Long Term Care Facility vs Assisted Living Compared

11 Jan 2022
Deciphering 'long term care facility vs assisted living': make an informed choice for your loved ones.

Understanding Long-Term Care

Long-term care is a term used to describe various services and support systems that help individuals, particularly the elderly, meet both their medical and non-medical needs. Often, long-term care is necessary for those who have a chronic illness or disability that affects their ability to handle everyday activities, such as bathing, dressing, and meal preparation.

Different Types of Long-Term Care

Long-term care facilities offer a variety of services, including medical care, living accommodations, assistance with daily tasks like bathing, grooming, dressing, and meal preparation or eating, and social activities for the elderly living in a comfortable, home-like setting. These facilities are designed to cater to a wide range of needs, ensuring that every resident receives the appropriate level of care. They can range from residential homes to specialized medical facilities.

The types of long-term care facilities include:

  • Nursing Homes: These provide 24-hour skilled nursing care for the elderly and people with severe physical or mental illnesses.
  • Assisted Living: These offer a semi-independent living option for the elderly who need assistance with certain activities of daily living.
  • Residential Care Homes: These provide a homely setting and personal care services for small groups of adults.
  • Adult Day Service: These offer health, social, and therapeutic services for seniors in a safe, community-based setting.
  • Home Health Care: These provide a range of medical, therapeutic, and personal care services delivered at home.

Importance of Long-Term Care

Long-term care plays a crucial role in the lives of the elderly and their caregivers. These facilities are designed to allow aging individuals to maintain as much independence as desired while receiving necessary assistance with daily tasks, ensuring that healthcare needs will be met now and in the future. This provides peace of mind for both the elderly and their caregivers.

Furthermore, long-term care for the elderly can help prevent adult children from becoming overwhelmed by caregiving duties. They may not be qualified to provide all the necessary care needed on a daily basis for their aging parents, reducing the risk to their own health and quality of life.

Seniors residing in long-term care facilities often have a better quality of life and feel more independent compared to aging in place at home. These facilities encourage independence among residents and offer a supportive environment for the elderly.

Long-term care facilities are recommended when an aging loved one starts experiencing difficulties with activities of daily living or routine tasks. Researching facilities in the area can help in making the best decision for improving the overall quality of life for the elderly [1].

Nursing Homes vs Assisted Living

When discussing long term care facility vs assisted living, it is essential to understand the key differences. These differences primarily lie in the level of medical care provided and the residential environment.

Medical Care in Nursing Homes

Nursing homes, also known as skilled nursing facilities, are primarily medical environments. They are designed to provide round-the-clock medical care and help residents with chronic illnesses. This is accomplished through a professional nursing staff that is always available for the residents [2].

In addition to room and board, personal care, and housekeeping, nursing homes provide core services like nursing services, dietary services, social services, and activities. They are also responsible for arranging therapy, dental care, podiatry services, optometry services, and transportation to medical appointments [3].

Residential Environment in Assisted Living

Assisted living, on the other hand, is primarily a residential environment. It provides long-term housing for older adults who are generally active but need support with activities of daily living (ADLs). These activities could include bathing, dressing, and using the toilet [4].

Assisted living communities aim to keep residents as healthy, socially engaged, and independent as possible. They offer services such as meals, housekeeping, and personal care services, which are provided directly or through a written agreement with a licensed home care agency. However, they do not offer ongoing skilled nursing care, distinguishing them from nursing homes.

While nursing homes offer similar amenities, their main focus is providing round-the-clock medical care to treat more serious health issues. Assisted living, on the other hand, focuses on maximizing quality of life and providing a more independent lifestyle, often making it preferred over nursing home care when possible.

The choice between a nursing home and assisted living will depend on the individual's health condition and their need for medical assistance or independence. It is crucial to consider these factors when making an informed decision about long-term care.

Factors to Consider

When comparing long-term care options, there are several factors to consider. One of the most significant factors is cost, as the expenses associated with different types of care can vary dramatically. Additionally, it's important to understand what kind of coverage is provided by Medicare and Medicaid, as these programs can help offset some of the costs.

Cost Comparison

The costs of nursing home care and assisted living facilities can differ significantly. According to Healthline, nursing home care costs are roughly double that of assisted living residence costs. The annual cost of a semi-private room in a nursing home is around $89,000, whereas an assisted living facility costs approximately $48,000 a year.

The national median monthly cost of assisted living is $4,995, while the national median monthly cost of a private room in a nursing home is $9,733, according to A Place for Mom.

The difference in costs is even more pronounced in New England. Private nursing home costs average $10,000 - $12,000+ per month, while assisted living is about half that amount, as per Senior Living Residences.

Coverage by Medicare and Medicaid

Medicare and Medicaid can provide coverage for some of the costs associated with long-term care, but the specifics of what is covered can vary. Generally, Medicare does not cover the cost of long-term care in a nursing home or assisted living facility, except for specific medical services or for a limited period of time after a hospital stay.

Medicaid, on the other hand, does cover some long-term care services, including certain services provided in nursing homes and assisted living facilities. However, eligibility for Medicaid and the specifics of what is covered can vary by state.

When considering the best option for long-term care, it's important to consider all tangible and intangible benefits provided by each option. For example, assisted living incorporates living expenses into the monthly fee, along with various amenities and services such as dining, housekeeping, social programs, transportation, and more.

Therefore, while cost and coverage are critical factors, they should be considered in the context of the overall quality of life and well-being of the individual in need of care [6].

Regulations and Standards

When weighing the pros and cons of a long term care facility vs assisted living, understanding the regulations and standards governing these institutions can provide valuable insights. These guidelines ensure that operators uphold the necessary standards of care and respect the rights of those in their care.

Licensing Requirements

In regions like British Columbia, legislation such as the Community Care and Assisted Living Act and the Residential Care Regulation ensures protection for adults and children in licensed residential community care facilities. Individuals providing care to more than two unrelated individuals must be licensed to operate in a licensed setting.

Licensing Officers oversee the inspection, licensing, and monitoring of over 200 licensed residential care facilities in Island Health, British Columbia.

Types of licensed residential care include services such as Advance Directives and Care Plans, Agreement in Writing to the Use of Restraints, Immunization of Adult Persons in Residential Care, and Incident Reporting of Aggressive or Unusual Behaviour in Adult Residential Care Facilities [7].

Ensuring Quality Care

Ensuring quality care in these institutions involves several fundamental regulations:

  • A licensee must ensure that a person in care is not subjected to any form of abuse or neglect, including emotional abuse, financial abuse, neglect, physical abuse, sexual abuse, or deprivation of food or fluids as a form of punishment.
  • A licensee must ensure that a person in care has access to an employee who holds a valid first aid and CPR certificate and is capable of effectively communicating with emergency personnel.
  • A licensee must ensure that persons in care have immediate access to written documentation indicating their name, the community care facility's name, and emergency contact information when they leave the facility temporarily [10].
  • A licensee must establish a fair, prompt, and effective process for persons in care and their parents or representatives to express concerns, make complaints, or resolve disputes.
  • A licensee must regularly monitor the physical environment of the community care facility, as well as the care and services provided, to ensure compliance with the Act and regulations.

These regulations are designed to ensure that every individual in a long term care facility or assisted living is treated with dignity, respect, and given the highest standard of care possible. It's essential to verify that any potential facility adheres to these regulations before making a decision.

Choosing the Right Care Option

Deciding between a long-term care facility and assisted living requires careful consideration and understanding of the individual's needs. It involves assessing their health, lifestyle, and personal preferences.

Assessing Individual Needs

When it comes to choosing between a long-term care facility and assisted living, the individual's health condition plays a significant role. Assisted living communities provide long-term housing for older adults who are generally active but need support with activities of daily living (ADLs), such as bathing, dressing, and using the toilet. On the other hand, nursing homes provide long-term medical care for adults with serious health issues.

Assisted living services are geared toward those who may need some support from staff along with meals and socialization. They may require that residents are able to eat independently or can transfer between a bed and a wheelchair without extensive assistance. They may also not accept residents with severe cognitive impairment or behavioral issues. For someone to qualify for nursing home care, an assessment typically must be completed, and at least one physician should sign off on the recommendation [4].

Balancing Independence and Support

Another factor to consider is the level of independence the individual wishes to maintain. Assisted living strives to offer a balance of independence and support, providing a residential environment with services and amenities to keep residents as healthy, socially engaged, and independent as possible [4].

Assisted living communities may have specialized areas for individuals with Alzheimer’s where increased supervision is provided to help prevent wandering. This indicates that individuals with Alzheimer’s or dementia may find suitable care in assisted living without needing nursing home care.

Nursing homes, by contrast, are more medical in their approach, providing medical and personal care in a clinical setting. Individuals who need frequent hospital stays may prefer nursing homes due to the additional services provided, which can prevent the need for moving as often [5].

In conclusion, the choice between assisted living and a long-term care facility is highly personal and depends on an individual's health condition, lifestyle, and values. It's crucial to thoroughly research each option, consider the individual's needs and preferences, and consult with healthcare professionals to make an informed decision.


[1]: https://www.asccare.com/types-long-term-care-services/

[2]: https://www.healthline.com/health/assisted-living-vs-nursing-home

[3]: https://forltc.org/types-of-longterm-care

[4]: https://www.aplaceformom.com/caregiver-resources/articles/assisted-living-vs-nursing-homes

[5]: https://www.payingforseniorcare.com/assisted-living-vs-nursing-homes

[6]: https://www.seniorlivingresidences.com/family-guide/financial-options/comparing-senior-living-options/

[7]: https://www.islandhealth.ca/our-services/community-care-facilities-licensing/residential-care-licensing

[8]: https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96_2009#section52

[9]: https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96_2009#section43

[10]: https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96_2009#section56

[11]: https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96_2009#section60

[12]: https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96_2009#section61

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