Page Reviewed / Updated - Oct. 2019
Choosing between nursing home care and assisted living for a loved one who requires residential care is a difficult decision and one that is faced by many families. Typically, families have very little experience with either type of care and often feel ill-prepared to make the correct decision. The objective of this article is to help families by comparing the strengths and weaknesses of each type of care, including an examination of the payment options, since a decision cannot be made without taking this factor into account.
Overall, the main difference between nursing home care and assisted living is that nursing homes provide medical and personal care in a clinical setting, while assisted living primarily provides personal care in a home-like, social setting. While there are some conditions and needs that cannot be met in assisted living, the services and intermittent medical care that are often provided can make assisted living a viable option for more seniors than ever before. Since assisted living maximizes quality of life and provides a more independent lifestyle, it’s often preferred over nursing home care when possible.
Assisted Living vs. Nursing Home Care Comparison Table
|Assisted Living||Nursing Home Care|
|Types of Care Services:||-Assistance with the activities of daily living (personal care) -Medication management and administration||-Assistance with the activities of daily living (personal care) -Medication management and administration -Skilled nursing -Limited medical treatments|
|Non-Care Based Services:||-Extensive recreational activities -Non-medical transportation -Meals, laundry, housekeeping -Supervision||-Limited recreational activities -Meals, laundry, housekeeping -Supervision|
|Living Space:||-Private or shared apartments and studios with private baths and kitchenettes -Extensive common living space and outside grounds||-Private or shared rooms -Some common areas and limited or no outside areas|
|Number of Residents:||-Ranges from as few as 5 to as many as 300; the average is approximately 50 individuals||-While smaller nursing homes exist, the majority are large and accommodate on average 100 residents|
|Appropriate for Individuals that:||-Require some personal care -Can walk or are ambulatory -Are receptive to assistance -Note: individuals with Alzheimer's or dementia can do quite well in assisted living or special Memory Care units||-Require extensive personal care -Are not mobile without assistance -Require daily medical care -Have severe cognitive impairments -Are resistant to assistance or have other behavioral problems|
|Costs:||-Approximately $4,000 / month for assisted living or $4,800 - $5,200 / month for supervised Alzheimer's care. More details.||-Approximately $7,441 / month. More details.|
|Payment Options:||-Predominately paid for out-of-pocket but financial assistance is available in VA Pensions, from Medicaid in some states and other options exists. There is also help specifically for Alzheimer's. Learn more about paying for assisted living.||-Predominately paid for by Medicaid, but beneficiaries must spend down their own assets on care before coverage kicks in or alternatively working with a Medicaid planner can preserve assets. Learn more about paying for nursing home care.|
|Other Names:||-Adult Foster Care -Senior Living Communities||-Intermediate Care Nursing Facilities -Skilled Nursing Facilities|
Individuals who need frequent hospital stays may prefer a nursing home as the additional services that can be provided there may prevent them from having to move as often.
Having Alzheimer's or dementia does not necessarily mean nursing home care is required. Many assisted living communities have specialized areas for individuals with Alzheimer's in which increased supervision is provided to help prevent wandering.