When to Move From Assisted Living to a Nursing Home

Our health needs change as we age and sometimes require more specialized care. For many seniors, this means moving from independent living to assisted living or nursing home care.

While both types of care provide support and assistance to seniors, there are some key differences between them. Assisted living facilities offer independence with additional help provided by staff, whereas nursing homes provide round-the-clock medical care and supervision.

Knowing when to transition from one type of care can be challenging. This article gives guidance on when moving from assisted living to nursing home care may be appropriate.

Assisted living vs. nursing home facilities

While assisted living and nursing home (also known as skilled nursing) facilities both provide care and support for seniors, there are some critical differences between the two. Here are some of the main distinctions:

Assisted living

• Offers a lower level of care than a skilled nursing facility, providing help with activities of daily living such as dressing, bathing, dressing, or meal prep.
• Residents typically live in private rooms or apartments and can access communal areas for meals and social activities.
• Staff can assist as needed, but residents are encouraged to keep as much independence as possible.
• Assisted living facilities may have medical staff available but are typically not trained in providing skilled nursing care.
• Cost is generally lower than in skilled nursing facilities.

Skilled nursing facilities

• Provide a higher level of care than assisted living, including round-the-clock medical care, rehabilitation services, and assistance with daily activities.
• Residents typically live in semi-private or private rooms and can access communal areas for meals and activities.
• Staff includes licensed nurses and certified nursing assistants trained in providing skilled nursing care, administering medications, and managing medical equipment.
• Skilled nursing facilities may offer specialized care for conditions such as dementia or Parkinson's disease.
• The average cost is generally higher than assisted living facilities.

Generally speaking, assisted living is geared towards older adults who need some help with daily living but can still maintain a degree of independence. Skilled nursing facilities are for those who need more medical care and supervision.

Signs it may be time to consider a nursing home

While assisted living can be a great option for many older adults, there may come a time when a move to a nursing home is necessary. Here are some signs that it might be time to consider a nursing home for your loved one:

1. Physical decline or illness that requires more intensive care: Seniors with chronic conditions or serious illnesses may require more medical attention than an assisted living facility can provide. Nursing homes offer skilled nursing care, including wound care, medication management, and physical therapy.
2. Cognitive decline or dementia that makes it difficult to manage activities of daily living: Seniors with cognitive impairment may require assistance with basic tasks such as bathing, dressing, and eating. Skilled nursing facilities can provide specialized memory care units and staff trained in caring for those with dementia.
3. Increased dependence on caregivers or need for specialized medical equipment: Seniors who require a higher level of assistance may need specialized medical equipment or devices, such as oxygen tanks or wheelchair ramps. Nursing homes can provide access to this equipment and staff trained in its use.
4. Safety concerns due to falls or other accidents: Seniors at risk of falls or other accidents may require round-the-clock supervision to ensure their safety. Skilled nursing facilities can provide 24-hour care and monitoring to reduce the risk of accidents.
5. Inability to participate in activities or socialize with others in assisted living: Seniors who can no longer participate in the activities and socialization provided by assisted living may benefit from the structured activities and social opportunities offered by nursing homes.

If a person's care needs exceed what can be provided in an assisted living facility, or if they require a higher level of medical care or supervision, it may be time to consider a move to a nursing home.

Evaluating the options for nursing homes

Choosing a skilled nursing facility can be daunting, but taking the time to research and evaluate different options can help ensure that you find the best fit for your needs. There are several types of nursing homes to consider, including skilled nursing facilities, memory care units, and continuing care retirement communities.

Different types of nursing homes

• Skilled nursing facilities provide round-the-clock medical care and assistance with activities of daily living.
• Memory care units are designed for seniors with dementia or other memory impairments, with staff trained in providing specialized care.
• Continuing care retirement communities offer a range of living options, from independent living to assisted living and skilled nursing facilities, allowing older adults to age in place.

How to research and evaluate nursing homes

When evaluating nursing facilities, it's essential to consider location, staff qualifications, services provided, and cost. Here are some tips for researching and evaluating nursing homes:

1. Visit in person: Schedule a visit to the nursing home and take a tour to get a sense of the facility and its staff.
2. Check for accreditation: Look for nursing facilities accredited by organizations such as The Joint Commission or the Commission on Accreditation of Rehabilitation Facilities.
3. Review staff qualifications: Check the qualifications of the nursing staff, including nurses, nursing assistants, and therapists.
4. Look at services provided: Consider the services offered, like physical therapy, occupational therapy, or speech therapy.
5. Consider location and accessibility: Consider the nursing home's location and whether it's easily accessible for family members to visit.
6. Check cost and payment options: Research the cost of the nursing home and whether it accepts Medicare, Medicaid, or private insurance.

By taking the time to research and evaluate different nursing facility options, you can find a facility that meets your needs and provides the care and support you require.

Making the decision to move from assisted living to nursing home care

Moving from assisted living to nursing home care can be difficult and emotional for the individual and their family. This decision is not a failure but a recognition of changing needs and a desire for additional support and care.

Moving to a nursing home can be challenging for seniors, who may be leaving familiar surroundings and routines. Family members may also feel guilty or anxious about deciding to move their loved one to a skilled nursing facility.

To have productive conversations about the decision to move:

1. Approach the topic with sensitivity and empathy.
2. Encourage open and honest communication, and take the time to listen to the concerns and fears of all parties involved.
3. Offer reassurance and support, and involve the senior in decision-making as much as possible.

It can also be helpful to seek advice from professionals such as doctors, social workers, or elder care specialists. They can give valuable guidance and support through the decision-making process and help connect you with resources and services to ease the transition to nursing home care.

Ultimately, the decision to move to a nursing home should be based on the individual's needs and preferences, as well as their safety and well-being. By approaching the decision with compassion and support, you can help ensure a smoother transition and a better quality of life for your loved one.

Costs of nursing home care and funding options

Nursing home care can be expensive, and the cost can vary widely depending on the location and level of care required. According to the Genworth Cost of Care Survey, the median price of a private room in a nursing home in the United States in 2021 was $8,821 per month or $105,852 per year. Semi-private rooms were slightly less expensive, with a median monthly cost of $7,756 or $93,072 annually.

Many families are unable to afford the cost of nursing home care out of pocket and may need to consider funding options such as Medicare, Medicaid, or long-term care insurance.

Medicare is a federal program that provides health insurance to people aged 65 and older and younger people with specific disabilities. While Medicare does cover some nursing home costs, it only covers short-term stays for rehabilitation and does not cover long-term care.

Medicaid is a joint federal and state program providing health insurance to people with limited income and resources. Medicaid can cover the cost of nursing home care for eligible individuals, but eligibility requirements vary by state and may include income and asset limits.

Long-term care insurance is another option, but it can be expensive and may not cover the total cost of nursing home care. Researching and comparing different insurance policies carefully is essential to find one that meets your needs and budget.

Planning and considering funding options early can help ensure you are prepared for the cost of nursing home care if and when needed.

A note from Givers

Deciding when to move from assisted living to nursing home care is a complex decision that requires careful consideration of the individual's changing needs and available options. There is no one-size-fits-all answer to this decision, and each individual's situation should be evaluated on a case-by-case basis. We offer encouragement and support to those facing this decision and urge them to seek professional advice and support as needed.