Assisted Living vs. Nursing Home

At some point, you or a loved one might need more regular or full-time care than you can handle at home. There are numerous long-term care solutions out there, including nursing homes and assisted living.

To decide which is right for your specific situation, start by identifying what level of care is needed. This guide untangles the differences between assisted living and nursing homes, the levels of care they each offer, who they're best for, and how to know when it's time to consider one.

What Is a Nursing Home?

Nursing homes are long-term residences that focus more heavily on medical assistance for those with chronic illnesses, injuries, or who need round-the-clock care. Many people turn to nursing homes when they need more consistent medical help than assisted living provides, but it's not always permanent. Some residents are only there for recovery and need weekly dialysis or intensive physical therapy. Roughly 84 percent of nursing home residents are age 65 or older.1

People often use the term “nursing home” interchangeably with “skilled-nursing facility” (SNF), but they're two different things. SNFs provide broader medical services for more acute needs, such as terminal illness, or 24-hour care for Alzheimer's. Medicare- and Medicaid-certified nursing homes require a licensed nurse to be on the premises at least part of every day, but most nursing homes do not have doctors on staff for specialized care.

Typical nursing home services include:

• Custodial care: bathing, eating, dressing, and using the toilet
• Medication management
• General mobility (sitting down and up)
• Transport throughout the residence
• Skilled nursing care, e.g., physical, occupational, or respiratory therapy
• 24-hour supervision and emergency care
• Social and recreational activities

For a closer look at nursing homes, watch the video below!

When to Move From Assisted Living to a Nursing Home

The decision to move into a nursing home is a very individual and personal one. For many, it means a marked loss of independence, which most people understandably resist. Many factors affect the choice to transition to a nursing home, from emotional readiness to proximity, services, and cost, but it often comes down to safety. Look for these signs that may indicate it's time for the next level of care:

• Terminal or chronic illness needing 24/7 supervision or care
• Debilitating or worsening emotional disorders or dementia-related conditions
• Multiple medical conditions at once, or conditions getting worse
• Increases in falling, sprains, or broken bones
• Trouble managing money: money is being misplaced, overspent, or finances are overwhelming
• Cleanliness: difficulty keeping up with house cleaning and personal hygiene
• Declining mental acuity: increased memory loss, confusion, or disorientation
• Depression: increasing feelings of isolation or withdrawal from people and activities

What Is the Difference Between Assisted Living and a Nursing Home?

In general, assisted living is for people who might need help with daily tasks. Nursing homes are for people who need a higher, more consistent level of care, often round-the-clock. Both assisted living facilities and nursing homes offer some of the same essential services, but studying the differences below can help you decide which type of care you need.

Assisted Living vs. Nursing Home Costs

Both long-term facilities are expensive, but nursing homes can be more than double the cost of assisted living.2 The average cost for a nursing home ranges from $6,844 to $7,700 per month,3 while assisted living is around $3,628 per month, on average. So how can you pay for hefty assisted living or nursing home costs?

How to Pay for Assisted Living

Most assisted living facilities are considered “custodial care” by the government and require out-of-pocket payment. Medicare and Medicaid don't cover them. However, there are other payment options available, including veterans benefits and long-term care insurance. The National Council on Aging offers a Benefits Checkup website, where you can easily find out which benefits you're entitled to. For more information on assisted living and ways to pay, head to our assisted living costs guide.

How to Pay for a Nursing Home

If a nursing home adheres to national and state licensing requirements, it will often be covered by Medicare or Medicaid. Original Medicare covers up to 100 days of skilled nursing coverage, and Medicare Advantage offers supplementary nursing home care coverage. Medicaid's website also has resources for comparing nursing homes and exploring coverage options. Our nursing home costs guide offers more details on ways to pay for nursing home care.

Picking the place you'll be happiest is such an important decision. It's also one that you shouldn't make alone. Talk to your family, your doctors, the staff, and other residents at places you're considering. Remember: you'll be happiest at the place that makes you feel the most comfortable, safe, and well taken care of.