It is common for families and individuals to have reservations about assisted living or nursing home care. In many cases, this is due to unfamiliarity with what these types of care provide. Although the decision to transition a senior into an assisted living community or nursing home may be difficult, this type of move is ultimately meant to help seniors who need hands-on assistance on a more consistent basis to have a better quality of life overall.
Talking to family and trusted friends who have gone through the experience of setting up assisted living or nursing home care for a senior is valuable insight. But past these conversations, understanding the basics of assisted living communities and nursing homes can help you to decide which type of facility and support is best suited for the needs of your loved one.
When Should I Consider Assisted Living or Nursing Home Care?
It is important to remember that although assisted living communities and nursing homes share similarities, they do provide different types of support. However, before you can decide what type of care is best, you need to decide if a senior needs extra support. There are some basic areas of a senior’s life that should be reviewed:
Overall Physical Health
Many seniors will experience limitations that are caused by certain chronic diseases and/or physical disabilities. These conditions may make it difficult for seniors to perform the essential “Activities of Daily Living” (ADLs) which include personal care tasks such as bathing, maintaining personal hygiene, safe mobility, and other.
Mental Health
In certain situations, seniors may encounter a diagnosis for psychiatric disorders, Alzheimer’s or Dementia. These types of issues may also make it difficult for seniors to function during their daily routine.
Concerns Over Taking Medication
A potentially serious issue can arise when seniors become unable to take their physician-prescribed medication as directed. It is also common for seniors to develop a need to take intravenous (IV) drugs or require dialysis.
Need for Additional Support
Many seniors may be faced with a general need for more support. Although adult children and other families may be providing the best support that they can, seniors will eventually require more involved care and consistent assistance/supervision.
Difficulty Managing Finances
In many situations, seniors may become unable to successfully manage their own financial affairs or may have difficulty continuing to maintain other aspects of their lives.
Support in Many Areas
This is just a broad list of potential areas that could signal that is is time for a senior to have more support. It is also not uncommon for seniors to display a need for support in several of these areas at once. For example, a senior who is battling Dementia will likely become unable to manage their finances due to the cognitive difficulties such as confusion, or other memory-related issues that are caused by the disease.
Assisted Living vs. Nursing Homes
Assisted living communities can provide seniors with assistance with ADLs and other services. Many assisted living facilities are also designed for seniors, which can increase comfort and safety. Assisted living homes are not equipped for seniors who require constant skilled nursing. Seniors who require 24 hour skilled nursing care will most likely be candidates for nursing home level care.
Level of Care
Both assisted living communities and nursing homes are designed to support seniors. As mentioned previously, they are similar but each provides different support. One of the most important differences between assisted living and nursing homes is the level of care that each provides.
Determining Level of Care
In addition to a physician, a representative from a nursing home or assisted living community can help families to understand what support is available and whether assisted living care or nursing home care is the best option. Additionally, there are evaluations available that can help to determine how many ADLs a senior needs support with, and if they qualify for nursing home level care.
Transitioning from Assisted Living to Nursing Home
Assisted living communities provide care up to a certain point. If a senior needs care that an assisted living facility cannot provide, then they will likely qualify for nursing home level care. Because of this, many seniors begin with assisted living care, and then eventually shift into a nursing home as their needs become greater. When you are researching an assisted living facility, discussing the needs of a senior with their attending physician is highly-recommended before choosing.
Assisted Living vs Nursing Homes – Services Provided
Assisted living communities offer seniors support with all Activities of Daily Living (ADLs), as well as other support services. ADLs support can include but is not limited to:
- Safe mobility
- Personal hygiene
- Meal preparation
- Eating/feeding
- Housekeeping
- Health promotion
- Exercise programs
- Social and recreational activities
- Dressing
- Medication management
- Toileting
As mentioned above, nursing homes will provide the same support with ADLs as an assisted living community, but can also provide more involved care. Nursing homes are designed to provide 24-hour skilled nursing care and/or medical supervision for individuals with more acute issues. It is also important to remember that nursing homes do not provide the same level of care as a hospital.
The services mentioned above described assisted living and nursing home care in a general sense. However, families who are considering an assisted living community or nursing home should always make sure to confirm what support services a facility is equipped to provide.
Assisted Living vs Nursing Homes – Payment
Paying for assisted living or nursing home care is always an important issue. Assisted living care is not usually paid for by the Medicare or Medicaid programs. Many long-term care insurance policies can be used to pay for assisted living, but many individuals/families assume the cost themselves. The cost of assisted living will vary depending on the nature of the care provided, location of the facility, and amenities of the community.
Nursing home care is sometimes paid for by private pay and in some cases is paid for by private health insurance or long-term care insurance policies. Depending on the circumstances, Medicare or Medicaid may be able to pay for nursing home care. Like assisted living, the cost of nursing home care will vary depending on the services provided, location of the facility, and amenities of the facility.
Visiting a Facility

Before a senior becomes a resident of an assisted living community or nursing home, it is recommended for family members to tour the facility. Although both types of facility are different, here are some good tips to keep in mind when you are touring a facility:
Make a Mealtime visit – Because meals usually involve a large amount of residents and several staff members, try to visit during a meal time. This will provide useful insight on the quality of the food being served, and how well-staffed the facility is.
Talk to Residents and Staff – If possible, try talking to the staff of the facility and the residents of the facility. They may have useful information on what life is like inside of the facility that you may not hear during an initial meeting.
Bring a Companion – If you are in charge of organizing care for a senior, make sure to bring along a trusted friend or family member when you visit the facility. This way, you can have more than one person observing—especially if you cannot fully focus on the tour because you have to keep up conversation with the staff during the tour.
Remember Your Motivations
It is important for family members to remember that electing to place a senior in assisted living or nursing home does not mean that they do not care for their loved one. In fact, the transition into one of these facilities are meant to benefit the senior. Although the decision is difficult to make, remember that your loved one’s safety and well-being are the most important factors to consider.