Nursing Homes vs Assisted Living - What Are The Differences?
May 28, 2021Retirement Communities
The terms nursing home and assisted living are often used interchangeably, but they refer to very different things. Here’s what the differences are.
Nursing homes provide much more specialized care than assisted living facilities. Nursing home residents need round-the-clock care, while assisted living residents can usually stay largely independent, while still needing help with some daily tasks.
Nursing homes are really for people who have debilitating mental or physical conditions. They need nearly constant care, are often bedridden or wheelchair-bound, and generally can’t live independently. Assisted living residents, meanwhile, will need some assistance with tasks like bathing, dressing, and housekeeping, but they do not need round-the-clock care and can live largely independent lives.
We’ve put this quick guide together because we’ve had to ask these questions ourselves when our own loved ones were in need of additional care. What follows is based on our own research and our own experiences.
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Aren’t Assisted living and Nursing home the same thing?
For a long time, “nursing home” was a catchall term for residential facilities for the elderly. Over the past several decades, though, that’s been steadily changing. There are a few reasons for this.
Increased life expectancy
People live longer now than they used to. This is largely due to improved medical care that dramatically increased the survival rates for victims of heart attacks, cancer, and diabetes. In other words, we have a lot more senior citizens in our population than we used to.
Fewer people caring for their parents
There was a time when, as you grew older, you would rely on your adult children to care you for. It was common to move in with them when you were no longer able to work. However, it was also common for the grandparents to help raise the children, and help with the cooking and cleaning around the house.
The fact that people are caring for their elderly parents less is tied closely to the increase in lifespan. Our elderly parents are now often old enough that they can’t really help much around the house, and they often need a lot of care and attention themselves.
For these reasons, specialized facilities to care for the elderly have become much more common, and there are different types of facilities that are primarily differentiated based on the level of care they provide.
What is a Nursing Home?
Nursing homes are residential care facilities for persons who need full-time, often specialized, care. It’s often assumed that nursing homes are for the elderly, but that’s not entirely true. Many nursing home residents are disabled and unable to care for themselves. In addition, their families are unable to provide the level of care they need.
So, in a nursing home you’ll often see a mix of ages among the residents, even if the majority of the residents are seniors.
Nursing home residents don’t require the level of care that a hospital could provide, but they do require more care and attention than what could be provided if they lived at home. There’s a lot of room within that definition for different levels of care, and that’s because the term nursing home is a very broad one.
Almost any residential facility that’s designed to provide medical and social care for it’s residents can be described as a nursing home, and so there are additional terms that are often used to more accurately describe nursing homes.
Skilled Nursing Facility
These are the facilities that many people think of when they are talking about nursing homes. They are set up for residents who need nearly constant care. Residents in these facilities typically aren’t able to maintain much, if any, independence, and require assistance with most daily tasks.
These facilities are often set up much like a hospital, with nurse stations on each floor, hospital-style beds, and emergency medical care on site.
They’ll offer palliative care, as well as long-term preventative medical care. They often have rehabilitation specialists on staff to help with recovery from medical procedures.Speech, cognitive, behavioral, and physical therapists are often on staff or on call as well.
Memory Care Facility
A memory care unit can be an independent facility or it can a unit attached to a larger nursing home. These are designed for Alzheimer’s and dementia patients, particularly those whose dementia has progressed to an advanced stage.
These patients need a lot of attention, and there are special security concerns as well. Alzheimer’s patients have a tendency to wander and get lost, which can be life-threatening. Memory car facilities can prevent this from happening.
Generally, residents of a nursing home have debilitating physical or mental conditions that leave them unable to live alone. These facilities typically require a doctor’s prescription and a physical exam before they will admit a resident.
What is an Assisted Living Facility?
One of the most common senior living facilities you’ll see are Assisted Living Facilities. An assisted living facility is meant for older residents who need some help with the tasks of daily living, but who are otherwise able to maintain a high degree of independence.
In assisted living, most residents have an apartment, townhome, or condo to live in. They often have extra bedrooms and their own kitchens, and some even offer garages or covered parking.
There’s typically a central dining hall where meals are provided if they don’t want to cook, and most of the household chores (cleaning, mowing the lawn, etc) are done by the facility staff.
They often have transportation services and medication management services, too. Perhaps the biggest benefit of assisted living, though, is the community they provide. Planned social activities, clubs, and simply having neighbors to interact with all provide a great benefit to the residents.
It’s becoming less common to refer to assisted living facilities as nursing homes, since they really don’t offer much in the way of nursing, and are really residential facilities that simply offer a lot of assistance to the residents.
Assisted living facilities are really just a housing choice for seniors who aren’t able to continue living along, but still want a social and active lifestyle. Any senior who does not need full-time skilled nursing care can move into an assisted living facility, no prescription is needed.
What are the differences?
The main difference between nursing homes and assisted living facilities are in the level of care provided to the residents, and in the physical and mental condition of the residents.
Nursing home residents are in need of a lot more care and attention, and often can’t function independently.
In contrast, residents of an assisted living facility are usually capable of a high degree of independence. For most of their day, they own their own, in their own spaces. They can typically handle most tasks on their own, and only need assistance with certain things.
That can vary, though. Many assisted living residents require daily assistance with bathing, or getting dressed, but outside of those tasks they’re fine on their own.
To be admitted to a nursing home, a resident needs to have a debilitating physical or mental condition that renders them unable to live alone, and requires constant care. These individuals are often wheelchair-bound or bedridden, but not always.
While the goal of an assisted living facility is to create a place for seniors to enjoy a community and a high quality of life in their golden years, the goal of a nursing home is to ensure the comfort and safety of persons who need round-the-clock care from skilled nursing staff.
A nursing home is really a slimmed-down, specialized hospital, while an assisted living facility can be thought of as a specialized apartment or townhome community with lots of added amenities and benefits. Those are very broad, very simplified descriptions, but they’ll help you to understand the differences between the two.
What are the similarities?
Nursing homes and assisted living facilities do have some similarities. Obviously, they’re both intended primarily for seniors and other individuals who aren’t able to live alone.
Both nursing homes and assisted living facilities put a lot of time and effort into planning communal and social events for their residents. Loneliness is the silent killer among seniors. Feeling lonely and isolated can actually lead to chronic heart problems, and can cause severe depression. It can also speed up cognitive decline and create behavioral issues.
So, the socialization provided in nursing homes and assisted living facilities is actually one of the most important benefits they can offer. That alone can improve the quality of life for their residents dramatically.
While they might differ in the types of activity they can offer, both nursing homes and assisted living facilities will have regular schedules of events and activities for their residents to keep them as active as possible.
Meals are also provided in both types of facility. A nursing home will often be able to tailor each residents foods to their particular medical and nutritional needs, much like a hospital has specific meals available for patients based on their medical condition. Assisted living facilities tend to have a broader menu. But in both cases the residents can expect to have access to healthy, nutritious food without needing to cook it themselves. Malnutrition among the elderly is a real problem. Cooking can become a daunting task for some who lack the energy or the dexterity needed to do it, while others simply don’t know how- often one spouse did all the cooking, and when they pass, the other becomes malnourished. Nursing homes and assisted living facilities both ensure that this problem is addressed.
Quality of Life
Finally, both nursing homes and assisted living facilities ensure that each resident is getting the help that they need to have the highest quality of life that they can. In a nursing home, the residents usually have conditions that are going to limit their quality of life no matter what, but they’re better off in the nursing home than they would be otherwise.
Assisted living facilities offer what is arguably the highest possible quality of life that a senior citizen could hope to have. They’re largely independent but they have as much assistance as they need with the tasks of daily life.
Which one is right for me?
We’ll make this simple: if you’re trying to choose between a nursing home and an assisted living facility, choose the assisted living facility. If you or your loved one needs a nursing home, you’re not going to be presented with a choice.
Remember, nursing homes are prescribed by doctors. They are for people who need round-the-clock care, and have debilitating physical or mental conditions. Assisted living is for people who are otherwise healthy, but need some help throughout the day with some of the basic tasks of everyday life.
The good news is, that means that assisted living is the right choice for most people. The majority of us will not need a nursing home,but for those who do, it will be the clear and obvious choice.
Is Assisted Living better than Nursing Homes?
This really isn’t a matter of one being better than the other. They each provide a different service, and a different standard of care. So, if you need a nursing home, then yes, a nursing home is better for you than an assisted living facility.
Likewise if you don’t need a nursing home, then an assisted living facility is better for you than a nursing home. But there’s no universal superiority here. People often think that assisted living is better than a nursing home; that’s understandable, since they look more comfortable and being inside an assisted living facility is much more pleasant for most visitors than being inside a nursing home.
But an assisted living facility would be a terrible place for someone who needs the level of care provided by a nursing home. So, for many people, a nursing home is better, and for many others, an assisted living facility is better.
About THE AUTHOR
With multiple family members currently in senior living facilities, David is in the trenches every week, learning the ins and outs of nursing homes, assisted living, memory care, and general senior living.Read more about David Bolton
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We love planning for retirement. It's somewhat of a hobby, and we want to share what we've learned with you. Over the years we've found the best ways to live, how to travel, take on new hobbies and give back. Happiness in retirement is the main goal, and having the right information allows us (and you) to achieve that.