Skilled Nursing vs. Assisted Living

November 26, 2018 Cece Credille, RN, Vice President Quality Care Services

When an aging patient or loved one can no longer receive the care they need at home, either after an incident or overall declining health, two senior care options to consider are skilled nursing facilities (also called nursing homes) and assisted living communities.

Here, we explain the key differences between skilled nursing and assisted living, and provide situations where assisted living can be a good fit for seniors even with some medical needs.

Skilled Nursing

Skilled Nursing homes are for people who require significant medical care, such as a specialized line for IV medications, a ventilator, respiratory therapy, or have a stage 3-4 pressure ulcer (bed sore). Essentially, any senior who needs medical treatment from a registered nurse 24/7 or daily therapy services will need a skilled care setting. 

A stay in a skilled nursing facility is akin to a hospital stay. It is often temporary, with the goal of rehabilitating and then returning a patient to assisted living or back home. A nursing home may be a permanent placement for a patient with significant physical or medical needs.

Assisted Living

Assisted living is for seniors who do not require constant care but need assistance with activities of daily living (ADLs), such as assistance with eating, bathing, dressing, and medication management. 

Whereas skilled nursing is a medical setting, assisted living is a residential setting. Here, the focus on providing a healthy social environment with a full calendar of life enrichment activities, exercise classes, family events, and more. Transportation is often available so that those no longer able to drive can still be active in the community and attend church services, beauty appointments and other outings. 

The inviting dining rooms and large common areas typical in assisted living offer seniors unlimited opportunities for socialization and help residents feel a sense of community. Unlike nursing homes, assisted living residents are able to bring their own furniture and belongings, further creating a home-like environment. 

In contrast to skilled nursing facilities where doctors visit patients, assisted living communities like Enlivant feature an onsite full-time registered nurse who partners with a resident’s family and physician to manage care. They provide ongoing nursing oversight and serve as a liaison between the resident, physician, and any other health professionals as needed. At Enlivant, our onsite nursing staff provides each resident with an initial personalized care plan, and conducts re-occurring assessments every 90 days or sooner should the care need change. 

Assisted living communities may also partner with other health professionals, such as hospice and home health agencies, to bring in specialized care for resident needs. For example, if a resident needs outpatient therapy (e.g. physical, occupational, speech) three times a week, a home health agency can come into the assisted living community to provide that care. Hospice agencies can come in to provide end of life care, including wound care and pain management. This allows assisted living residents to “age in place” in their familiar, home-like environment, even as their care needs change. An assisted living setting can also provide care to manage chronic conditions such as diabetes and dementia. 

At the end of the day, a senior’s care needs will determine which type of facility is most appropriate. 

To ensure you are making an informed decision, we encourage you to visit your local assisted living communities and skilled nursing facilities. Talk to their staff about care capabilities and available services. You may find that an assisted living community offers a balanced solution that fosters independence, quality of life and safety.

For more information on exploring assisted living with your patient or loved one, visit The Enlivant Approach to Assisted Living.