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Nursing Homes vs. Assisted Living

An Overview of Their Significant Differences

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The main difference is that the level of medical care isn't the same between nursing homes and assisted living. Assisted living facilities may have a nursing staff and a health clinic. Assisted living facilities and nursing homes serve different types of residents—mostly—and are generally paid for by different programs, if you can get assistance; not everyone qualifies.

Below is an overview of the significant differences you’ll find between assisted living and nursing homes:

Assisted Living

The primary focus of assisted living is to help residents with activities of daily living. Activities of daily living (ADLs) are routine activities people do every day without assistance. There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring, and continence.

While assisted living facilities are still designed for residents who are more healthy and independent, more and more facilities have begun taking on residents with cognitive and physical impairments—and many assisted living facilities have separate memory care wings.

These types of communities are designed for adults who are able to do most things on their own, but who need a certain amount of support and companionship.

What to look for. Many assisted living facilities offer private apartments or condos but with an element of communal living. Assisted living facilities may provide planned activities, housekeeping services, meals, health and exercise classes, communal areas to casually socialize, and laundry services.

These types of facilities also offer help with activities of daily living including personal hygiene tasks, eating, cooking, dressing, medication management, and housekeeping. This is one of the key factors that separates assisted living from independent living facilities, which are designed generally for the healthiest and most physically independent category of older adult.

However, assisted living facilities do not usually offer round-the-clock medical support. Some facilities have a nurse or doctor visit periodically, and offer transportation to local hospitals to residents who need it.

Medicaid and Medicare do not pay for assisted living costs, although in 41 states including Texas, there are waiver programs that help low-income residents pay for assisted living. In Texas, it's referred to as the Texas STAR Plus Waiver Program which is active in select areas of the state.

Assisted living facilities are regulated at the state level, so the operating rules are slightly different on a state-by-state basis.

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Nursing Homes

A nursing home is a place for people who don't need to be in a hospital but can't be cared for at home. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day.

Nursing homes, also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus on medical care more than most assisted living facilities. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, are also available.

Some people stay at a nursing home for a short time after being in the hospital. After they recover, they go home. However, most nursing home residents live there permanently because they have ongoing physical or mental conditions that require constant care and supervision.

Talk to your doctor about the type of assistance you or your loved one needs, and you’ll be able to decide which is right for you.

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