| Written by Regina Asihene, M.D. from Majestic Gardens |

Families often have to make a difficult decision on the type of residential care that is needed for a senior member of the family who may be declining.  Does mom or dad need a nursing home or an assisted living facility?  This article will simplify the major differences between a nursing home and an assisted living facility.

1. Nursing homes are for those who need more medical care in a clinical setting. Assisted living facilities are for those who need personal care in a home-like, social setting.

Individuals who have frequent hospital admissions or multiple medical problems likely need a nursing home to continue to get more skilled nursing and limited medical treatments.  People who need assistance with most of the activities of daily living (bathing, dressing, toileting, transfer, mobility, feeding) probably need a nursing home.  A nursing home is for someone who needs medical professionals for 24 hours.

An assisted living facility is for someone who needs more personal care than medical care and can do some of the activities of daily living on their own.  Individuals who are still able to function in a home-like setting prefer assisted living.  Assisted living facilities are appropriate for those who can walk or are ambulatory and those who are receptive to assistance.

2. Nursing homes have limited recreational activities. Assisted living facilities have extensive recreational activities.

Nursing homes focus on stabilizing a person’s medical condition and provide daily medical care.  Activities are limited because many of the residents require a lot of personal care, are not mobile without assistance, may have severe cognitive impairments, or may have behavioral problems. There are also more residents, on average about 100, making it difficult to accommodate various interests.

Assisted living facilities focus on the quality of life and provide extensive recreational activities, such as exercise programs, music therapy, art therapy, gardening.  Non-medical transportation is often available for excursions. Meals, laundry, housekeeping, and supervision are provided.  There are fewer residents at assisted living facilities. A wide variety of life enrichment activities are designed to meet a resident’s physical, emotional and spiritual needs.

3. Nursing homes have limited living space. Assisted living facilities have more living space.

Nursing homes may have private or shared rooms, some common areas, and limited or no outside areas. Nursing home residents are more likely to share a room with another senior.

Assisted living facilities do not have an institutional appearance.  They generally have an upscale community feel.  At Majestic Gardens assisted living facility, all rooms are private with private bathrooms.  There is extensive common living space and outside grounds and beautiful landscaping.

4. Nursing homes often cost more than assisted living facilities.

Nursing homes can be expensive.  According to the American Council on Aging, the average cost in the United States in 2019 was $247 per day or $7,512 per month.  However, government assistance is available for lower-income residents. Medicaid provides most of the care but beneficiaries must spend down their own assets on care before coverage kicks in.

Assisted living facilities cost approximately $4,000 to $6,000 per month.  The payment is usually out-of-pocket but financial assistance is available in VA pensions from Medicaid in some states and other options can be explored with a social worker.  Assisted living facilities allow aging in place so that a person can stay there although their condition declines.

Overall, the main difference between a nursing home and assisted living is that assisted living maximizes quality of life and provides a more independent lifestyle for those seniors who are not yet very ill and is preferred over nursing home care when possible. Please ask a medical professional to assist you if you have further questions.