nursing home

What’s the Difference Between Assisted Living and a Nursing Home?

“Senior living” is often thought to be synonymous with nursing homes, but that isn’t the case anymore. In the past, nursing homes were a “catch-all” for seniors who couldn’t live on their own no matter the reason. Today, many nursing homes have a rehabilitation section that  specializes in convalescent and post-surgical care with the goal of returning the patient home, and a long term care section that has become the permanent home for seniors (or people of any age) whose disabilities or frailty mean they cannot safely live in a less restrictive environment.   Nursing homes are responsible for providing ongoing nursing and health-related services for their residents.

As Americans started living longer, the demand for senior housing has grown, as has the demand for assistance in only some areas.  Enter assisted living facilities, which are for individuals aged 55 or older who need assistance with just a few activities of daily living (hence the name “assisted” living), who may require medication management, or who, because of a dementia, may need supervision or a contained environment so that the senior does not wander into danger.

Understanding Assisted Living

Assisted living facilities tend to offer as much or as little help as the resident requires, short of medical assistance. The level of care provided determines the rate that the resident pays.  Assisted living facilities offer social activities, outings, meals and snacks, housekeeping, laundry, and medication management.  Depending on the resident’s needs, facility staff assist with bathing, dressing, and getting ready for bed.  The facility may provide specialized programming and activities for residents who need extra oversight because of memory deficits.  Some assisted living facilities even offer locked memory care units so that the resident cannot wander.

If you’re thinking to yourself, “Wow, that sounds like paradise,” then you’re not alone. Assisted living facilities tend to have satisfaction rates of over 90%.

In Virginia, assisted living facilities are regulated by the Department of Social Services if they care for four or more adults who are aged, infirm, or disabled.  A list of assisted living facilities can be found at

Different Types of Assisted Living

Assisted living facilities may be stand-alone or they may be a part of a continuing care community that also offers onsite senior independent living and nursing home services.  Assisted living facilities may offer memory care, including specialized units, but not all do, so if this service is important to have, be sure to ask about it.   Assisted living facilities may offer a choice of room layouts, including multiple bedrooms and bathrooms, which can provide more of an apartment feel to residing there.

Restrictions on Assisted Living

Assisted living is not the right choice for everyone. Most assisted living communities require residents to feed themselves or need minimal assistance in eating.  In addition, the resident may need to be able to self-transfer from bed to a wheelchair or be able to evacuate the building without assistance should an emergency arise.  If the resident cannot meet these requirements, then a nursing home may be the best available option, or the assisted living resident may be asked to hire private duty caregivers who will be with the resident around the clock to provide the necessary services.

When is Assisted Living the Right Choice?

Assisted living is often the right choice for seniors who need some assistance and for whom the tasks of maintaining a larger residence is too much. Assisted living facilities provide different levels of care so the resident may be able to remain at “home” as the resident’s care needs increase.   Assisted living facilities provide social activities and outings that can expand the horizons of a senior who may have given up these types of activities because of limitations on the senior’s ability to drive.

Economic Considerations

Assisted living costs vary depending on the level of care provided and the room layout.  In Virginia, assisted living can run $4,000 – $7,000 a month. In general nursing homes cost $7,000 – $10,000 a month. In Virginia, public benefits are much more likely to pay for a nursing home than they are for an assisted living facility.  In fact, many assisted living facilities in Virginia do not accept Virginia’s needs-based benefit for assisted living care because the reimbursement rate is so low.

Talk to an Elder Law Expert Today

If you require information regarding your or your loved one’s senior housing options, the attorneys at Promise Law can discuss the situation and analyze you or your loved one’s eligibility for benefits. Call us today at (757) 690-2470 to learn more.


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