Assisted Living or Nursing Home?

It Takes a Village

The difference between assisted living facilities and nursing homes

When does a person need to go to an assisted living facility and when does he or she really need a nursing home? It’s a question I’m often asked, and the answer is: it depends.

It’s actually not quite as easy as choosing between two options. Just within nursing homes you’ll find a wide variety of what kind of care can be offered. Assisted living facilities may vary even more than nursing homes because they have fewer regulations to keep them all on the same page. But basically it all depends on how much care is needed.

Assisted living facilities generally offer less care and more of a homelike feeling than nursing homes—although today’s nursing homes are much homier than in years past.

A nursing home is a good choice if you’re having surgery and need a place to get therapy and recuperate, or if you or your loved one is bed bound, needs a respirator, or has wounds that are not healing and require daily care. That’s because at a nursing home, as opposed to an assisted living facility, residents are under the 24-hour care of licensed or registered staff (if it’s a skilled nursing facility) or certified nurse assistants.

An assisted living facility is a good choice if you mostly just need more assistance with a couple activities of daily living, like bathing or dressing, but don’t need any medical care. Assisted living suites typically include a kitchen, which you won’t have in a nursing home, but if cooking isn’t on your list of things to do, then you won’t need that.

Or, the right choice may be a combination of nursing home and assisted living care. For example, you may want to come to a nursing home after you have surgery to have therapy but then choose to go to an assisted living facility to live.

Choosing between a nursing home and an assisted living facility may depend on your finances, too. Generally, Medicare and Medicaid won’t help with your expenses if you are at an assisted living facility, but one or the other or both likely will if you need nursing home care. If you have to pay for the care by yourself, assisted living is less expensive because fewer high-dollar services are offered.

But whichever setting you choose, be ultra careful before you actually decide on a specific residence. Get to know the staff and administrator well. Eat the food. Make sure the place has plenty of safety features, like non-skid surfaces and grab bars in the bathrooms. Read the resident contract and residence rules. Visit at different times during the day. Ask about who will draw up the care plan for you or your loved one and what kind of input you’ll have. Talk to the other residents about whether they like where they’re living. And talk with your or your loved one’s family doctor, senior centers, geriatric care manager, or long term care ombudsman to find out about the facility’s reputation.

And, if you can, begin the hunt well before you’ll need either nursing home or assisted living care—a few months before, to give yourself plenty of time to hunt and make multiple visits. If you wait until you’re on the verge of being discharged from a hospital, your choices will be more limited.

 Arbor Village provides long term care and rehabilitation at 310 West Taft in Sapulpa.