Assisted Living vs. Nursing Homes: What's the Difference?

Assisted living facilities and nursing homes are long-term housing and care options for older adults. Although people sometimes use the terms assisted living and nursing home synonymously, they are distinct.

Understanding the differences between assisted living and nursing homes is critical for those considering where to live as they age. This is because assisted living communities and nursing homes provide different types of care. While assisted living is appropriate for active older adults who need support with everyday tasks, nursing homes provide medical care to adults with significant health issues.

What Is Assisted Living?

Older adults who can no longer live on their own but do not require round-the-clock medical care can benefit from assisted living. While assisted living facilities can have nurses on staff, the primary focus is not on health care, but rather on supporting residents with daily life.

Activities of daily living (ADLs) are six basic activities that healthy individuals can carry out on their own on a daily basis. Depending on an individual resident’s needs, an assisted living facility can provide aid with showering, dressing, preparing meals, completing household chores, and taking medication on time at the correct dose.

While giving necessary support, assisted living communities maximize adults’ independence and autonomy. Residents typically live in private units similar to traditional apartments with kitchens that are part of larger communities offering opportunities to socialize with fellow residents. Units can have safety features tailored to older adults with mobility challenges, such as shower bars, widened doorways, safety rails, and enhanced lighting.

Difference Between Assisted Living and Nursing Home

Compared to assisted living, nursing homes may be the right fit for those with significant medical conditions requiring round-the-clock care. Nursing homes can offer more extensive health care services that are unavailable in many assisted living facilities. Therefore, nursing homes can be more appropriate for those with severe health needs.

As they provide critical medical support, nursing homes can help people with mobility complications or cognitive challenges that limit their autonomy. For instance, a person diagnosed with severe dementia might do better in a nursing home than in an assisted living facility. Some nursing homes have specialized memory care units for those with dementia. Nursing home staff can also provide medical care and supervision as well as help with the six activities of daily living.

Like assisted living facilities, nursing homes also offer help with daily living, such as bathing or help with medication management, and can adapt to individuals’ needs. For instance, showers and bathtubs may have safety bars, and doors may be wide enough to accommodate wheelchairs.

Yet nursing homes offer residents less freedom and independence than assisted living communities. Those receiving care typically do not have their own kitchens and may share a room with another patient.

What Are the Costs of Assisted Living Facilities and Nursing Homes?

Assisted living facilities and nursing homes can constitute a significant expense for residents and their families.

According to SeniorLiving.org, the median cost of assisted living in 2021 was $4,500 per month. Because of the higher level of medical care, nursing homes tend to be more expensive than assisted living. A private room in a nursing home averages $9,034 per month, and a shared room $7,908 per month.

Individuals can pay for assisted living or nursing home fees out of pocket or through long-term care insurance. Medicare does not cover assisted living or nursing home fees.

Medicaid coverage, however, does extend to nursing home fees. Though Medicaid does not pay for room and board at assisted living facilities, it includes the skilled nursing care and emergency response services that residents of assisted living facilities receive.