What You Need to Know About Skilled Nursing vs. Assisted Living

Choosing the right living option for yourself or for someone you care about can be confusing. Several types of living options are now available for older adults, and each has its own benefits. Two of the most common living options are skilled nursing and assisted living.

Skilled nursing and assisted living are similar in many ways, but the two supportive living environments are also quite different. Both are long-term care options that provide numerous supportive medical, social and personal services for those who may no longer be able to manage daily tasks. However, the biggest difference between skilled nursing and assisted living is the level of care provided and the people that provide that care. Residents of assisted living communities receive help with certain activities of daily living (ADLs) but can accomplish most activities on their own. Those living in skilled nursing communities, on the other hand, receive around-the-clock nursing care and assistance with most, or all, ADLs.

Skilled Nursing and Assisted Living: A Comprehensive Comparison

Assisted Living Communities

Assisted living communities are for individuals who can no longer live at home safely by themselves, but who do not require the higher level of nursing care provided in a skilled nursing facility. Assisted living residents are encouraged to live as independently as possible, while still receiving assistance with ADLs, such as bathing, grooming, dressing, toileting and managing medications, as needed.

Residents of assisted living communities often live in private or semi-private apartment-style residences. Each apartment typically features a living area, small kitchen, dining area and private bath. Residents can prepare meals in their own kitchen or enjoy prepared meals in centralized dining areas. Residents may also bring their own belongings and furnishings, which allows them to create a personalized environment that they can truly call home.

Most buildings feature spacious common areas to create a sense of community and to offer unlimited opportunities for socializing. Many offer calendars with scheduled enrichment programs, although residents can set their own schedules and pursue their own interests. Transportation is frequently available at most assisted living communities, so residents can attend church, go to concerts or sporting events, and enjoy all their favorite activities.

Assisted living communities commonly have trained professionals on-site to provide supportive healthcare services as needed. While these communities do not provide care for medically intensive needs, they may partner with other healthcare organizations that do.

Skilled Nursing Communities

Skilled nursing communities provide around-the-clock care, known as skilled nursing care, for individuals who require specialized medical attention or therapy services every day. Those who stay in a skilled nursing environment often do so following hospitalization, surgery, injury, heart attack, stroke or another significant health problem. Skilled nursing communities frequently focus on rehabilitative services intended to prepare people to return to their previously independent lifestyle.

Stays in a skilled nursing community may be temporary or longer-term. About one third of people stay in a skilled nursing community for two weeks or less, according to the Public Policy Institute of California, and about half stay between two weeks and three months. The rest stay in a skilled nursing community longer than three months.

Residents of long-term skilled nursing communities often have complex medical conditions that require routine skilled nursing services, including:

  • Wound care
  • IV medications
  • Physical, speech and/or occupational therapy
  • Ventilator care or respiratory therapy
  • Advanced-stage pressure ulcers, known commonly as bed sores
  • Feeding tube
  • Pharmaceutical, radiology and laboratory services
  • End-of-life or hospice care

Residents may share a semi-private room but high-quality skilled nursing communities offer comfortable, convenient and beautifully outfitted private suites so residents can continue to live graciously. Residents may enjoy meals in a common dining area or in the privacy of their own space. Skilled nursing communities typically fill the calendar with scheduled programs that residents can participate in if they wish. Those unable to engage in the group activities may participate from the comfort of their suite.

Teams of registered nurses (RNs), licensed practical nurses (LPNs) and nursing assistants (NAs), along with other support personnel, provide specialized health services. Skilled nursing communities keep varying numbers of RNs, LPNs and NAs on site throughout the day and night, depending on the number of residents and the level of care they require. The goals of the medical staff are to enhance quality of life and to help each resident reach his or her highest levels of independence.

Medicare, Medicaid and most long-term health insurance policies will cover the cost of your stay, as skilled nursing communities provide medically necessary care, supervised by a licensed physician.

Choosing Between Assisted Living and Skilled Nursing Communities

Choosing the right living arrangement may seem overwhelming, especially when a serious event has made it necessary. Deciding between assisted living and skilled nursing is often essential, though, when it is no longer safe for someone to live independently. Comparing the services of each should make the decision easier.

Assisted living communities and skilled nursing communities offer housekeeping and laundry services, assistance with activities of daily living, various activities and transportation to and from doctor appointments when available. Both assisted living and skilled nursing communities offer meals in a centralized dining area but residents of an assisted living community may have a kitchen in their apartment. Those who enjoy cooking in their own kitchen or occasionally dining out may prefer an assisted living environment, while someone who has trouble with meal preparation or clean up would benefit more from living in a skilled nursing residence.

Assisted living communities provide a homelike environment that helps residents live independently and receive help with some activities of daily living. The nursing staff does not monitor each resident closely but are always nearby when needed. Anyone who is generally independent might opt for assisted living, while someone who needs a great deal of support or medical attention might choose skilled nursing care.

Skilled nursing communities offer substantially more nursing care than do assisted living communities. Skilled nursing communities provide medically intensive care for people with chronic or complex medical needs, permanent disabilities or severe pain and for people who are recovering from an illness, injury or surgery. Because they provide a higher level of nursing care, skilled nursing communities may seem less private and more institutional in nature, however, many communities offer private accommodations for maximum comfort.

Assisted living communities are typically private pay, while Medicare, Medicaid, Veterans Benefits and most long-term insurance policies will pay for care in skilled nursing communities.

Choosing between various living options can seem confusing at first, especially when coupled with the stress of a major medical problem requiring extended care. Taking some time to learn the difference between assisted living and skilled nursing care can help.

For more information about the similarities and differences of skilled nursing and assisted living, contact your full-service retirement community, Forest Hill. As the first continuing care retirement community in Monterey, Forest Hill has a long history and reputation for offering unparalleled care. Contact us today to learn how you can choose the living option that best meets your personal style and needs.

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