You ask, we answer…..Understanding the Differences Between Assisted Living and Skilled Nursing
When considering options for senior care, two common choices are assisted living and skilled nursing communities. Some senior communities offer all the levels of care under one roof, called a CCRC (Continuing Care Retirement Community) where residents can age in place without moving. There are also other types of care models, such as Memory Care communities that cater to the distinct needs of residents with Dementia or other cognitive issues. In this article, we will review the difference between Assisted Living and Skilled Nursing care. While both cater to the needs of senior adults, they serve distinct purposes and provide varying levels of care. It’s crucial for families and individuals to understand the differences between the various levels of care and to make informed decisions about the most suitable care setting.
Assisted Living: A Home-like Setting with Supportive Services
- Independence and Autonomy:
Assisted living communities are designed for seniors who can generally live independently but require some assistance with daily activities. Residents in assisted living maintain a level of autonomy and privacy, residing in private apartments. This setup allows individuals to lead a relatively independent lifestyle while receiving necessary support. - Services and Amenities:
Assisted living facilities offer a range of services, including meal preparation, housekeeping, and assistance with activities of daily living (ADLs) such as bathing, dressing, and medication management. Commonly, Assisted Living communities such as The Selfhelp Home also organize social and recreational activities to promote engagement and socialization among residents. - Care Level:
The care provided in assisted living is considered non-medical or custodial care. While staff may assist with basic healthcare monitoring and ADL’s, residents typically do not require continuous medical supervision. The focus is on enhancing quality of life, providing support, and fostering a sense of community. - Cost:
The cost of assisted living varies based on factors such as location, facility amenities, and the level of care needed. In general, assisted living tends to be more affordable than skilled nursing care, reflecting the lower intensity of medical services provided. Rates will vary and will likely depend on the size of the unit (studios, one- bedrooms, etc.) and the level of assisted living care. Some communities have a range of levels of care from moderate to heavy. Insurance and Medicare does not cover assisted living and residents pay privately. In some cases long term care policies cover assisted living. Supportive living communities that are licensed as such accept public aid or Medicaid in Illinois. - Entry Criteria:
Residents of assisted living facilities are generally more independent and do not require constant medical attention. They enter these facilities voluntarily, seeking a balance between independence and the assistance needed for daily living activities. A nurse will asses the resident to ensure they are appropriate for Assisted Living and determine the level of care needed. Many communities require certain financial criteria to enter the community, or require a one time community fee for entrance. - Assisted Living communities are certified and licensed by the local health authorities.
For example, The Selfhelp Home in Chicago is licensed by the Illinois Department of Public Health to provide Assisted Living services. Communities may offer “assistance” or may call it “alacart care” provided by caregivers employed by an outside agency or their own staff, but are not licensed to provide “assisted living” that is overseen by a Registered Nurse and regulated by a public health agency. It is important to understand these differences in what is being provided when researching communities.
Skilled Nursing: Intensive Medical Care for Complex Needs
- Medical Care:
Skilled nursing facilities, on the other hand, provide a higher level of medical care. They are equipped to handle complex medical needs, chronic conditions, and rehabilitation services. Registered nurses, licensed practical nurses, and certified nursing assistants are typically present to provide round-the-clock care. - Rehabilitation Services:
Skilled nursing facilities often serve as rehabilitation centers for individuals recovering from surgery, illness, or injury. This includes physical, occupational, and speech therapy to help residents regain or improve their functional abilities. - 24/7 Supervision:
Unlike assisted living, skilled nursing facilities offer constant medical supervision. Residents in skilled nursing care usually have more critical health conditions that require ongoing monitoring and immediate access to medical assistance. - Cost:
Due to the higher level of medical care and supervision, skilled nursing facilities tend to be more expensive than assisted living. The cost is influenced by factors such as the intensity of medical services, the expertise of the staff, and the facility’s location. Skilled nursing care may be paid privately by the resident, or by public aid if the community is licensed to accept public aid (Medicaid). Long Term care insurance may cover the cost or partially cover the cost of skilled nursing. For short-term rehabilitation stays, following a hospital visit, Medicare or private insurance may cover the stay. - Entry Criteria:
Residents in skilled nursing facilities typically require a higher level of care and supervision due to complex medical conditions or rehabilitation needs. Admission often follows a hospital stay or a decline in health that necessitates more intensive care. A nurse assessment from the community you are considering may determine if the person is appropriate for skilled nursing. Many communities require certain financial criteria to enter the community to ensure they can afford to stay and pay privately for an extended period.
Making the Right Choice
- Assessment of Needs:
Choosing between assisted living and skilled nursing begins with a thorough assessment of the individual’s needs. If the primary requirement is assistance with daily activities and a supportive community, assisted living may be suitable. For those with complex medical conditions or a need for intensive rehabilitation, skilled nursing may be more appropriate. - Healthcare Management:
Consideration of the individual’s healthcare requirements is crucial. If the need for medical supervision is minimal, assisted living can provide a comfortable and supportive environment. However, if continuous medical care and monitoring are necessary, skilled nursing is the better choice. - Financial Considerations:
Understanding the financial implications is essential. Assisted living is generally more cost-effective, making it a viable option for those who do not require extensive medical care. Skilled nursing, while offering a higher level of care, comes with a higher price tag. - Long-Term Planning:
Long-term care planning involves considering potential changes in health and care needs. Some individuals may start in assisted living and transition to skilled nursing as their health declines. Facilities that offer a continuum of care may provide a smoother transition between these levels of care. - Family Involvement:
Family preferences and involvement play a significant role. Some families may prefer assisted living for its focus on independence and a more home-like setting. Others may prioritize the comprehensive medical care and rehabilitation services provided by skilled nursing facilities.
Assisted living and skilled nursing facilities cater to different needs within the spectrum of senior care. Assisted living offers a supportive and community-oriented environment for individuals who can live relatively independently, while skilled nursing provides intensive medical care and rehabilitation services for those with complex health needs. Making the right choice involves a careful consideration of the individual’s current and potential future needs, financial considerations, and family preferences. Ultimately, the goal is to provide the best possible care and quality of life for seniors in a setting that aligns with their unique requirements.
The costs associated with assisted living and skilled nursing facilities are multifaceted and influenced by various factors. Families and individuals must carefully assess their financial situation, insurance coverage, and the level of care needed. It’s advisable to inquire about all potential fees, including any additional or hidden costs, when exploring different senior care options. Additionally, long-term financial planning and consultation with financial advisors can help individuals and families prepare for the potential challenges associated with senior care costs.
What’s Life Like? Assisted Living Vs. Skilled Nursing
When comparing assisted living and skilled nursing facilities, the cultural aspects of each setting play a significant role in shaping the overall experience for residents. “Culture” in this context refers to the values, atmosphere, social dynamics, and overall lifestyle within the facility. Understanding the cultural differences can help families and individuals make decisions that align with personal preferences and priorities.
Assisted Living Culture:
- Independence and Autonomy:
Assisted living facilities generally promote a culture that emphasizes independence and autonomy. Residents are encouraged to maintain as much control over their daily lives as possible, making decisions about activities, meals, and social interactions.
- Social Engagement:
Assisted living facilities foster a sense of community. Social activities, events, and outings are common, providing residents with opportunities to engage with peers and participate in shared interests. The goal is to create a supportive and socially vibrant environment.
- Homelike Setting:
The physical environment of assisted living is often designed to resemble a home rather than a medical facility. This contributes to a more relaxed and comfortable atmosphere, promoting a sense of normalcy for residents.
- Flexibility in Daily Routine:
Residents in assisted living typically have more flexibility in their daily routines. They can choose when to participate in activities, when to have meals, and how to structure their days based on personal preferences.
- Staff Interaction:
Staff in assisted living facilities often take on a supportive and facilitating role. While they assist with daily activities and provide necessary support, the emphasis is on fostering independence and creating a positive living experience.
Skilled Nursing Culture:
- Medical Focus:
Skilled nursing facilities have a more pronounced medical focus. The culture revolves around providing intensive medical care, monitoring residents’ health conditions, and addressing complex medical needs. This can result in a more structured and regimented daily routine.
- Rehabilitation Emphasis:
Skilled nursing facilities often prioritize rehabilitation for residents recovering from surgery, illness, or injury. The culture may revolve around therapy sessions, medical interventions, and a more goal-oriented approach to improving residents’ health and functionality. Some communities like the Selfhelp Home offer specialized rehabilitative activities such as Music Therapy, Art Therapy and other activities that work towards improving the overall health of the resident through engagement.
- 24/7 Medical Supervision:
Due to the higher level of medical care required by residents, skilled nursing facilities maintain a 24/7 medical presence. This can contribute to a more clinical and less homelike atmosphere compared to assisted living.
- Structured Daily Activities:
Daily activities in skilled nursing facilities may be more structured and revolve around medical appointments, therapy sessions, and health monitoring. While social engagement is encouraged, it may be secondary to medical priorities.
- Staff Expertise:
Skilled nursing facilities employ a range of healthcare professionals, including registered nurses, licensed practical nurses, and certified nursing assistants. The staff is highly trained to address complex medical needs and provide specialized care.
Other Considerations
- Individual Preferences:
Individual preferences play a crucial role in determining the cultural fit of a facility. Some individuals may thrive in the more social and independent environment of assisted living, while others may find comfort in the structured medical focus of skilled nursing.
- Health Status and Care Needs:
The current health status and care needs of the individual are essential considerations. If intensive medical care and rehabilitation are primary concerns, a skilled nursing facility may be more appropriate. If the focus is on maintaining independence with some support, assisted living may be a better fit.
- Long-Term Outlook:
Consideration of the long-term outlook is vital. Some individuals may transition from assisted living to skilled nursing as their health declines. Facilities that offer a continuum of care can provide a smoother transition for residents. - Family Involvement:
The involvement of family members in decision-making can influence the cultural dynamics of senior care. Families should consider the preferences and comfort levels of the individual receiving care, balancing the need for medical support with lifestyle preferences.
To learn more about Assisted Living and Skilled Nursing at The Selfhelp Home and other programs and services offered at The Selfhelp Home in Chicago, please contact us, or schedule a personalized tour.