Assisted Living vs Skilled Nursing: Choosing the Right Care

Understanding Care Options

Understanding the available care options for seniors is crucial to making an informed decision that meets their individual needs and preferences. Let's delve into the differences between two common options: assisted living and skilled nursing.

Assisted Living Overview

Assisted living communities provide long-term housing for older adults who are generally active but need some assistance with activities of daily living (ADLs). These activities may include bathing, dressing, and using the toilet. The primary aim of assisted living is to keep residents as healthy, socially engaged, and independent as possible, while providing necessary support for daily tasks [1].

Moreover, assisted living communities offer a more social lifestyle, allowing seniors to engage with their peers and participate in various activities. This can have a significant impact on their overall well-being and quality of life. They usually cost less than nursing homes, making them a preferable choice for seniors who require some assistance but are generally active and independent.

Skilled Nursing Overview

In contrast to assisted living, nursing homes, also known as skilled nursing facilities, are designed to provide the highest level of care for individuals who do not require hospitalization but do need full-time monitoring and medical assistance. They are equipped to treat more serious health issues and provide round-the-clock medical care.

Nursing homes serve seniors and others who require more intensive care, including those with serious health issues or those who are recovering from surgery or illness. While nursing homes also offer amenities and services to keep residents engaged, their main focus is on providing comprehensive medical care. Due to the higher level of care provided, nursing homes usually cost more than assisted living communities [1].

In conclusion, the 'assisted living vs skilled nursing' decision largely depends on the individual's health status, level of independence, and personal preferences. It's essential to consider all these factors to ensure the chosen option provides the best possible care for the individual's unique needs.

Services and Amenities

Understanding the services and amenities provided in different care settings is essential when comparing assisted living vs skilled nursing. These offerings can significantly impact the quality of life and overall health of residents.

Assisted Living Offerings

Assisted living communities aim to offer services and amenities that keep residents as healthy, socially engaged, and independent as possible. They provide a home-like setting where older adults can enjoy a social environment with life-enriching activities.

These communities focus on the holistic aspects of senior wellness, such as physical and mental health, spirituality, and social connection. They generally promote social engagement through events, outings, and other opportunities for residents to socialize.

In terms of specific services, assisted living facilities offer assistance with daily living tasks such as housekeeping, laundry, and transportation. They also provide recreational and wellness activities, along with limited medical assistance.

Assisted living communities are ideal for older adults who are generally active but may need support with activities of daily living (ADLs). These could include bathing, dressing, and using the toilet.

Skilled Nursing Services

On the other hand, skilled nursing facilities, also known as nursing homes, offer round-the-clock medical care to treat more serious health issues. These facilities have medical professionals on staff to provide comprehensive care, including physical therapy, occupational therapy, and medication management.

Skilled nursing facilities are designed to accommodate individuals who require constant medical care. These could include those recovering from a serious illness or surgery, or those with chronic health conditions that require close monitoring and care.

While skilled nursing facilities also offer activities and social engagement opportunities, their primary focus is on providing high-level medical care. This makes them a more suitable choice for individuals who have significant health conditions or those who require a higher level of care.

Level of Care Provided

Understanding the level of care provided in different senior living settings is crucial when considering 'assisted living vs skilled nursing'. Both options cater to the needs of the elderly, yet they offer different degrees of assistance.

Assisted Living Care Level

Assisted living communities, as their name suggests, are designed to assist residents with activities of daily living (ADLs). These could include but are not limited to bathing, dressing, and using the toilet. The objective in these communities is to maintain as much independence as possible for the residents, while providing the necessary support. Assisted living communities offer a more social lifestyle for seniors who are generally active but need some help with everyday tasks [1].

The level of care provided in assisted living communities is suitable for older adults who are still relatively independent and do not require round-the-clock medical attention. The care aides in these communities are highly trained, although they may not be medically certified. The focus here is on providing residents with a comfortable, engaging lifestyle that caters to their unique needs and preferences.

Skilled Nursing Care Level

On the other hand, nursing homes, also known as skilled nursing facilities, provide the highest level of care for individuals who don't require hospitalization but do need full-time monitoring and medical assistance. They cater to adults with serious health issues, offering round-the-clock medical care to treat more serious health conditions.

In contrast to assisted living communities, nursing homes offer a higher level of medical care, including skilled nursing care provided by trained medical professionals. This intense level of care is suitable for individuals who have complex medical needs that require regular professional attention.

In summary, the choice between assisted living and skilled nursing facilities depends largely on the level of care required by the individual. Assisted living offers a supportive environment for those who need help with some daily activities, while skilled nursing facilities provide intensive medical care for those with serious health conditions. Understanding these differences is vital in making an informed decision regarding the best care option for your loved one.

Cost Comparison

Understanding the cost of care is a crucial factor when deciding between assisted living and skilled nursing. This section provides a comparison of the costs associated with each setting.

Assisted Living Costs

Assisted living is often more affordable compared to skilled nursing. According to Senior Services of America, the national average monthly cost for assisted living care in 2020 was $4,300. However, these costs can vary depending on the community and the type of room selected. Larger spaces, for instance, may cost more. Similarly, A Place for Mom places the national median monthly cost of assisted living at $4,995.

Average Cost	Source
$4,300	Senior Services of America
$4,995	A Place for Mom

Keep in mind that while Medicaid typically covers services like personal care assistance in assisted living, it generally does not cover room and board.

Skilled Nursing Costs

In contrast, skilled nursing facilities are more expensive due to the round-the-clock medical care provided. The national average cost for a skilled nursing facility in 2020 was $8,821 per month as per Senior Services of America. A Place for Mom puts the national median monthly cost of a private room in a nursing home at $9,733.

Average Cost	Source
$8,821	Senior Services of America
$9,733	A Place for Mom

Generally, Medicare covers up to 100 days in a skilled nursing facility per benefit period. However, the financial impact of skilled nursing care is considerably higher than assisted living costs, so it's crucial to plan accordingly.

In conclusion, while assisted living generally costs less than skilled nursing, the choice between the two should be guided by the level of care required. It's also important to consider potential financial assistance options, like Medicaid and Medicare, and how they apply to each care setting.

Admission Criteria

As you assess the options for elderly care, understanding the admission criteria for both assisted living and skilled nursing is crucial. These criteria are determined based on the individual's health status, functional capabilities, and specific care requirements.

Assisted Living Requirements

Admission into an assisted living community typically requires residents to meet certain health standards and functional requirements. The eligibility for assisted living is primarily based on the individual care requirements of the potential resident.

Generally, assisted living is deemed appropriate for individuals who require assistance with at least two activities of daily living such as bathing, eating, dressing, toileting, walking, and continence. However, assisted living is not ideal for individuals who require round-the-clock monitoring or those with severe medical needs [5].

To qualify for assisted living, individuals need to be stable and predictable in their conditions, meaning they should be able to control their medical conditions with minimal assistance. Admission can be denied if a person does not meet these criteria, especially when the level of care the facility can provide is insufficient. Denials often occur when the safety and health of the resident or other residents could be at risk.

Severe memory impairments may disqualify a person from entering assisted living if they require 24/7 supervision, as most assisted living facilities do not have as much staffing as memory care facilities. Extensive medical needs, such as extensive wound care, can also disqualify an individual from assisted living admission.

Skilled Nursing Eligibility

Unlike assisted living communities, admission into a skilled nursing facility typically requires confirmation that seniors necessitate a higher level of care. Skilled nursing facilities are designed to provide intensive, therapeutic care for individuals who are recovering from surgery or a serious illness.

To be eligible for admission into a skilled nursing facility, individuals typically must have a medical condition that requires the skills and expertise of licensed nurses. This often includes individuals who have severe chronic conditions, those who are recovering from a major surgery or illness, or those who require complex wound care or rehabilitation services.

The admission process usually involves a thorough health assessment to determine the individual's care needs and ensure that the facility can provide the necessary level of care. This evaluation is typically performed by a team of healthcare professionals, including doctors, nurses, and social workers.

In conclusion, the admission criteria for assisted living and skilled nursing facilities are designed to ensure that each resident receives the appropriate level of care. By understanding these criteria, you can make a more informed decision when choosing an elderly care option that best fits the individual's needs.

Health Conditions and Care Needs

When comparing assisted living vs skilled nursing, a key factor to consider is the specific health conditions and care needs of the individual. This section will focus on the conditions frequently associated with nursing home admission and the particular case of diabetes in the nursing home population.

Conditions for Nursing Home Admission

The main chronic medical conditions associated with nursing home admission are dementia and stroke. Mental disorders represent 48% of all admissions, followed by somatic disorders at 43%, and social/emotional problems making up 8%.

When it comes to somatic disorders, diseases of the circulatory system such as stroke and heart failure are the most frequently mentioned, accounting for 35% of cases. Diseases of the nervous system (mainly Parkinson's disease) and the musculoskeletal system (mainly osteoarthritis) are also commonly mentioned.

Conditions	Percentage
Mental Disorders	48%
Somatic Disorders	43%
Social/Emotional Problems	8%

Symptoms like dizziness, impaired vision, and frailty are also relevant indicators of admission to nursing homes.

Diabetes and Nursing Home Population

The prevalence of diabetes is rising globally, and this trend is also seen in nursing home populations. Between 1993 and 2005, the prevalence of complicated diabetes mellitus as a primary diagnosis for nursing home admissions increased from 4.3% to 11.4%. This increase was especially pronounced in cases with amputations and blindness.

Year	Prevalence of Diabetes
1993	4.3%
2005	11.4%

However, those with well-managed diabetes have a decreased risk of functional disability and institutionalization. This underscores the importance of appropriate diabetes management for those living in nursing homes.

In conclusion, the health conditions and care needs of an individual greatly influence the decision between assisted living and skilled nursing. Understanding these factors is crucial in making the most informed decision for the care of your loved ones.