Assisted Living vs. Nursing Home Care - LCB Senior Living, LLC

Helping an elderly parent transition out of their home environment is difficult enough; deciding among residential options can be downright agonizing. When it comes to nursing home care versus assisted living, the differences are substantial and critical to your selection. We’re here to help you break it down, based on some key considerations:

Living Environment:

Assisted Living resembles apartment-style living, with residents occupying individual units that they furnish and decorate themselves. Most communities offer units with efficiency kitchens for additional cost; all have communal dining and living/recreation spaces. Community activities are offered daily, and range from art and exercise classes to holiday celebrations to local excursions.

Nursing Home residents sleep in hospital-style rooms that are often shared, with separate communal living and dining areas. Activities and excursions are generally not a primary feature of nursing homes, since their residents are most often either physically or cognitively unable to participate.

Health and Personal Care:

Assisted Living communities offer 24-hour staffing in the case of resident need or emergencies.  They are, however, by definition non-medical care facilities, and therefore do not usually have a medical professional in residence. Their focus is on providing a healthy and vibrant social environment that supports healthy cognitive function and prevents isolation. Members are generally expected to require minimal assistance with dressing, bathing, and medications (but can pay for additional personal care services if needed). Residents are also expected to possess the cognitive ability necessary to function in a semi-independent environment – for example, your dad should be able to safely get to and from the bathroom in the middle of the night, or be able to be alert and aware enough to participate in a group activity with other residents.

Nursing Homes’ primary function is to offer medical care for seniors with moderate-to-severe cognitive impairment; for those with debilitating medical conditions; and/or for those with medical conditions that require regular monitoring.  Such conditions range from dementia, to severe heart disease, to those which require frequent assessment and tweaks in medication dosage. While they can offer limited recreational activities, nursing homes are fundamentally medical facilities that offer the most extensive medical care one can get outside of a hospital.

Cost and Payment:

Because assisted living facilities are not medically-licensed, their services are not usually billable to health insurance or Medicare/Medicaid. That said, there are long-term care insurance policies that will cover assisted living.  Costs will vary, depending on the level of care, size of the apartment, and services provided–and also depending on the community itself. The average cost per month in the state of Massachusetts is roughly $5,200.

Nursing home care can sometimes be paid by private pay, private health insurance policies or long-term care insurance policies. Some facilities approved by Medicare or Medicaid can bill services to those organizations. Again, costs will vary depending on the level of care and services provided. The AARP continuing care calculator can help estimate monthly costs in your area based on the services your loved one requires.

Of course, this decision is fundamentally a medical one that should be made in close consultation with your parent’s physician, and with an eye towards long-term evolving healthcare needs. For more on what questions to ask, click here for a helpful resource guide.