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Assisted Living vs. Skilled Nursing: What’s the Difference?

If you or a family member are struggling to live independently, it might be time to transition to a senior living community. But how do you decide which level of care is appropriate? More specifically, how do you choose between assisted living and skilled nursing?

Though assisted living and skilled nursing are often confused, they are very different. While assisted living provides support for daily activities in a residential setting, skilled nursing provides a higher level of healthcare in a medical environment.

Continue reading to learn more about the distinctions between these senior care options.

Contents

Infographic: Comparison between assisted living and skilled nursing care?

What Is Assisted Living?

Assisted living is a long-term housing choice designed for older adults who don’t require intensive medical support, but who still need extra assistance. At an assisted living community, the staff is available to help with self-care tasks like eating and bathing. However, residents are encouraged to live as independently as possible.

Assisted living communities also promote social engagement by hosting events, outings and other opportunities to socialize with friends. Residents are free to set their own schedules, picking and choosing which activities to participate in.

What Care Is Offered in Assisted Living?

At assisted living communities, staff help residents with activities of daily living (ADLs). ADLs are fundamental to maintaining a healthy and productive life and include self-care tasks such as:

  • Getting in and out of bed
  • Toileting
  • Bathing or showering
  • Getting dressed
  • Personal hygiene
  • Eating
  • Walking

Staff also provide assistance with instrumental activities of daily living, or IADLs. These activities are less imperative but important nonetheless. Examples include:

  • Shopping
  • Cooking
  • Medication management
  • Cleaning
  • Running errands
  • Managing finances

What Services Are Provided in Assisted Living?

Assisted living communities offer a robust lineup of amenities and services that focus on holistic aspects of senior wellness like physical and mental health, spirituality, and social connection. Most communities offer:

  • Chef-prepared meals and happy hours
  • Outings and transportation to shopping centers, museums, and parks
  • Assistance with housekeeping and laundry
  • Common areas like wood working shops, crafting rooms, and theaters
  • Care management services to help with insurance questions, planning operations, and more

How Much Does Assisted Living Cost?

Since assisted living residents require less intensive medical support than those in a skilled nursing community, this senior living option is generally more affordable. Whereas a Concord, New Hampshire nursing home costs $8,000 per month, an assisted living community costs a little over $5,500. At an assisted living community, this monthly fee includes expenses such as:

  • Rent
  • Utilities
  • Home maintenance
  • Trash removal
  • Landscaping
  • Housekeeping services
  • Dining

Your monthly bill will be affected by the room you select. As a general rule, larger spaces cost more. If your community offers either shared or individual bathrooms, for instance, the layout with a private bath will be more expensive.

Does Medicare Cover Assisted Living?

Medicare typically doesn’t pay for assisted living. However, some long-term care policies do offer limited coverage.

Floor Plans at Assisted Living Communities

Many older adults fear that transitioning to senior care will compromise their independence and privacy. However, life in an assisted living community is very similar to an apartment or condo—except that assistance is just a call button away.

Assisted living communities offer a warm, residential atmosphere. These communities provide apartment-style residences, which may be private or semi-private. Each living space typically consists of a bedroom with a private bath and residents are encouraged to bring their own furniture to create a space that truly feels like home.

Advantages of Assisted Living Communities

Do you find it hard to keep up with household tasks? Do you need some help taking a shower and getting dressed in the morning? If so, assisted living communities provide an affordable alternative to aging in place. Advantages of transitioning to an assisted living community include:

  • 24/7 assistance with self-care tasks like bathing, toileting, and eating
  • A maintenance-free lifestyle; seniors are no longer responsible for mowing the lawn, washing dishes, or fixing leaky pipes
  • Chef-prepared meals
  • Safe and convenient transportation services
  • Social connection; the ability to live independently in a group setting staves off loneliness and isolation

Who Can Benefit From Assisted Living?

Assisted living communities are designed for older adults who want to maintain their independence but are struggling to do so at home. Assisted living could be a viable option for someone who:

  • Has experienced at least one fall, with or without injury
  • Is struggling to clean their house and cook for themselves
  • Needs help getting dressed, toileting or eating
  • Is feeling isolated

What Is Skilled Nursing?

Skilled nursing communities—also called nursing homes—provide all the services of an assisted living community, plus 24/7 medical care. Many older adults come to skilled nursing communities after a significant health event like a stroke or heart attack. They are too well to stay in a hospital but still need around-the-clock care to remain stable.

Nursing homes require a much higher level of staffing than assisted living communities. At a certified skilled nursing community, licensed practical nurses (LPNs) are on duty at all times and a registered nurse (RN) is on duty at least eight hours every day.

What Care Is Offered in Skilled Nursing?

Skilled nursing care can be either short-term or long-term. Short-term stays are generally arranged for post-acute care, typically following hospitalization, injury, or surgery. Because of this, care is focused on rehabilitation with the goal of returning home.

However, for the majority of skilled nursing residents, the community is their permanent home. Long-term residents receive assistance with ADLs and IADLs, generally at a greater level than what is required by assisted living residents. They also receive complex medical care and supervision.

What Services Are Provided in Skilled Nursing?

Though skilled nursing residents still benefit from certain amenities like chef-prepared meals, staff efforts are more so focused on medical care. As such, most skilled nursing communities provide services such as:

  • Physical, speech, and/or occupational therapy
  • Wound care
  • Advanced stage pressure ulcer care (bed sores)
  • Feeding tubes
  • Intravenous (IV) medications
  • Respiratory therapy or ventilator care
  • End of life or hospice care
  • Laboratory, radiology, and pharmaceutical services
  • Supplies, equipment, and other services necessary to the health of the patient

How Much Does Skilled Nursing Cost?

Since skilled nursing residents require a higher level of support, it’s generally the most expensive form of senior care available. In Concord, New Hampshire, a nursing home costs approximately $8,000 per month. This cost includes expenses associated with your care as well as rent, food, utilities, and more.

How much you can expect to pay each month depends on the community. However, it also depends on whether you choose a private or semi-private room. Typically, private rooms cost about $1,100 more than semi-private rooms.

Does Medicare Cover Skilled Nursing?

Unlike assisted living, the cost of skilled nursing home care is covered by most long-term care insurance policies and Medicare and Medicaid when all stipulations are met.

In the case of short-term rehabilitation, residents can expect full Medicare coverage for 60 days if they enter the facility after a qualifying hospital stay. After two months, the resident will be charged a daily coinsurance.

Floor Plans at Skilled Nursing Communities

Living in a skilled nursing community or nursing home can be compared to a long-term hospital stay. Residents may have a private or semi-private residence, though most rooms are semi-private.

Residents receive their meals in a communal dining area unless they are too ill to do so. Communities also offer a published calendar of daily programming for residents to enjoy. However, activities are brought to the rooms of residents who aren’t physically capable of attending group events.

Advantages of Skilled Nursing Communities

If your health is declining or you recently experienced a life-changing event such as a heart attack or stroke, a skilled nursing community can provide the 24/7 medical support you need. Advantages of transitioning to a skilled nursing community include:

  • 24/7 medical support and assistance with self-care activities
  • Access to short- and long-term rehabilitation services
  • Engagement; activities are designed with mobility and cognitive impairments in mind
  • Convenient transportation to doctors and specialists
  • Security; nurses are just a call button away

Who Can Benefit From Skilled Nursing?

Skilled nursing communities are designed for older adults who need more intensive medical support than assisted living staff can provide. Skilled nursing could be a viable option for someone who:

  • Was recently hospitalized for an illness or injury
  • Is recovery after a major surgery, such as coronary bypass or joint replacement
  • Requires 24/7 nursing care because of a chronic condition
  • Needs palliative care

Assisted Living vs. Nursing Homes: How To Choose

Even when you know living independently at home is no longer safe, you may struggle to determine which is more appropriate: assisted living or skilled nursing/nursing homes.

As a general rule, if you or a family member require 24/7 nursing care for a chronic medical condition or daily rehabilitation services, then a skilled nursing community is best.

However, if you just need help with ADLs and IADLs like bathing and cooking, an assisted living community is a more appropriate and affordable senior care solution.

Receive Assisted Living & Nursing Home Care at a CCRC

When older adults transition to assisted living, many worry that their current community will be unable to meet their changing needs. Fortunately, continuing care retirement communities (CCRCs) provide a continuum of care—independent living, assisted living, memory care, skilled nursing, and rehabilitation services—so that you receive appropriate support, no matter what.

In a CCRC, each level of care is designed for individuals in different seasons of life.

Independent living is for active, healthy adults who want to enjoy a maintenance-free lifestyle while memory care is designed for residents with dementia and other cognitive impairments.

When you choose a CCRC, you gain a sense of security in knowing that you will never have to leave. If and when your health changes, your community will help you seamlessly transition to a higher level of support.

Find Peace of Mind at Havenwood Heritage Heights

As one of just three New Hampshire CCRCs accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), Havenwood Heritage Heights provides Concord, NH seniors with a continuum of high-quality care. Our residents rest easy knowing they will always receive the support they deserve, no matter what happens in the future.

To learn more about joining our beautiful New Hampshire senior living community, please contact our team today!

By Mike Wall