Assisted Living vs. Nursing Home: How Do They Differ? (2023)

Assisted living is primarily a residential environment, while nursing homes — also called skilled nursing facilities — are considered medical environments.

To clarify the distinction, here’s a summary of some key differences between the two.

Medical services

Assisted living

In an assisted living facility, residents have access to different levels of medical attention depending on their individual needs.

For example, a facility may provide transportation to doctor appointments or help with taking medications. Some assisted living facilities offer special areas for people with dementia or conditions that affect memory.

In general, people in assisted living facilities are in fairly good health.

Nursing home

In a nursing home, medical care is provided round the clock. A nursing staff helps care for residents with chronic illnesses.

Rehabilitative services such as physical, occupational, respiratory, and speech therapy are provided for those who need them.

Some residents live there long term, and some are admitted for a shorter period of rehabilitation after a hospital stay.

Living space

Assisted living

In an assisted living facility, people often live in individual or shared apartments with kitchens, bedrooms, and living rooms.

Some facilities offer furnished spaces. Common areas invite residents to share meals and activities if they choose.

(Video) Assisted Living vs Nursing Homes | Understand the difference

Nursing home

In a nursing home, people generally have individual or shared rooms with en-suite bathrooms.

Many nursing homes or skilled nursing facilities have common spaces where residents can share meals or participate in activities together.

Assistance with daily activities

Assisted living

If residents of an assisted living facility need help with daily activities, such as bathing or getting dressed, those services are provided.

Laundry, housekeeping, and meal preparation services are available to residents who need them.

Nursing home

In a nursing home, most people need more extensive help caring for their daily needs.

Staff members help residents bathe, dress, use the restroom, and take their medications. Meals are prepared by a kitchen staff, and the staff take care of laundry and cleaning for the residents.

Recreational activities

Assisted living

One of the hallmarks of assisted living facilities is the wide range of activities offered to residents.

Research shows that staying physically active and socially connected is crucial to maintaining the health of older adults.

Most assisted living facilities offer opportunities for physical exercise, creative expression, and socializing. Some also offer religious services and opportunities to volunteer in the community.

Nursing home

In nursing homes, the variety of recreational activities may be more limited.

Many nursing homes offer art classes, choir, cooking classes, animal therapy, educational courses, and mentally stimulating games for residents to enjoy.

Exercise activities are often supervised by physical therapists who focus on helping residents gain strength, improve mobility, and prevent falls.

(Video) Nursing Facilities vs. Assisted Living? | Dr. Marc

A 2018 research review showed that these supervised physical activity sessions have important health benefits for residents of long-term care homes.


Assisted living

In an assisted living facility, residents may cook for themselves in their kitchenettes or take meals in community dining rooms.

Some facilities offer meal delivery services for a fee. Dining rooms may stay open all day or may serve meals at set times throughout the day.

Nursing home

In a nursing home, dieticians prepare meals for residents. Depending on their personal wishes and mobility, residents may be served in their own rooms or in a communal dining room.

Personal aides are usually available to help residents who have difficulty eating on their own.


The American Health Care Association has reported that the cost of nursing home care is roughly double the cost of assisted living residence.

For residents paying out of pocket, the annual cost of a semi-private room in a nursing home is around $89,000, while an assisted living facility costs approximately $48,000 a year.

Insurance coverage

Medicare does cover some costs of a nursing home or skilled nursing facility if you need to be there to recuperate from a health condition, surgery, or injury.

But you typically have to cover some costs yourself if your stay extends beyond 20 days.

Medicare usually does not pay for assisted living or for help with custodial care (help with the activities of daily living).

Some state Medicaid programs pay for assisted living or nursing home care, but the rules vary in each state. Some states may require Medicaid beneficiaries to spend their funds before Medicaid begins paying for services.

According to, some people invest in long-term care insurance policies to cover their costs, but the specific benefits vary in each plan.

(Video) Webinar: Assisted Living vs. Nursing Homes - What are the Differences?

Some policies only cover care in a nursing home while other policies include at-home care and assisted living facilities.

Before you purchase a long-term care policy, be sure to read the provisions carefully so you understand in advance what is and isn’t covered.

The kind of facility that’s right for you will depend on your health and how much help you need with daily activities.

Here are a few questions to help you decide which kind of facility is best suited to you or someone in your care:

  • How much help do you need to take care of daily activities like bathing, dressing, and using the restroom?
  • Do you need medical care for serious health conditions?
  • Are you able to prepare your meals?
  • How do you plan to pay for the care you need?

Once you’ve decided which type of facility best meets your needs, you’ll need to explore individual facilities to find a good match.

As you compare facilities, keep these questions in mind:

(Video) What's the Difference Between Nursing Home and Assisted Living | Dr. Macie

  • Is the facility licensed by a state agency?
  • Has the facility been audited or inspected by any healthcare agency, and are the reports available?
  • Do the residents seem happy and well cared for?
  • What medical professionals are on staff, and what’s their availability?
  • What’s the ratio of residents to staff members?
  • What’s the staff turnover rate?
  • What’s the procedure for handling a medical emergency with a resident?
  • Can people receive visits from their doctors or home healthcare providers?
  • Which services are included in the basic cost and which are offered at an extra charge?
  • Who gives people their medications?
  • Is transportation provided to doctor appointments?
  • How close is the facility to your family and friends?
  • What kind of recreational activities are offered?
  • Do residents go on community outings?
  • Can residents bring their own furnishings?
  • Are bathrooms shared?
  • Is the facility affiliated with a particular faith tradition?
  • Can you review a copy of the contract, so you understand the policies, procedures, and costs carefully?

If possible, visit facilities more than once. Talk with friends, neighbors, colleagues, medical professionals, and local organizations that serve older adults to get a sense of which facilities provide the best care in your area.

If independent living is the goal, you may find it more appealing or more cost-effective to use home health aides or assistants to help care for an older adult at home.

Another increasingly popular option is shared housing, in which older adults live together or with a younger person. This may help keep down housing costs, while also staving off loneliness and isolation.

For people who want companionship but don’t need extensive medical care, board-and-care homes (also called adult family homes) may be an option.

Board-and-care homes are smaller residential settings where several older adults live in a single home with a caregiver on site.

Deciding when to transition from independent living to an assisted living or skilled nursing facility isn’t easy. Understanding the options in your area is a good place to begin.

(Video) Difference between Skilled Nursing and Assisted Living? Does Medicaid pay for Assisted Living?

Assisted living facilities may be a good choice if you’re in fairly good health but need help with some daily activities. A nursing home may be better if you need 24-hour medical care along with basic services.

Once you’ve identified the type of facility you need, take a closer look at the options in your area to find one that fits your budget, meets your needs, and provides the services that are right for you.


What is the difference between a care home and assisted living? ›

In assisted living, residents may need some help with transportation, medication management, housekeeping and other specific activities of daily living such as dressing and personal care, but still live independently. Residents in a nursing home require around the clock care and monitoring.

What is a disadvantage of an assisted living facility? ›

The major drawback of assisted living is its cost, as it is not covered by Medicare. Assisted living facilities often include only a small number of activities in their base monthly price. In addition to monthly costs, personal care services, such as laundry or medication reminders, are charged additionally.

How does a nursing home differ from a care home? ›

Individuals in a residential care home need support with their personal care, and they might want a break from day-to-day tasks like cleaning and cooking. Residents in a nursing home will have a range of medical needs, and nurses provide medical care 24 hours a day.

What are the advantages and disadvantages of living in a nursing home? ›

The Pros and Cons of Nursing Homes
  • Pro: Full-Time Care. As family members age, it becomes increasingly difficult to care for them ourselves. ...
  • Con: Expensive. ...
  • Pro: Structured Schedules. ...
  • Con: Lack of Freedom. ...
  • Pro: Active Social Life. ...
  • Con: Nursing Home Horror Stories.
19 Aug 2013

What is difference between skilled nursing and assisted living? ›

Essentially, in assisted living communities, residents receive assistance with activities of daily living (ADLs), while still handling most activities on their own. In a skilled nursing community, residents receive constant nursing care and need assistance with most, if not all, ADLs.

Does Medicare cover assisted living? ›

Medicare won't cover most assisted living costs. Medicare does not pay for “custodial care,” a term referring to help with daily life tasks, such as eating, bathing or dressing. Most of the care given at an assisted living facility is considered custodial care.

How long do most people stay in assisted living? ›

The average length of stay in assisted living has dropped significantly over the past two or so years. In the past, the national average has been around two years. Today, the national average is closer to one year. Different factors can play into how long someone spends in assisted living.

What are the three principles of assisted living? ›

What Are the Three Principles of Assisted Living?
  • Person-Centered Care. With this guiding principle in place, loved ones can always expect to get care that is centered on their individual needs. ...
  • Practice Ethics at All Times. Every assisted living community should operate on a foundation of trust. ...
  • Mission Statement.
26 Feb 2021

What food should not be served at assisted living? ›

10 Foods Older Adults Should Avoid Eating
  • Raw Seafood. Sushi and sashimi are popular delicacies, but seniors need to take a few precautions before eating raw seafood. ...
  • Grapefruit. ...
  • Soda. ...
  • Soft Cheese. ...
  • Sports Drinks. ...
  • Processed Meats. ...
  • Raw Eggs. ...
  • Unpasteurized Milk.
28 Mar 2018

Do dementia patients need a care home or a nursing home? ›

A person with dementia will need more care and support as their condition progresses, and there may come a time when they will need to move into full-time or residential care. This could be because a care home may be able to meet the needs of the person better.

Do people live longer at home or nursing home? ›

However, new research suggests people who live at home (“live in place”) or at an independent living facility may be more likely to live longer and healthier without needing to be transferred to a nursing home.

Is a nursing home better than a care home? ›

The main difference is that a nursing home always has a qualified nurse on-site to provide medical care. Both nursing homes and residential care homes provide care and support 24 hours a day, however, the main difference is that a nursing home is able to provide a higher level of care.

What are the 3 most common complaints about nursing homes? ›

What Are the Three Most Common Complaints About Nursing Homes?
  • Slow Response Times. By far, the most common complaint in many nursing homes is that staff members are slow to respond to the needs of residents. ...
  • Poor Quality Food. ...
  • Social Isolation. ...
  • When Complaints Turn into a Dangerous Situation.
29 Dec 2021

How long does the average person last in a nursing home? ›

Once in a nursing home, about half of residents stay for at least a year, while 21 percent live there for almost five years, according to the Health in Aging Foundation.

What is the average life expectancy of a person in a nursing home? ›

The average length of stay before death was 13.7 months, while the median was five months. Fifty-three percent of nursing home residents in the study died within six months. Men died after a median stay of three months, while women died after a median stay of eight months.

What are the advantages of assisted living? ›

This allows residents to stay in a community, even if needs should change over time. Many assisted living communities offer seniors a carefree way of living with housekeeping services, linen and laundry services, holistic dining plans, fitness classes, day trips, dynamic activity calendars, and so much more.

What differentiates the services of a long term care facility from that of an assisted living facility? ›

Assisted living communities provide a more social lifestyle for seniors who are generally active but need help with everyday tasks. Nursing homes provide long-term medical care for adults with serious health issues. Nursing homes usually cost more than assisted living due to the higher level of care.

What is the average length of stay in a long term care facility? ›

How long will I need long-term care? According to the latest AOA research, the average woman needs long-term care services for 3.7 years, and the average man for 2.2 years.

How is most assisted living care usually paid for? ›

Most families use private funds to pay for assisted living. This means a combination of personal savings, pension payments, and retirement accounts. Though many seniors save for retirement over the years, family members often contribute to elder care costs.

How much does assisted living cost? ›

The Genworth Cost of Care Survey 2021 says that the national median cost for assisted living per month is $4,500, which breaks down to around $148 per day (and adds up to $54,000 per year).

What happens when you run out of Medicare days? ›

Medicare pays all but the daily coinsurance. For days beyond 100: You pay the full cost for services. Medicare pays nothing. You must also pay all additional charges not covered by Medicare (like phone charges and laundry fees).

At what age do most seniors go into assisted living? ›

The average age of an assisted living resident is 87. While some people transition to assisted living communities as soon as they reach the age minimum — generally 60-65 — most wait until they need additional care, or until they can no longer remain in their own homes without assistance.

How do you know when it's time for assisted living? ›

7 Signs it's Time For Assisted Living
  1. Poor Health That's Just Getting Worse. A chronic health condition that's deteriorating by the day is a red flag. ...
  2. Changes in Hygiene. ...
  3. Isolation. ...
  4. Safety Concerns. ...
  5. Increasing Difficulty Managing Daily Tasks. ...
  6. Trouble Keeping Up with Bills. ...
  7. Inability to Properly Care For Home.

What are the odds of ending up in a nursing home? ›

1: Very few people end up using long-term care. This study by researchers from the National Bureau of Economic Research estimates that a 50-year-old has a 53 to 59% chance of entering a nursing home during his or her lifetime.

What questions to ask when considering assisted living? ›

Questions You Should Ask an Assisted Living Facility
  • How Does Your Community Welcome a New Resident? ...
  • What Kind of Training Does Your Team Undergo? ...
  • How Many Residents Do You Have? ...
  • Do You Have Staff on-Site 24/7? ...
  • What Kind of Meal Services Do You Offer? ...
  • What Type of Activities Are Available?
6 Dec 2021

What is the most common type of patient in assisted living facilities? ›

The typical assisted living resident is a senior citizen who suffered a mild decline in their overall health, usually due to an injury, an illness or simply because of aging.

How would you describe assisted living? ›

What Is 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 120 or more. Typically, a few "levels of care" are offered, with residents paying more for higher levels of care.

Which item should not be served to an elderly person? ›

Raw meat or poultry. Rare ground meats of any kind. Raw sprouts (alfalfa, clover, and radish). Unpasteurized or untreated fresh fruit or vegetable juice (they will carry a warning label).

At what stage should someone with dementia go into care? ›

Confusion and disorientation that imperils physical safety

"Someone with dementia symptoms may forget where they've walked, and end up somewhere they don't recognize," Healy says. "When your loved ones are continually putting their physical safety at risk, it's time to consider memory care."

What stage of dementia is hoarding? ›

Hoarding for a person with dementia may be more likely to happen in the early and middle stages of dementia and often stems from trying to have some control in their lives. People with dementia may be driven to search or rummage for something that they believe is missing.

Where is the best place for someone with dementia? ›

Where is the best place for someone with dementia?
  • In-home care. Most dementia patients prefer to stay in their own home as long as possible. ...
  • Adult day care programs. ...
  • Adult family homes. ...
  • Continuing care retirement communities. ...
  • Nursing home facilities. ...
  • Memory care units.
30 Apr 2021

Which elderly are more likely to end up or be in nursing homes? ›

Who Lives in Nursing Homes? Almost half of all people who live in nursing homes are 85 years or older. Relatively few residents are younger than 65 years of age. Most are women (72%), many of whom do not have a spouse (almost 70% are widowed, divorced, or were never married).

Are dementia patients better off at home? ›

Home care is often recommended by experts through end of life. However, every family and situation is different, so permanent home care may not always be possible. Research shows keeping a loved one with dementia at home helps them be happier and live longer; however, it is most impactful when introduced early.

Does dementia get worse in a nursing home? ›

People with Alzheimer's disease or a similar dementia are at an increased risk for falls, delirium, and other negative conditions once they have become residents of nursing homes.

Are nursing homes actually good for elderly people? ›

Nursing Home Benefits

Another benefit of nursing homes is that they tend to be quite secure. If your parents have dementia or Alzheimer's disease and tend to wander, this can help ensure that they stay safe. At a nursing home, your elderly parents will have social opportunities they might not otherwise have.

Why home care is better than assisted living? ›

Seniors who stay at home tend to live longer than those who live in nursing homes, and studies have confirmed this fact. In addition, those who stay at home tend to be physically and mentally healthier compared to the residents of nursing homes.

Do you have to pay for a nursing home? ›

Yes, everybody has to pay something (with a few exception such as Section 117 clients). People with over £23,250 in savings will have to pay the full cost of the permanent residential or nursing care home.

What is the most common diagnosis in nursing homes? ›

Urinary Tract Infections

The UTI is perhaps the most common infection in the nursing home and is the most over-diagnosed infection among nursing home residents.

What is the biggest problem in nursing homes? ›

Typically, in a nursing home, there are a few main problems that can exist that could cause your loved one harm. This includes physical abuse, mental abuse, financial abuse, malnourishment, and neglect.

What is the second most common cause of death in aged care facilities? ›

Coronary heart disease (14%) was the leading underlying cause of death for people who had used aged care, followed by Dementia (11%).

What is the youngest age for assisted living? ›

Typically, residents who qualify for assisted living are seniors. The exact age requirements will differ depending on the facility, with some serving seniors as young as 55 and others requiring a minimum age of 62 or 65 for admission.

How do you tell a parent they need a nursing home? ›

Express the concerns you have about being able to provide good care, reminding your parent that you want him or her to be as safe, comfortable, and happy as possible. Use any falls or accidents as examples of the need for added care. Talk about the challenges you and your siblings face.

How long do people live in nursing homes dementia? ›

However, the median survival time for an older adult with dementia from onset to death is 4.1 years (IQR 2.5–7.6) for men and 4.6 years (IQR 2.9–7.0) for women [39]. Survival varies substantially dependent on age of onset, with those diagnosed younger (between 65 and 69 years) potentially living over 10 years [39].

When should someone with dementia be placed in a nursing home? ›

Generally, a senior with dementia should go into a care home if you're struggling to meet their needs and your mental and physical health as a caregiver are at risk. Importantly, the safety of your loved one should be a key factor in deciding whether it's time for memory care.

Is an assisted living facility a care home? ›

Assisted living, (also known as Extra care housing) provides housing with some care. It is ideal for older people who have additional care needs but don't want to move into a care or nursing home.

When should you consider a care home? ›

A care home may be the best option if you or someone you know: is struggling to live alone – even with help from friends, family or paid carers. had a needs assessment that suggested a care home is the best choice. has a complex medical condition that needs specialist attention during the day and night.

What is the average age to go into a care home? ›

If they are to continue, the average age of someone going into a care home in 2025 will be 80 and by 2030 it will be just 75. Get in touch to see how we can help you...

What is the highest level of care in assisted living? ›

Level 3 assisted living care, sometimes referred to as enhanced assisted living, is typically the highest level of care available in an assisted living facility. This level of care includes extensive hands-on assistance with multiple ADLs throughout the day, such as toileting, bathing and communicating.

Does Medicare pay for nursing home? ›

Medicare and most health insurance plans don't pay for long-term care. stays in a nursing home. Even if Medicare doesn't cover your nursing home care, you'll still need Medicare for hospital care, doctor services, and medical supplies while you're in the nursing home.

What age do most people go into assisted living? ›

There are some who move in close to the minimum age requirement (usually about 65), but most make the move between the ages of 75 and 84. The typical assisted living resident is an 87-year-old woman who needs help with two or three activities of daily living, such as dressing, bathing and medication management.

Why do people choose assisted living? ›

Assisted living communities offer clear benefits that can help improve your loved one's health and wellness and emotional well-being thanks to daily opportunities for dining, activity, and socialization. Senior living provides great peace of mind for both caregivers and their loved ones.

Who is assisted living best for? ›

Assisted living is a great choice for many seniors looking for a relaxing, engaged retirement. However, it may not be the best care type for your loved one, depending on their individual care needs and interests.

Do dementia patients do better at home? ›

Home care is often recommended by experts through end of life. However, every family and situation is different, so permanent home care may not always be possible. Research shows keeping a loved one with dementia at home helps them be happier and live longer; however, it is most impactful when introduced early.

Do people live longer at home or in a nursing home? ›

However, new research suggests people who live at home (“live in place”) or at an independent living facility may be more likely to live longer and healthier without needing to be transferred to a nursing home.

What is the average length of time someone lives in a nursing home? ›

Once in a nursing home, about half of residents stay for at least a year, while 21 percent live there for almost five years, according to the Health in Aging Foundation.

What percentage of people end up in a nursing home? ›

Only 0.46% (roughly 1.5 million) people live in nursing homes in America. Around 0.21% (1 million) of elderly adults live in assisted living facilities in the U.S. The average age of a nursing home resident is 81.1 years old.


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