Assisted Living vs. Nursing Homes

Finding the right senior housing is no easy feat. In particular, it’s challenging to know what your loved one’s needs are now – and what they’ll be in the future. The choice between assisted living vs. nursing homes is a common dilemma for families looking for the best long-term care solution. Assisted living vs. nursing homes may have some overlap, but they’re focused on different areas of care and level of amenities. Let’s take a deep-dive into assisted living vs. nursing homes so you can make a more informed decision about your senior housing.  

How do I decide between assisted living vs. nursing homes?

Senior housing is a life-changing decision. It’s important to consider all the factors in order to find the “best fit” for you or your loved one. Some key considerations include: 

• Your health, i.e. need for specialized care
• Your safety when unsupervised
• Your ability to do daily tasks such as bathing and dressing
• Your ability to cook and do errands
• Your current caregiving situation
• Your level of isolation or loneliness 
• Your insurance and finances

All of these factors play a role in deciding what senior housing may be best. You should carefully analyze each area and understand your priorities. 

About nursing homes

Nursing homes have a bad reputation, but they’re excellent in terms of providing 24/7 specialized nursing care. Many care facilities have also improved in recent years to provide a more holistic experience for seniors, including recreational activities. 

Profile: Seniors who require specialized nursing care, due to chronic illnesses such as heart disease, cancer, diabetes, stroke, arthritis, etc. The nursing home provides a 24/7 level of care. Because the focus is on care, there aren’t usually extra amenities. 

Housing: Nursing home living arrangements are typically private or shared rooms with some common areas available. 

Amenities: Varies greatly depending on the facility. May include meals, housekeeping, laundry, transportation and recreational activities.

Staff: Daily 24/7 contact with nurse and/or health aide. Medication management, as well as more serious care plans for chronic illnesses. 

ADL care: Provided daily, as seniors are too ill or injured to perform daily tasks. 

Nursing care: Provided daily, as seniors are too ill or injured to live without 24/7 care.

Cost: $8,121/month for a private room or $7,148/month for a shared room (according to Genworth’s Cost of Care Survey).

Payment method: Nursing care likely covered by Medicare, Medicaid, Aid and Attendance benefits, or private insurance. Other amenities will have to be paid privately (unless Medicaid).

Benefits: Daily specialized care and sense of community. 

About assisted living 

This senior housing is ideal for seniors who may require some nursing support, but not intensive care. Assisted living gives seniors help with daily tasks within a convenient facility that includes amenities.

Profile: Seniors who need some extra help with daily tasks and may have an underlying health condition that could get worse. They may also be feeling lonely and want to meet other seniors. Ideally, the senior would have some kind of health insurance (Medicaid or long-term care) to help cut costs. 

Housing: Assisted living arrangements are typically private or shared quarters in an apartment building with some common areas available. Sometimes kitchenettes are available for home cooking. 

Amenities: Meals, housekeeping/maintenance, laundry, transportation, entertainment (social calendar, game room, fitness center, etc.).

Staff: Daily contact with health aide and medication management, as well as comm system available for security/medical emergency.

ADL care: ADL care provided (bathing, toileting, grooming, mobility tasks, etc.).

Nursing care: Some nursing care provided for a continuum of care, often at extra cost.

Cost: $4,051 (according to Genworth’s 2019 Cost of Care Survey).

Payment method: Nursing care likely covered by Medicare, Medicaid, Aid and Attendance benefits, or private insurance. Other amenities will have to be paid privately (unless Medicaid).

Benefits: Daily ADL care and sense of community. 

Example profiles of assisted living vs. nursing homes

Let’s look at some example profiles of seniors who are looking for new senior housing arrangements. These situations will help you better understand whether assisted living or a nursing home is right for you. 

Situation #1: Jenny

Ever since she had a stroke, Jenny has struggled with mobility. She lost some motor functions and can’t perform daily tasks such as getting dressed or cooking meals. She also requires specialized physical therapy to relearn certain skills. During this process, Jenny is also feeling lonely and would like to make new connections with other seniors. Currently, Jenny has Medicare coverage and owns a small home.

Best choice: Nursing home. Jenny requires specialized nursing care for her stroke recovery. She’s also unable to care for herself (bathing, feeding, etc.), which is performed at nursing homes. If she finds a Medicare-approved nursing home facility, her short-term recovery care will be covered. However, for long-term care and other amenities such as meals and laundry, Jenny might consider selling her home. 

Situation #2: Carlos

Carlos currently lives with his son. He was recently diagnosed with Parkinson’s disease, which is making it difficult for him to do basic tasks such as toileting or making breakfast. His son works at an office and is unable to help him during daytime hours. He’s also a bit lonely on his own. Carlos is worried what he will do if his Parkinson’s disease gets worse. He has Medicare and life insurance.

Best choice: Assisted living. Carlos needs some extra help to bathe and get dressed, which is included in assisted living. He could also benefit from amenities such as meals and recreational activities to make friends with other seniors. At an assisted living facility, Carlos will be able to get a continuum of care in case his Parkinson’s disease gets worse. Any nursing care will be covered by Medicare, though he will need to consider how to pay for ADL care and other amenities such as meals. He should check his life insurance to see if there’s a rider to use it for chronic illness. 

Now that you have a sense of both assisted living vs. nursing homes, let’s compare the two in greater depth.

Comparing differences in depth

To help you understand the differences, we’ve created this comparison chart, so you can best find out which option fits best with your needs. 

	Nursing home	Assisted living
Housing	Private or semi-private apartment; room may be shared to cut costs	Living quarters are more spacious and home-like. Private or semi-private apartment; room may be shared to cut costs.
Amenities	Fewer amenities, such as standard meals and amenities.	More amenities, including meals, housekeeping/maintenance, laundry, transportation, entertainment (social calendar, game room, fitness center, etc.).
ADL care	24/7 care	Included
Nursing care	24/7 care	Some care included but costs extras
Cost	$7,000-$8,000/month	~$4,000/month
Payment method	Nursing care covered by Medicare, Medicaid, Aid and Attendance VA benefits, or private insurance. Other amenities are usually privately funded.	Nursing care covered by Medicare, Medicaid, Aid and Attendance VA benefits, or private insurance. ADL care and amenities are usually privately funded.

Conclusion

As you make your decision about senior housing, you should consider all these factors. While assisted living and nursing homes have some overlap, they are unique in their focus.

Remember that senior housing entails a wide range of options. You can learn more about senior housing options and other senior topics at My Caring Plan. Simply start your search for assisted living or nursing homes near you by entering your zip code. 

Sources

1. Independent Living for Seniors, HelpGuide, www.helpguide.org