Nursing Home vs. Assisted Living Facility: What’s the Difference?


Life is not always easy. This is especially true for seniors and their caregivers. It goes without saying that life gets more difficult as we grow older and begin to require more care. Unfortunately for some, the need for long-term care comes sooner than later. In our practice, we often see how tough it can be for seniors and their caregivers each day when long-term care becomes necessary. Navigating the day to day can almost seem impossible.

Which Option Should I Choose?

We will all likely be caregivers for someone at some point. As our loved ones grow older, members of the immediate family often find themselves in the caregiving role. As caregivers, we soon realize that Mom or Dad need assistance with everyday activities such as cooking, eating and/or getting dressed.

Also, as caregivers, we face complex issues when making important decisions regarding the needs of our loved one. We do all we can to promote independence but many times we are forced to consider making some changes. Should Mom still be driving? Should Dad have access to using the stove? Is living at home alone still appropriate? Is it time to consider Assisted Living? How about a Nursing Home? How do we know which? For some, it can be difficult to distinguish between an Assisted Living Facility and a Nursing Home.

In our practice, we often meet with people asking these questions. Because many of our senior clients require or will eventually require some form of long-term care, we find it important to distinguish between different levels of care (i.e. Assisted Living vs Skilled Nursing). This conversation is usually had with the client’s spouse or children who are serving as the primary caregivers.

At our initial meeting, we spend time gathering information by reviewing documents and asking questions. We also give people an opportunity to simply tell their story. As we listen, we hear things like “Dad needs to be in a nursing home.” We hear how Dad is having trouble dressing himself, is having accidents or is having difficulty getting around the house. In a situation like this it becomes obvious that Dad needs some assistance.

As more of the story comes out, we realize that the best course of action may be an Assisted Living Facility. Many of the people we meet with don’t realize that there is a difference between a nursing home and an assisted living facility. Our job is to educate people about their options as we meet with them. This is the reason people schedule appointments to meet with us.

Important Things to Consider About Caregiving

So, what is the difference? Nursing homes and assisted living facilities both provide care in a long-term setting; however, each has a different approach to care and will offer a different level of care. Why exactly are these differences important? What does it mean for our clients and their caregivers?

This four-part series will aim to answer these questions. This first part in the series will focus on defining a few of the common terms used in a long-term care setting. We will begin with defining what Long-Term care means and will continue with defining a few other important and common terms.

Long-Term Care

Long-term care is a type of extended care required by an individual when he or she depends on others for assistance with daily medical care and/or personal needs. It is a combination of services designed to assist in meeting medical and/or nonmedical needs of an individual and can be offered in different settings. Many people have the mistaken belief that this type of care is only offered in nursing homes. Long-term care can also be offered at home, an adult day center or in assisted living facilities.

Medical care in the context of long-term care may include provision of nursing services, medication and/or therapy. Non-medical care may include assisting with personal needs or Activities of Daily Living and can include monitoring of an individual’s health and safety as well.

It is important to keep in mind that long-term care is designed to assist people to live as independently as possible. The need for care becomes evident as individuals show signs of struggle in their day-to-day routine at home with what we call “Activities of Daily Living.”

Activities of Daily Living

Activities of Daily Living [ADLs] are everyday activities and include things such as eating, dressing, transferring, toileting and bathing. In this context we refer to “transferring” as the ability of one to get into or out of a bed or chair.

Bathing includes tasks such as taking a shower or a bath, while toileting includes the ability to get to and from the toilet. It is important to discuss long-term care options when people begin to show signs of struggle in these areas. There are many caregiving possibilities that will allow the individual to maintain as much independence as possible.


A caregiver is any individual that assists with providing care for another individual, often a senior. Caregivers are usually a spouse or close family member but can also be a friend or neighbor. Caregivers can also be others employed by the senior or member of the senior’s family. A caregiver’s job is to assist the senior with ADLs.

Many of the people we meet with in our office are the primary caregivers for our clients. Nothing about being a caregiver is easy. Being a caregiver can be emotionally, mentally and physically exhausting. It’s very common for a primary caregiver to put someone else’s needs ahead of their own. Respite care should be considered as it is important that the primary caregiver be able to take breaks from the daily responsibilities they face.

Respite Care

This type of care is temporary in nature and is for a set amount of time (i.e. a few hours or a few days). Respite care is geared toward offering relief for the primary caregiver, which is often the spouse or close family member. This type of care can be provided in the home setting, a facility or at an adult day care center.

Assisted Living Care

Assisted living is a form of long-term care that provides limited services to individuals requiring some assistance with ADLs. This type of care is coordinated and tailored based on an individual’s specific need. This type of care is designed to promote independence in a homelike environment while providing care to those who can no longer live safely in the home setting on their own. An assessment will take place to determine what service plan is appropriate for the individual. This type of care does not provide hands on nursing, medication or therapy services.

Assisted Living Facility

An assisted living facility is a residential facility that offers limited care and assistance with ADLs. An assisted living facility also provides monitoring of an individual’s health and safety. It is important to keep in mind that an assisted living facility does not offer nursing services.

Skilled Care

This is a form of long-term care that helps with medical care such as nursing, medication and therapy. In terms of nursing services, skilled care includes monitoring medication, wound care, injections and feeding. Skilled care also includes therapies such as occupational, speech, physical and respiratory.

Skilled Nursing Facility/Nursing Home

This is a residential facility that provides around the clock care in the form of medical monitoring, personal care, nursing and therapy. A skilled nursing facility can offer short term rehabilitation services as well as long-term custodial care. This type of facility is only appropriate for individuals that are unable to care for themselves or need extensive medical care.

Memory Care

Memory care is a type of long-term care that is designed to meet specific needs of individuals with cognitive impairments such as dementia or Alzheimer’s disease.

Long-term Care Ombudsman

The Long-Term Care Ombudsman exists to assist with seniors with problems they face as residents of long-term care facilities such as Assisted Living Facilities and Nursing Homes. Their job is to investigate and resolve problems faced in a facility setting. They are advocates for assisted living or nursing home residents.

In Conclusion

In this part of the series we’ve defined a few important terms. In “Part 2 - Level of Care: Differences Explained,” we will discuss what “Level of Care” means and how it differs in the Assisted Living and Nursing Home setting.

If you have additional questions or wish to speak to an Elder Law Specialists, please contact our office today to schedule an appointment.

By Jonathan Kinsella

To speak to a lawyer at HKH Elder Law, call (727) 240-2350 today to request your consultation with a lawyer at our law firm.