Assisted Living vs Skilled Nursing: What's the Difference?

Assisted living vs skilled nursing care

If you or a family member is looking after an aging parent or loved one who can no longer receive the care they need at home, there are two care options that you might consider: skilled nursing facilities (also sometimes known as nursing homes) and assisted living facilities.

These two senior living communities are for those who can no longer live safely on their own. The biggest differences between the two are who provides the care, what type of care they provide, and what level of care. Assisted living communities encourage independence and provide less medical care; whereas skilled nursing communities are more restrictive but provide more medically intensive care. 

At the end of the day, the care needs of the senior will determine which type of community is most appropriate for their given situation.

What does assisted living entail?

Assisted living is a long-term care option for seniors who need help with activities of daily living (ADLs), such as dressing, bathing, toileting, eating, and medication management, but don’t require around-the-clock care that is offered in a nursing home. 

An assisted living facility offers seniors room and board, full-time 24-hour (non-medical) care, housekeeping, laundry services, social engagement, wellness programs, transportation and outings, meals, and more in addition to personal care. 

Most assisted living facilities are large, hotel-like properties, or smaller and more intimate like single-family homes (often called board and care or residential care homes). The assisted living rooms are apartment-like residences and the rooms can be private or semi-private. 

Depending on where you live the terminology can vary from state to state; for example, you might see assisted living communities referred to as long-term care facilities. 

The care and compassion for older adults with ADLs is a priority at all properties.  The types of services, amenities, community atmosphere, and culture will vary from property to property but the basic premise of helping those who need assistance every day always remains consistent.

The assisted living community is a residential setting that offers social and physical environments that encourage healthier, more active lifestyles. The focus lies on providing an extensive calendar of daily activities for residents as well as providing transportation so they can maintain their independence in the outside world and still be active members of their community. 

Assisted living facilities offer a number of services to assisted living residents and sometimes those suffering from Alzheimer’s or dementia. Some assisted living facilities may also have memory care units where staff members receive additional training and work in specialized areas emphasizing memory loss and cognitive care.

Assisted living is a great place for seniors who want to maintain their independence and still have the companionship of others. The inviting dining rooms and large common areas typical in assisted living communities offer an unlimited opportunity for socialization that can help residents feel like they're part of their own retirement community. 

What does skilled nursing offer?

Skilled nursing, also known as nursing home care, nursing homes, or convalescent homes, offers 24-hour medical care and supervision by licensed practical nurses (LPN), registered nurses (RN), health care workers, and includes medical treatments and monitoring. The medical treatments may include wound care, injections, catheter placement, and intravenous therapy to name a few. Skilled nursing care may also include services from other medical professionals, such as speech therapists, respiratory professionals, physical therapists, and occupational therapists.  These communities offer short-term or long-term care for seniors recovering from an illness or injury, those with chronic conditions.

Residents of skilled nursing communities typically have their own semi-private rooms but share common areas such as dining areas and activity rooms. Meals are usually served in the common dining area, but for residents who are too ill or incapacitated to make it to the dining area, meals can be brought to their rooms. There are usually a variety of scheduled activities each day, such as exercise classes, arts and crafts, and social gatherings. For residents who cannot make it to the group activities, there are hobbies that can be brought to their rooms, such as books, magazines, and puzzles.

Nursing homes offer the most intensive level of care. They provide rehabilitative services, nursing, and therapy services to help patients live more independently until they can possibly return back into their own personal environment, or if necessary, on an ongoing basis.

Assisted living vs nursing home features

Assisted living provides assistance with:

• Medication management
• Meals
• Activities of daily living (ADLs) such as bathing, dressing, and eating
• Housekeeping
• Activities
• Can be covered some by Medicaid but typically are private pay only
• Residents must not have cognitive impairment
• Residents need to be able to walk and stand

Skilled nursing offers all of the above and:

• Physical therapy, speech therapy, and/or occupational therapy
• Post-hospitalization rehabilitation services
• Ongoing palliative and preventative long-term care
• 24-hour care/7 days a week nursing care
• Can help with walking and standing
• More complex medical needs
• Most facilities accept insurance as well as Medicare and Medicaid

Who can benefit from assisted living?

If you're thinking about assisted living for your aging loved one, here are a few things to consider.  The community is designed with the goal of allowing independence as long as possible while still providing security and care when needed; this may be an option if they fit any or all of these descriptions:

• Needs help with ADLs like bathing and dressing
• Has chronic health problems but isn’t ready for a skilled nursing community
• Needs more care than can be provided at home
• Wants to live in a community setting with social activities and events
• Looking for a maintenance-free lifestyle
• Currently in good health but may need more help in the near future

Who can benefit from skilled nursing?

Skilled nursing care is best for those who require more intense medical services, care, and supervision. These facilities offer 24-hour medical care and are supervised by licensed nurses. Seniors who typically receive skilled nursing care are those recovering from an illness or injury, those with chronic health conditions, and those who need help with activities of daily living. Skilled nursing may be an option if:

• Long-term care or short-term care is needed and rehabilitation following an injury or illness
• Have complex medical needs that require monitoring and treatment by licensed nurses
• They have significant mobility concerns
• Unable to feed themselves independently
• Significant rehabilitation is needed

Summary

There is no one-size-fits-all answer to the question of whether assisted living or skilled nursing is the best option for your senior. The type of care that is right for a particular individual will depend on their specific needs and preferences. However, in general, assisted living communities are better suited for seniors who are still relatively independent and mobile, while skilled nursing communities are better equipped to provide the level of medical care and supervision that is often required by seniors who are recovering from illness and need rehabilitation. Your loved one’s doctors can tell you what level of care they require, and the communities and facilities themselves will perform their own evaluations, to ensure that any potential resident will receive the care they need.