Many families searching for senior care don’t know the difference between a nursing home and an assisted living community. Learning the distinction between these different kinds of long-term care providers can help you more quickly and efficiently identify the right care option for your parent or other older loved one.
Before my family and I had to go through the process of finding care for my Aunt Agnes about six years ago, I was completely ignorant about the kinds of senior communities that were available, and how they differ from one another. To me, they were all “rest homes”, places where seniors go to live together and receive care. The process of finding care for Aunt Agnes helped me gain at least a basic understanding about the kinds of care is available to seniors. I learned, for example, the term “rest home” isn’t even used anymore, and that the kind of care that was appropriate for Agnes was called assisted living. But even then, my understanding was vague and superficial, and I didn’t really begin to learn for a clear picture of the distinction between these care types until I joined the senior care industry four years ago.
The Cost of Senior Care Confusion
Most families searching for senior care start out similarly oblivious to senior living terms. After all, it’s not something enthusiastic hobbyists research for fun. It’s necessity that forces families to take a crash-course in the senior living industry terms rather than an insatiable desire to be a learned eldercare scholar. For this reason, a family caring that is caring for an elderly loved one may reach the point where it’s obvious that professional care is essential, but they still may not know what kind exactly. During the period that I myself offered one-on-one advisement to families, perhaps around one third of the average conversation and consultation would be explaining to the loved one (usually the senior’s child) the difference between the main types of senior care.
Research by A Place for Mom (parent company of this website) suggests that senior living consumers tend to use “nursing home” as a catch-all term for all kinds of senior care. Our analysis demonstrates that of 100 families who search online for nursing home care, an average of only 21 ultimately choose a nursing home for their loved one, while 34 choose assisted living, and the rest chose other kinds of care. In short, a family who believes their loved one is in need of a nursing home is more likely to be mistaken than to be correct. Sean Kell, CEO of A Place for Mom, said this is indicative of a “severe lack of consumer education” that’s not only harming occupancy at senior communities but that’s also preventing families from arranging the right care in a timely manner.
Consumer confusion about kinds of care can causes trouble on multiple fronts. The lack of clarity about senior community types not only inconveniences families who waste time and energy researching inappropriate care options. It can also potentially endanger the senior when the family’s confusion about the right care type causes a delay putting in place the appropriate kind of care. Or in the rare but troubling cases when communities don’t have top-notch admission procedures, residents may be admitted to facilities that don’t offer an adequate level of care, which is obviously dangerous to the resident. Other times residents may admitted to communities that offer much more care than is required, which usually results in unnecessary money being spent and also a resident who is unsatisfied and out of place because he is among the only relatively healthy seniors among a group of elderly people who need much more intense care.
It’s essential that the senior’s community offer enough care, and it’s ideal that residents have the opportunity to be among peers with similar ability levels. These simple but important criteria can be met when the right kind of facility is chosen.
The large of expert Senior Living Advisors that work with AssistedLiving.Com help families determine the appropriate type care for their loved one. A ten to fifteen minute consultation is usually enough time for a Senior Advisor to determine right kinds of care to explore. It’s very common for them to need to help families distinguish between assisted living care and nursing home care. If you are in the process of making the determination right now, we encourage you to contact us for free guidance from an Advisor. But whether or not you speak with an Advisor, it can be empowering to educate yourself about the options.
Here is a short guide to help you begin to understand the difference between nursing home care and assisted living care, and to help you understand which care type your family should begin explore. These questions are just a starting point. Firstly, assisted living facility regulations vary state by state, so assisted living facilities in some states are allowed to offer higher level of care than in other states. Secondly, the questions are designed to educate you about what options to explore, but are in no way a replacement for a consultation from a medical professional. If you take away only one thing from this article, remember that nursing homes offer a higher level of care than assisted living facilities, which means nursing homes care for the frailest residents while assisted living communities care for residents that maintain a modicum of independence despite having some care needs.
1. Is your loved one ambulatory?
Assisted living residents generally must be at least somewhat ambulatory(be able to get around on their own). Bedridden seniors, and sometimes even wheelchair bound seniors, are rarely good assisted living candidates and their families should explore nursing homes. While a limited number of assisted living communities are able provide one or two person transfers, or even use mechanical lifts, most cannot.
2. Does your loved one have a feeding tube, tracheostomy, colostomy, chronic wound, or require insulin injections to be administered?
Assisted living communities rarely are allowed to care for residents with feeding tubes, tracheostomy’s colostomy’s or chronic wounds. Furthermore, a large number of assisted living communities are not allowed to provide insulin injections. There are a few states where assisted living facilities can obtain additional licensing to offer care like this, for example, assisted living facilities in Florida can offer the above mentioned care if they have a “limited nursing services license”, but as a rule of thumb, the kind of care described above is indicative of the need for nursing home care.
Assisted living communities can offer a high level of care with “activities of daily living”, such as dressing, bathing, toileting, and so on, but this kind of care is considered nonmedical. If your loved one needs medical attention from a nurse or doctor on an ongoing basis, a nursing home is preferable to assisted living.
4. Does your loved one require rehabilitation, for example after a surgery or hospitalization?
Rehabilitation services are offered at a nursing home and are covered by Medicare for up to 100 days. If your family is looking for rehab, explore nursing homes rather than assisted living. It is worth noting though, that after rehab, many seniors move to assisted living.
5. Does your loved one have late stage Alzheimer’s or dementia?
While regular assisted living communities may be able to offer sufficient care to people with early to moderate Alzheimer’s or other kinds of dementia, they are usually not equipped to care for people with symptoms associated most advanced stages of the illness, which include difficulty chewing and swallowing, as well as behavior problems and a host of other issues. In this case, dedicated memory care is required. Sometimes this can be offered at an assisted living facility with a special memory-care unit, but a nursing home with an Alzheimer’s specialization is most often preferable in cases of late stage Alzheimer’s and dementia.
In sum, long-term care residents at nursing homes are typically in pretty bad shape. According to a study by the Journal of American Geriatrics, the median length of stay at a nursing home before the resident passes away is just five months. On the other hand, according to research by MetLife, the average stay at assisted living is more than two years, and seniors who leave assisted living communities usually end their residency because they need a higher (or sometimes lower) level of care rather than because they have passed away. In sum, assisted living communities are focused on a providing an active and enriching lifestyle with access to unskilled personal care, while nursing homes that provide long-term skilled medical care geared towards the frailest of the frail, often those who are nearing end of life.
Do you have advice about how to choose between a nursing home and an assisted living community? What are your thoughts? We welcome your comments below.