Comparing Assisted Living and Nursing Home Care

Page Reviewed / Updated - May 2016


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 consideration to that factor.

Most people know that nursing homes provide care for individuals who require a higher degree, or a greater frequency, of medical attention than those in assisted living. What is less well known are the specific conditions or behaviors that predicate the need for nursing home care. Individuals with Alzheimer's or dementia, for example, often require a high degree of supervision, but do not necessarily require medical care, while persons with later stage kidney disease might require a lot of medical attention, but very little supervision.


Comparison Table

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
-Limited recreational activities
-Meals, laundry, housekeeping
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 $3,950 / month for assisted living or $5,100 / month for supervised Alzheimer's care. More details. -Approximately $6,800 / 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


Other Considerations

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.

Other Resources

Understand how assisted living charges residents
Use our Resource Locator Tool to find sources of financial assistance
Read Medicaid's long term care eligibility requirements