Having your parents move out of the family home and into a senior living facility is a major life event. This is an emotionally charged and intellectually taxing decision that requires careful consideration of a wide range of factors.
It’s tough for anyone to give up their freedom and independence, and your parents are probably no exception. Furthermore, you may have many fond memories connected to the house your parent is selling, dating back to when you were a kid. Having to deal with this can make it much more challenging to make this decision.
Not only is this a tough decision to make for your parents, but is also a tough decision for those taking care of a spouse living with dementia, especially navigating the grief & guilt when it comes to making these types of decisions.
The good news is that there are various senior living options, each with a unique approach. According to the level and type of care, your parents and/or spouse desire and require during this transitioning period.
Adults typically choose between assisted living facilities (also known as retirement homes) and nursing homes when looking for a place to live when needing some assistance with performing day to day tasks.
At first, look, assisted living and nursing homes may appear to be the same thing, but there are important differences to be made between the two.
When searching for a new place to call home, it’s vital to consider several factors, including the individual’s preferences and financial situation. Which option is best for you often depends on how much assistance is required, where that person would be happy, and the costs involved.
Let’s examine the differences between these two types of residences so you can guide your aging parent toward the one that will best meet their needs and preferences.
Assisted Living
Assisted living facilities provide their residents with some level of assistance with everyday tasks while allowing their residents to retain some autonomy. Between 25 to 120 people can usually be found calling one of these communities home.
Assistance with daily activities, including washing, dressing, and using the restroom, may be offered on a minimal to intensive scale. Those who require more extensive medical attention can anticipate paying more. Some assisted living facilities may provide transportation to local medical institutions or have on-site medical staff available on a limited to full time basis.
Niche populations are also well served by assisted living facilities. For example, some assisted living communities are pet-friendly. In contrast, others focus on memory care, yet others have a religious association or offer gourmet meal plans.
Nursing Homes
Nursing homes have a nurse on duty 24/7, and provide services that assist with basic activities of daily living like dressing and bathing, and include IADLs like cooking, cleaning, medication management. They provide both medical care and assistance with day to day tasks.
A trained nursing team is available around the clock to care for residents who live in either private or communal quarters.
Most older or younger individuals who enter a nursing home do so permanently due to their ongoing need for care. This is referred to as long term care. However, other people only stay for a brief time as they recuperate from surgery or a serious illness. This is referred to as a short term stay or short term care.
Physical and occupational therapists are usually available, either permanently on staff or making regular visits, to both short- and long-term residents.
Who Can Benefit From Assisted Living?
Typically, those individuals who are more independent with their daily needs may be ideal candidates for assisted living. Keep in mind, this does differ depending on the assisted living. Some assisted living’s are referred to as memory care, which if this is the case, this type of assisted living can be a great option for someone living with dementia to take care of day to day needs. Services like washing, cleaning, and on-call employees can considerably improve the quality of life for these older individuals. Some may be in pain or have mobility & cognitive limitations that make daily duties difficult. The residents can also gain from the companionship of other people with similar interests or those who are navigating a similar situation.
Who Can Benefit From Nursing Homes?
People of all ages whose health has deteriorated to the point where they can no longer care for themselves at home can benefit from a nursing home. They may choose a nursing home because of the medical care and security it provides. However, many younger, middle aged, & older people living in nursing homes require supplementary assistance with even the most fundamental forms of mobility.
Short-term stays in nursing homes can provide the care needed to help get that person back to their baseline (before the injury occurred). In some cases, especially if it’s a progressive condition, that individual may require ongoing assistance and may require a long term stay in that facility, in home (if care is able to be provided) or somewhere else appropriate for their needs.
Difference Between Assisted Living And Nursing Homes
There are a variety of housing alternatives for individuals, including assisted living and nursing homes. Still, the two can differ greatly in the care given, amenities offered, environment, and overall cost.
1. Care Given
Care for individuals that is not medical is not included in assisted living facilities. There is a wide range of intensity in the level of assistance provided, from light housekeeping and laundry to more involved assistance with eating and toileting. However, assisted living communities may not offer any form of medical treatment.
However, some assisted living facilities have agreements with medical providers who regularly visit the community, so residents who need to see a doctor no longer have to travel.
The amount of medical and custodial attention provided by nursing homes is unparalleled outside medical facilities/hospitals. Many patients require assistance with basic self-care tasks like bathing and feeding. They require constant monitoring by nurses or other trained medical professionals.
Nursing home residents are routinely examined by a doctor. Next, the doctor discusses each patient’s care with the staff there. Some facilities also offer dental treatment and physical, speech, and occupational therapy to their residents.
2. Costs
The price of an assisted living facility or nursing home can range from a few thousand to tens of thousands of dollars each year. It depends on the facility’s location, the services it provides, and the type of care that you or your loved one will need.
Even while nursing homes cost about $4,000 more per month than assisted living facilities, financial aid is more likely to be available to help cover the difference.
In the United States, a month’s cost of assisted living averages $4,300. So whether you go with a semi-private or private room in a nursing home, you should expect to pay between $7,750 and $8,800 monthly on average.
3. Staff
For nursing homes, at least eight continuous hours of care must be provided by a registered nurse each day, seven days a week, with the remainder of the shift covered by a licensed practical nurse.
It is common for nursing homes to employ speech, occupational, and physical therapists. Like a hospital, nursing aides care for residents’ basic needs while registered nurses handle medication and treatment programs.
In contrast, assisted living facilities may not employ any nurses or have only those nurses available for care plans and on-call. Therefore, the staffing requirements for an assisted living community are different for a level I facility than for a level II institution.
At assisted living facilities, they may have therapists that work in a therapy gym inside the facility, but in my experience, therapists are typically hired from an outside agency that come to see the patient on a home health basis. Or it can be a combination of both, where they are seen under a short term rehab stay, then transition to home health therapy.
4. Housing
Nursing facilities frequently take on similar appearances, where they have hallways dedicated to short term stays (individual will not stay there long term) and long term stays (individual lives there). Individuals living in the community are more likely to have to share a bedroom. It is expected that nursing home patients will require more assistance with day to day tasks.
On the other side, assisted living facilities will typically resemble a retirement complex or guarded condominium complex. The facility may allow residents to bring their spouse and pet to live with them in their private suite (varies depending on the facility)..
Many assisted living facilties will also offer non medical transportation services to help their residents go out and about for grocery shopping, religious services, visits with family and friends, medical appointments, and social events. The goal of these set-ups within assisted living homes is to foster a strong sense of autonomy among the individual.
5. Financial Aid
The price of assisted living and nursing home care may appear exorbitant to the typical American. Thankfully, numerous sources of financial aid can help lessen the overall cost of caring for an individual.
Most of the time, the same organization funds assisted living and nursing home care. Financing for nursing care is typically easier than aid for assisted living. However, the proportion of care covered and eligibility restrictions differ.
6. Medicaid
In 41 states, Medicaid may help cover a portion of the cost of assisted living. In other states, however, Medicaid does not cover the expenses of assisted living facilities.
Financial aid for assisted living is most frequently provided via Medicaid. Your monthly income must be below the minimum established by your state to be eligible.
Due to their high-income levels, Medicaid long-term care benefits are out of reach for many, but there is still hope. It is possible to get Medicaid in those states that let seniors qualify by setting up a trust for their additional monthly income.
If you are eligible for Medicaid and your doctor has determined that you need to live in a nursing home, the government program will pay for the majority of your living expenses there. However, there are costs that are not covered, such as those that are not directly associated with your medical treatment.
7. Medicare
Medicare will cover 100 days of care in a nursing home during a benefit period if it is required because of a significant illness, injury, or surgical procedure. If you stay for 100 days, that will pay for the first 20 days and 80 percent of the remaining cost.
While Medicare won’t pay for assisted living, some Medicare Advantage plans will cover the expense of daily living assistance (sometimes known as “custodial care”).
How to Choose Between Assisted Living and a Nursing Home?
Choosing between assisted living and a nursing home can be difficult if both options appear suitable for your loved one’s needs. The question is how to determine which care option is best for your loved one. Consider the following:
1. Medical Needs
Think about your family member’s overall health and how often they need medical care. Do they handle their condition well on their own, or do they require frequent visits from a nurse?
Is it just age-related forgetfulness, or do they have a significant memory impairment that may require round-the-clock care? Is there a worsening of a degenerative ailment that they’re experiencing? Do they always have to deal with incontinence, or is it just an occasional problem?
2. Suitability of Individual Care
Go over the care requirements with of your loved one. They may be a good choice for an assisted living home if they require assistance with only a few activities of daily living (ADLs) and instrumental activities of daily living (IADLs), such as cooking, cleaning, and bathing.
Even if they don’t have any other health problems, it may be appropriate to consider a nursing home if they need help with several ADLs (such as dressing, eating, bathing, etc.).
Your loved one may not need to move into a nursing home if they are requiring level with higher level tasks like medication management, cooking, cleaning, thanks to the assistance offered by assisted living staff.
3. Mobility
When deciding between an assisted living facility and a nursing home, one must consider the resident’s mobility. It’s generally ideal for your loved one to live in a nursing home if they’re bedridden or have lost all use of one side, as can happen after a stroke. Keep in mind there could be assisted living facilities that can provide this type of assistance too, which is why it’s important to speak to someone like the doctor or consider an outside service such as Oasis Senior Advisors or A Place for Mom.
Assisted living is likely to be successful for a wheelchair user with minimal difficulty with ADLs and good control of chronic conditions.
4. Cost
Your best (or only) option may be a nursing home if your loved one does not qualify for government aid but does not yet have the health and mobility to live in an assisted living facility. Unfortunately, the gap between assisted living and nursing facilities is significant, costing an average of $4,000 per month more.
However, if your loved one is eligible for Medicaid and needs round-the-clock medical care, you have a much better chance of costs being covered more at a nursing home rather than at an assisted living community.
Insurance, retirement funds, veteran benefits, and senior citizen groups are just a few potential sources of financial aid. Each may have its own policies on whether or not they will contribute to the cost of assisted living as opposed to a nursing facility.
Which is Better For You, Assisted Living or a Nursing Home?
Both choices aim to give your loved one a place to call home that is safe, healthy, and happy, but which one you pick will depend on that person’s degree of independence and health.
People with a higher level of function and independence, who can benefit from and participate in assisted living’s social and wellness programs, are the greatest candidates for this type of care.
In general, those unable to care for themselves and whose medical issues require closer observation will do their best in a nursing home setting.
The level of physical and medical care is the primary distinction between an assisted living community and a nursing home. Therefore an accurate assessment from your loved one’s doctor is essential, and everyone should have a say in the final decision. When caring for a loved one, it is important to take into account both their physical demands and the kind of medical attention they will require.
Wrapping Up
Moving a loved one to an assisted living facility or senior community can be tough. Still, many families put it off for too long, leaving them with no other choice than a nursing home.
To determine when the time is appropriate to relocate and which type of care best suits your parent’s needs, you should be familiar with the distinctions between assisted living and nursing facility care.
References
- https://cateredliving.com/abbey-manor/blog/difference-between-assisted-living-and-nursing-home/
- https://peachtreevillage.org/what-is-the-difference-between-assisted-living-and-nursing-homes/
- https://www.theseniorlist.com/assisted-living/assisted-living-vs-nursing-home/
- https://blog.highgateseniorliving.com/assisted-living-facilities-vs-nursing-home-care-whats-the-difference
- https://theridgeseniorliving.com/blog/assisted-living-vs-nursing-homes/
- https://www.elderneedslaw.com/assisted-living-vs-nursing-home
- https://www.storypoint.com/the-difference-between-nursing-homes-and-senior-living/
- https://www.seniorliving.org/compare/assisted-living-vs-nursing-home/
- https://www.humangood.org/resources/senior-living-blog/differences-between-assisted-living-and-nursing-homes
- https://www.aplaceformom.com/caregiver-resources/articles/assisted-living-vs-nursing-homes
- https://www.payingforseniorcare.com/assisted-living-vs-nursing-homes
- https://www.elizz.com/planning/assisted-living-vs-nursing-home/
- https://trilliumcommunities.com/assisted-living-vs-nursing-home-understanding-the-differences/
- https://www.leisurecare.com/resources/difference-assisted-living-nursing-home/
