Assisted Living vs Nursing Homes

Whether you are looking at senior care options for yourself or for a loved one, it is important to evaluate the differences between assisted living and nursing homes  so you can make an informed decision and find the appropriate senior living option. We’ll unpack the differences between assisted living and nursing home care and who they are intended for. 

What is Assisted Living

Assisted living communities provide activities, amenities, social events and limited medical services to seniors who are able to live independently and are looking to maintain an active and social lifestyle. Many facilities provide increased levels of care for residents who have increasing medical needs as well as specialized care options.

Continue Reading: What is Assisted Living

What is a Nursing Home

Nursing homes are able to provide 24-hour care and medical supervision to nursing home residents who are unable to live on their own due to medical conditions or mental health issues. 

Quick Overview: Assisted Living vs Nursing Home Facilities 

Assisted LivingNursing Home
OverviewAssisted living facilities typically offer activities, amenities, social events, with limited medical care for residents who can live independently.  Nursing homes focus on providing a higher level of medical care to residents unable to live on their own with fewer activities and amenities. 
Who is it forSeniors who can living independently and want social and recreational activities.Seniors who need either significant or round the clock care due to inability to care for themselves or more serious medical conditions.
Level of care providedOften, medication management and administration are provided onsite while therapists, nurses and other care professionals may visit.
May also provide help with daily living tasks such as housekeeping and bathing.Some facilities may provide graduated or specialized treatment.
Often provides basic medical treatments onsite as well as some therapy / rehab treatments. Nursing staff is available 24/7 to provide round the clock care and treatment to people.
Average facility size50 residents 100+ residents
Type of FacilityAssisted living facilities are considered residential communities.Nursing homes are considered medical facilities. 
Level of IndependenceModerate to highLow to moderate
MealsMeals are served in Dining rooms and facilities often provide the ability for residents to cook in their own rooms. Some may feature restaurant style dining.Dietitians typically prepare meals for residents that are serviced in a dining room or the resident’s room.
LifestyleEmphasis on activities, amenities, and social interaction.Less social interaction and activities as they are more focused on providing care to residents.
Types of activities offered Classes, exercise, outings, games, mental stimulation activities, etcGenerally limited and may included educational classes or mental stimulation activities.
Average cost$4,000 per month$7,500 per month

What’s the difference: Assisted Living vs Nursing Homes

The key differences between assisted living and nursing home facilities are: 1) an individual’s ability to live on their own and 2) the type of care required by the individual. Assisted living is best for adults who desire independent living, social activities, and who don’t need extensive medical care. Nursing homes are a better choice for residents who require more medical attention, complex medical services, and need personal / custodial care to help with the activities of daily living.

Who Is It For

In short, assisted living facilities are for individuals who want to stay active, maintain an independent lifestyle and do not require significant medical assistance or help with everyday activities. Nursing homes on the other hand, are residential care facilities for older adults who have significant health problems, chronic illness or deteriorating health and need support services for every day life activities and elevated medical care on a daily basis.

Related: How to Get Your Parents into Assisted Living

Setting and Size

In general, assisted living facilities tend to be smaller than nursing home facilities, with an average of 50 residents in contrast to an average of about 100 residents for nursing facilities. That said, there is a wide range and you’ll be able to find larger or smaller facilities for both types of care. 

Length of Stay

Nursing homes provide both short-term and long-term care – shorter stays in nursing homes (or skilled nursing facilities) tend to be in order to receive more focused or specialized medical attention in response to an event (such as a fall or recovering from a medical procedure). Typically a doctor’s prescription is needed to get into a nursing home as they are considered medically necessary healthcare facilities, not a retirement community.  

Individuals typically have longer stays at Assisted living facilities (also called ALFs), as they typically require people to be mobile and self able when they move in, and often allow for seniors to age into higher levels of care in the facility.

Level of Care Provided

While both types of residential communities will have a resident nurse (or several depending on the size of the facility), as a general rule of thumb, a higher level of medical equipment and care is provided onsite at nursing homes while assisted living residents can have medical professionals visit, or some assisted living facilities provide transportation services to x and other healthcare services. 

Assisted Living FacilitiesNursing Care Facilities
Help with bathing & hygiene Typically offered for a feeTypically included
Laundry serviceTypically offered for a feeSometimes included
Housekeeping serviceTypically offered for a feeSometimes included
Continence  helpTypically offered for a feeTypically included
Mobility helpTypically included, but less availableTypically included & readily available
Medication managementTypically offered for a feeTypically included
Medication administrationTypically offered for a feeTypically included
24-hour nursingcareSometimes offeredYes
Rehabilitation servicesSpecialists can visitOften onsite
Physical therapy Physical therapists can visitOften onsite
Occupational therapyOccupational therapists can visitOften onsite
Speech therapySpeech therapists can visitSometimes onsite
Registered nurse on siteTypicallyYes
Specialized memory loss / dementiacareIn some facilitiesIn some facilities
Palliative careIn some facilitiesOften onsite
Dental services providedNoTypically

Lifestyle and Activities

Assisted Living

In an assisted living setting, seniors typically have their own apartments complete with kitchens where they can live alone or with a spouse / partner. They are expected to, at least initially, primarily live independently. 

Much of the focus and draw of assisted livings are the amenities, activities, and social / community activities. Often, assisted living homes will provide amenities and recreational activities like:

  • Organized outings (ex: museums, restaurants, plays, concerts, farmers markets, movies)
  • Activities like happy hours, gardening, bingo, book clubs, painting classes, and dancing
  • Memory boosting games like crosswords, sudoku, and trivia
  • Exercise classes like yoga, stretching, swimming, golf / putting, and walks
  • Transportation to doctors appointments
  • Hair and beauty services

Additionally, these facilities are often designed with common areas for family visits.

Nursing homes

In a nursing home, residents may have either their own private room or a shared room, but do not have kitchens as all meals are prepared by a dietitian. Residents are expected to require much help to perform daily life activities.

While activities are not a primary focus of nursing care centers, they typically do provide some activities for their residents, such as:

  • Memory boosting games like crosswords, sudoku, and trivia
  • Transportation to doctors appointments
  • Hair and beauty services

Cost and Insurance

On average, assisted living costs about $4,000 per month while nursing homes cost on average about $7,500 per month due to the higher degree of attention needed from staff members and medical personnel. 

Related: How to Pay For Assisted Living

As nursing homes are federally regulated medical facilities, Medicare typically covers a portion of nursing home costs for the first 20 days. Longer stays are typically the responsibility of the patient. 

Related: Does Medicare Pay For Assisted Living

Assisted living facilities are regulated by individual states. As such, some state Medicaid programs will pay for assisted living costs. 

Long-term care insurance plans often pay for both assisted living and nursing homes up to a certain amount specified by the particular plan. These plans typically cost anywhere from $2,000 to $9,000 per year depending on a variety of factors such as age, benefits, duration, and health.

Related:Does Long Term Care Insurance Cover Assisted Living


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