Assisted Living vs Nursing Home

Assisted Living vs Nursing Home

Have you been noticing some signs that your loved one might need help?

Are they having difficulty with tasks that were once easy for them, or forgetting to pay bills and other important life tasks?

There are a variety of indicators that our loved ones may not be able to carry on with their usual pattern of life any longer. This is one of the hardest topics to broach with someone who has been used to living a familiar and independent lifestyle, but often it means the difference between safety and danger.

Or perhaps the issue is more of a medical issue and you’ve realized that your loved one may need more consistent care than occasional trips to the doctor.

These are all things that weigh heavily on those of us with beloved seniors in our lives, and can lead to deep and compassionate conversations with them.

But before you get into the topic, it’s a good idea to figure out what the best option for them might be so that you can present them with all the information. Having all the facts will help them feel more at ease about a big change in their lives. Anything vague and unknown almost always causes fear or uncertainty, so the more detailed a picture you can paint for them, the easier it will be to discuss this delicate topic.

So let’s get you some information.

Two of the most common types of facilities available for aging seniors are Assisted Living Facilities (ALF) or Nursing Homes. Here’s an overview of these options in order to equip you with the knowledge you’ll need to decide which one is best for your loved one.


What Is Assisted Living?

You may already have an idea of what this is from the name. Assisted Living is provided for seniors who are no longer able to accomplish those daily tasks that were once simple and stress-free. Things that we take for granted in youth and health can be a struggle for those whose bodies are aging.

Imagine this: A person who once prided themselves in their meticulous care of their house and yard realizes that they no longer have the energy to do yard work or the strength to fix the roof. Slowly the upkeep of their beloved home becomes too much. Or tasks like lifting heavy pots and pans to cook or using a can opener become frustratingly difficult.

At this stage, a senior citizen might still have much of their mobility and independence, but just needs some help with these basic tasks that are becoming exhausting burdens. Assisted living provides this kind of help.

A day in the life of a resident at an Assisted Living Facility might look something like this:

  • They wake up in their own apartment, and are helped out of bed by one of the staff if need be. If they are not able to walk, the staff member may help them to the restroom and onto the toilet or into the shower.
  • Breakfast is served in a community eating area, but some facilities also have apartments with small kitchen units where seniors who wish to do so can fix their own meals or snacks throughout the day.
  • At a specific time of day, a staff member may help the resident take their medication, and there are usually activities or community areas for social interaction.
  • There are call buttons so a senior can get help whenever needed, and the staff is aware of their specific care  throughout the day.

With over 30,000 Assisted Living Facilities now operating nationwide, this is a great resource to look into if your loved one is showing signs of needing daily help.

Pros and Cons of Assisted Living


  • Private apartment or shared apartment options
  • Meals provided
  • Social activities
  • Assistance with basic daily needs
  • Nurse on staff to monitor health needs and administer medications
  • Wide variety of staff members
  • Customized living areas for memory loss residents
  • Generally less expensive than nursing homes


  • Fewer skilled medical services provided
  • Less frequent in-depth health check-ups
  • Medical needs are tended to by trips to their personal physicians


The cost of Assisted Living will vary from state to state or facility to facility, but a rough average is about $3,600 per month. This may sound like a lot, but don’t forget that other customary expenses will be included in this total, such as meals and utilities. Depending on what part of the country or city you’re in, you may find other price options to choose from as well.

Payment Options

Many people use personal savings to pay for their loved one’s senior living costs or pool the resources of several different family members. Another option is selling assets that your loved one had, such as a home or vehicle, that they will no longer be able to use at this stage of life.

If these options are still not suitable for your situation, there are other financing options available, such as:

  • VA Medical Benefits
  • Long-Term Health Insurance
  • Medicaid
  • Converting Life-Insurance

You can find more information about these options in our Senior Living Glossary.

You Probably Want to Go with Assisted Living If…

  • Your loved one is forgetting important tasks such as paying bills or taking medication
  • Your loved one is having difficulty with daily needs such as using the restroom, preparing meals, moving around the house, walking, bathing, or dressing
  • Your loved one doesn’t have a progressive medical condition

If you think this is the option for your loved one, find out more in Assisted Living 101.


What Is a Nursing Home?

According to the CDC, there are 15,600 Nursing Homes  about half as many as Assisted Living Facilities  nationwide, with over 1.4 million Nursing Home residents. Though the facilities typically have stricter guidelines and schedules, you’ll find that Nursing Homes are equipped with a far greater level of medical care.

Nursing Homes are meant for those who need their health consistently monitored or who require frequent medical treatment.

Imagine someone who has an illness that they’ve dealt with most of their lives, like diabetes or Parkinson’s. As they get older, the illness will need more and more detailed attention.

Another thing to consider: Many Assisted Living Communities require residents to agree to a month-to-month contract. This contract usually includes a requirement that the resident move out if the facility feels that they are no longer able to offer the level of care necessary for the resident’s wellbeing. In other words, if a resident begins to need constant medical attention that the Assisted Living staff is not equipped or certified to provide, they may insist that the resident be transferred out of their facility.

If this occurs, then transferring them to a Nursing Home that has a full staff of medical professionals may be the right choice. What the Assisted Living Facility wasn’t able to help with, such as wound care, IV therapy and other skilled care services, the Nursing Home will be ready and able to provide on a daily basis.

A day in the life of a resident at a Nursing Home might look something like this:

  • They might wake up in their own room or greet their roommate in the bed next to them.
  • Nurses check in on them consistently and help with medications and IVs. Physicians will administer any skilled medical procedures as needed.
  • Meals will be provided in bed if necessary, and throughout the day the senior will be helped with their toilet and bathing needs.

Pros and Cons of Nursing Homes


  • Increased attentiveness to each patient’s medical needs
  • Higher level of skilled medical attention
  • Consistent monitoring of health and wellness
  • Meals provided
  • Larger medical staff


  • Less privacy
  • Stricter structure of schedule
  • Less variety choice in activities throughout the day
  • More expensive than assisted living


Genworth quotes the average monthly cost of a nursing home at around $6,800.

That’s about double what you’d pay for Assisted Living, and Nursing Homes generally charge per day instead of per month, so other fees may be added in depending on your loved one’s specific medical needs and treatments.

Payment Options

While you’d generally go about this the same way as paying for Assisted Living, there are a few extra options for those in need of greater medical attention in their senior years:

  • Medicare
  • Medicaid
  • Veteran’s Affairs Benefits
  • Private Insurance
  • Reverse Mortgage

You can find more information about these options in our Senior Living Glossary.

You Probably Want to Go with a Nursing Home If…

  • Your loved one has an ongoing or progressive condition that needs consistent medical attention
  • Your loved one’s health is declining and you want to ensure that their health is frequently monitored and attended to
  • Your loved one’s care needs go beyond basic daily tasks and needs


Safety and Accountability

Sadly, you do occasionally hear about seniors being neglected or mistreated in Assisted Living Facilities or Nursing Homes. This is why it’s so important to allow yourself plenty of time to do research on each facility and to visit them yourself before making any plans.

Every facility is required to meet care and safety standards as established by each state. They are then licensed and inspected by the Department of Social Services, Community Care Licensing. This is not required for senior housing that only provides living arrangements and housekeeping without personal care assistance.

Here’s a tip:

Every facility is required to show you the report of their last inspection if you request it. Aside from looking for online reviews from residents and family members or talking to those people directly, this may be one of your best tools in determining the safety and standards of each facility.

How to Broach the Subject with Your Loved One

Chances are, your loved one has a familiar routine that they have enjoyed for many years. Whether it’s a favorite room in their home where they like to sit and read at night, or the neighbors that they’re used to saying hello to every morning, these precious pieces of their life should not be disregarded and rushed past in the process of getting them the help that they need.

Here’s the best way to promote the change:

  • Show them that you value their feelings and where their life has been.
  • Before you launch into the details of Assisted Living or Nursing Homes, or even ask them which they’d prefer, take the time to express your concerns about their wellbeing, and truly listen to their concerns about leaving behind the rooms, routines, and relationships that they love.
  • Make this the bulk of the conversation if you need to.

The more they see that you understand their attachments and reluctance, and validate them, the more willing they will be to eventually talk about transitioning out of it.

After you’ve given them plenty of time to express their emotions, and you’ve listened compassionately, asked questions, and shown that you care, there are a few things to bring up that may soften the subject:

  • More social interaction: As seniors lose their mobility or their eyesight fades, there are fewer opportunities to get out and enjoy activities with other people. In Assisted Living Facilities, they will be able to see and interact with people just like them, build a variety of friendships, and fill that social need that they may be lacking in their current housing situation.
  • Access to religious services: Many ALFs either host their own religious services, invite guest ministers, or provide transportation to weekend services. If your loved one hasn’t been able to get to the services they love to attend, this may provide the chance for them to revive that spiritual connection.
  • Safety: As much as they may try to hide it, it’s scary to be alone as a senior and know that if you fall or have an accident, there may be no one there to help you. Assisted Living apartments are equipped with call buttons, so your loved one will never have to fear that moment of feeling helpless and alone.

Transitioning To a Nursing Home

The transition from Assisted Living to a Nursing Home may be equally as difficult for them. After finally agreeing to move into Assisted Living for their own safety, they have now spent months or even years getting to know the staff, the other residents, and the grounds and neighborhood. Many times the people in their Assisted Living Facility are like a second family to them.

When medical issues arise requiring them to move to a facility with more skilled medical professionals available, it may be hard to detach once again. These transitions and losses are a part of life for all of us. Once again, be sensitive to their feelings, and assure your loved one that you’re going to walk with them through the process every step of the way.