65+ live in nursing homes, while 1 million live in assisted living communities. But are there differences between nursing homes and assisted living communities? And, if so, what are they?
If you're wondering whether one of these long-term care options is right for you (or an aging loved one), keep reading. Below, we'll compare the differences and overlap between a nursing home vs. assisted living. In addition, we’ll dive into other housing options you might want to consider in your search.
Nursing Home vs. Assisted Living: Levels of Care
Both assisted living communities and nursing homes provide onsite care. Both provide assistance with daily activities by serving onsite meals or helping with cleaning, bathing, or other personal hygiene tasks. Both facilities commonly provide weekly recreational activities, such as supervised exercise, movie nights, or group outings.
The primary difference between nursing homes and assisted living comes down to the level of care provided.
Assisted Living Facilities Provide Personal Care
Residents of a nursing home require a higher level of care than those in an assisted living facility. At an assisted living facility, the primary focus is on helping residents with basic tasks — for example, staff may help residents get in and out of the tub, get dressed in the morning, or manage their medication.
An assisted living facility will have processes in place for emergency situations, but they're not required to have a round-the-clock, skilled nursing staff onsite. In addition, residents are typically allowed to come and go, although they're sometimes required to be signed-out by a staff member or family member.
Nursing Homes Provide Medical Care
If you or someone you know needs daily medical care, then a nursing home is a better fit than an assisted living facility. At a nursing home, onsite staff helps with rehabilitation services, memory care, medication management, and other medical care.
Nursing homes are best suited for adults with cognitive impairments, such as Alzheimer's disease, or those who depend on others to complete activities of daily living (ADLs) such as toileting, eating, or bathing.
Sometimes, nursing homes don’t serve as a permanent residence. Instead, an older adult might stay for just a short while, particularly if they’re recovering from surgery, illness, or another incident that requires medical care. In fact, according to the NIH, short-term stays at nursing homes are among the fastest growing segments of post-acute care.
Nursing Homes vs. Assisted Living: Payment Options
Both assisted living and nursing homes can be expensive. According to the Genworth Cost of Care Survey 2019, the national median for an assisted living facility is $4,051 per month. By comparison, a nursing home will run $7,513 for a semi-private room with one roommate, while a private room will cost over $8,500.
These figures vary according to the state in which you live. For example, a private room in a nursing home in New York City costs $13,429 on average. By comparison, a private room in Iowa or Oklahoma will cost $6,878 and $5,627, respectively.
Traditionally, assisted living facilities do not accept Medicare and Medicaid. Instead, these facilities accept what they refer to as "private pay," also known as out-of-pocket payment. However, unlike assisted living facilities, if someone meets the medical requirements to be in a nursing home, Medicare and Medicaid typically cover the costs.
Alternatives to Nursing Homes and Assisted Living Facilities
Are there alternatives to nursing homes and assisted living facilities? Absolutely.
Depending on the level of personal care you or your loved one needs, there are plenty of alternative housing options for older adults. These facilities allow you to maintain your independence while getting the quality care you need — and they typically come at a much lower price point than nursing home care or assisted living. Here are some options.
Home Modifications and Hiring Help
If you wish to stay in your own home, that's certainly an option. A few home modifications could greatly increase your quality of life: Install guard rails in your bathroom and shower, replace hardwood floors with carpet, or add a chair lift to your staircase.
Various smartphone apps and delivery services can make living at home more manageable. Meals on Wheels, InstaCart, and HelloFresh are just a few popular companies that deliver groceries or prepared meals. If you no longer drive, installing the Uber or Lyft app can help get you where you need to go.
Finally, installing Snug on your phone can give friends and family members peace of mind that you're safe at home. With Snug, you can complete a daily check-in with one tap. If you miss a check-in, we'll send a text to your emergency contact, alerting them to check on you.
At-Home Care
Surprisingly enough, home health care (or geriatric care) is more affordable than staying at a skilled nursing facility.
The Genworth Cost of Care Survey 2019 estimates that home services conducted by a skilled nurse costs $87.50 per visit. If you need someone to stop by 1-2 times per week to check your blood pressure or help with personal hygiene tasks, at-home care providers offer a viable alternative to round-the-clock care.
Respite Care
If you are a primary caregiver watching over an aging loved one, there will be times when you need a little relief. Whether you're traveling out of town, running errands, or worried about a loved one who underwent a medical procedure, respite care can provide the extra help you need.
Respite care offers short-term care for aging adults, and can come in the form of both paid-for care and care provided by volunteers. With respite care, you can either hire a caregiver to come stay at your loved one's home, or you can bring your loved one to an adult day care center. Many respite programs offer overnight or day-trip stays, and provide social activities, meals and snacks, and peer support.
Retirement Communities or Senior Housing
A retirement community, unlike assisted living or nursing homes, does not provide medical care or nursing support. Instead, these independent living communities allow seniors to live a more convenient, comfortable life. Many exist in urban apartments or campus-styling housing, with access to a cafeteria. If you’re interested in finding a retirement community that suits your interests, Kiplinger offers a great guide on narrowing down your choices.
In retirement communities, seniors probably won't attend physical therapy, need assistance with medications, or require other skilled care services. Instead, onsite staff might provide transportation services or try to combat senior loneliness by organizing social activities and outings.
Convalescent Home
Convalescent homes are short-term rehabilitation centers staffed by trained healthcare providers, including doctors, nurses, and occupational therapists. These care facilities typically help seniors recover from surgery, illness, or other physical hardship.
If you're having a hip replaced or have the flu, you may want to look into convalescent homes in your area. These facilities can help you recover quickly so you can return to your own home.
There Are Many Options When It Comes to Senior Living
If you're wondering whether a nursing home vs. assisted living facility is right for you, there are a few key differences to consider. A nursing home will have onsite skilled nursing staff, occupational therapy, and other medical services. An assisted living facility, on the other hand, will have limited medical services available.
When browsing through senior housing options, it's important to know the resources available to you. Hiring senior care services or making modifications to your home allows you to reduce your costs and stay at home. In addition, respite care and convalescent homes offer short-term care when you need it. Finally, senior apartments or retirement communities provide social services and activities, while allowing you to maintain independence.