Skilled Nursing vs. Assisted Living

April 20, 2016 Cece Credille, Vice President Quality Care Services

When you have an aging patient or loved one who can no longer receive the care they need at home, either after an incident or if their overall health is declining, two senior care options you may 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, even for seniors with some medical needs.

Skilled Nursing

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 that requires the care 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 being rehabilitation and then moving a patient to assisted living or back home. A nursing home may be a permanent placement for a person 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. 

While skilled nursing is a medical setting, assisted living is a residential setting with the focus on providing a healthy social environment with a calendar full 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 centralized 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 in nursing homes, assisted living residents are able to bring in their own furniture and belongings, further creating a home-like environment.

Whereas in skilled nursing, doctors visit patients, at assisted living communities like Enlivant, an onsite full-time registered nurse partners with a resident’s family and physician to manage their care. They provide ongoing nursing oversight and serve as a liaison between the resident, physician, and any other health professionals needed. At Enlivant, our onsite nursing staff provides each resident with an initial personalized care plan, and then conducts re-occurring assessments every 90 days, or sooner if there is a change in care needs. 

Assisted living communities may also partner with other health professionals, such as hospice and home health agencies, to bring in care the 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. Assisted living can also provide care to manage chronic conditions such as diabetes and dementia. 

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

To ensure you are making the best recommendation, we encourage you to visit your local assisted living communities and skilled nursing facilities and talk to their staff about care and services available.

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


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