What’s the Difference Between Assisted Living, Nursing Homes and Other Care Options?
Sometimes living at home is no longer safe or comfortable for an older adult. Maybe family can help for a while, but sometimes more support is needed. That’s when residential care comes in: places like assisted living, nursing homes, board and care homes or continuing care communities.
So what’s the difference? Let’s break it down.
Board and care homes
These small private facilities usually have 20 or fewer residents. You’ll get meals, personal care and staff on-site 24/7, but not full medical or nursing care.
Cost: Mostly private pay. Medicare doesn’t cover it; Medicaid might help depending on your state. Long-term care insurance? Check your policy.
Nursing homes
Also called skilled nursing facilities, these provide a wide range of health and personal care services. Their services focus more on medical care than most assisted living facilities or board and care homes. They offer 24-hour nursing, meals, help with daily activities and social activities. They also offer post-hospital, short-term rehab services like physical, occupational and speech therapy.
Cost: Medicare covers short-term rehab, not long-term stays. Medicaid for long-term care may help if you qualify. Insurance can offset some costs (check with your insurance company for details).
Assisted living
Assisted living is for people who need help with daily care, but not as much help as a nursing home provides. Assisted living facilities range in size from as few as 25 residents to 100 or more. Typically, a few levels of care are offered, and residents pay more if they need extra services or special care.
Assisted living residents usually live in their own apartments or rooms and share common areas. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and on-site staff; and social and recreational activities. Some assisted living facilities are part of a larger organization that also offers other levels of care. For example, continuing care retirement communities may also offer independent living and skilled nursing care. Exact arrangements vary by facility and by state.
Cost: Private pay is common. Medicare doesn’t cover it; Medicaid sometimes does. Insurance may help.
Continuing care retirement communities (CCRCs)
One-stop shop: independent living (in houses or apartments), assisted living, short-term rehab and nursing care all on one campus (like Avina/Avina Living of Milwaukee). Health care services and recreation programs are also provided. You move between levels of care as your needs change.
Cost: Medicare and Medicaid cover some services, depending on the level of care provided; insurance varies.
Tips for making the transition to a long-term care facility
- Get to know the staff before the person moves into a facility. Talk with them about ways to make the transition go smoothly.
- Be an advocate for the needs and preferences of the older adult.
- Be supportive and listen to any concerns, but don’t argue with the older adult about why they need to be there.
- Share your feelings with a social worker or mental health professional. Feelings about moving an older adult into a new place may range from loss and guilt to a sense of relief. Get the support you need to help you and the older adult adjust.
