Assisted Living vs Nursing Homes

What Is the Difference Between Assisted Living vs. Nursing Homes?

It used to be that assisted living communities and nursing homes were essentially the same things.

Over the past few decades, though, the two have differentiated themselves. Today, each one offers services catered to a certain type of resident.

Which one is right for you or your loved one? Read on to find out.

What Is an Assisted Living Community?

Assisted living communities are designed for older adults who can no longer live independently, but also don’t require consistent health care. These communities are designed to be “like home.” Residents enjoy their own spaces and continue to live their lives as they choose.

These older adults may need a little bit of help with meals, housekeeping, laundry, taking their medications, and maybe even bathing. But they can still live in their own rooms or apartments and manage many of the tasks of daily living on their own.

Assisted living communities vary widely in size, housing as few as 10 residents to a few hundred. Most offer social and recreational activities like book clubs, field trips to movies and concerts, and exercise and wellness programs.

What Is a Nursing Home?

A nursing home is a facility designed for people who no longer need to be in the hospital, but can’t care for themselves or be cared for at home. Most offer care in a more clinical setting, though many now include home-like touches as there’s a growing emphasis on patient-centered care.

According to the Health in Aging Foundation, almost half of people who live in nursing homes are 85 years or older, with relatively few residents younger than 65 years of age.

The most common reason for a person to live in a nursing home is a disability. The residents typically need help with three or more activities of daily living, such as dressing and bathing. More than half have incontinence and/or dementia, and more than a third have difficulty hearing or seeing.

Many people who stay in nursing homes do so for only a short period of time, either for rehabilitation or end-of-life care. About half stay for at least one year, while about one-fifth stay for almost five years.

How are Nursing Homes and Assisted Living Facilities Similar?

There are some similarities between nursing homes and assisted living facilities. They both offer:

  • Daily Help: Support with the activities of daily living, such as dressing, bathing, and personal care (if needed). They also offer transportation to doctors and other medical appointments.
  • Medication Management: Staff will help make sure residents take the appropriate medications at the right times.
  • Life Enrichment: Isolation puts seniors at risk for more health problems. Both assisted living communities and nursing homes offer a variety of life-enrichment activities to encourage social interaction, physical activity, and spiritual practice.
  • Meal Services: Residents of both types of communities receive well-balanced meals and nutritious snacks that are made and served by the staff.
  • Safe Environment: Though these communities are often set up differently, they both offer security for older adults. Handrails and grab bars are part of the design, as are other features meant to keep residents safe.

What are the Main Differences Between Nursing Homes and Assisted Living Facilities?

Some of the main differences between assisted living and nursing homes include:

The Amount of Care

Assisted living communities are designed for older adults who need a little help but are still capable of managing themselves for the most part. The community may offer help with transportation, medication, housekeeping, meals, and some personal care, but otherwise, the resident is allowed to live as they choose.

In a nursing home, it is expected that the resident will need ’round the clock care and monitoring. They usually live with more complicated health issues and require assistance daily, such as help getting around, respiratory care services, daily medical treatments, and more.

Non-Care Based Services

In assisted living communities, the staff is focused on helping residents continue to live full and rewarding lives. They will likely supply extensive recreational activities, as well as transportation wherever residents want to go (as opposed to just medical-related transportation).

A nursing home, on the other hand, will provide some recreational activities, but most of the staff’s time will be spent providing care to the residents.

Living Space

Assisted living communities are designed to echo the comforts of home. Residents enjoy private or shared apartments and studios with private baths and kitchenettes. There are also common living spaces and outside grounds for them to enjoy. Dining is restaurant-style, and outings may include those to local stores, theaters, and museums.

Nursing homes, though they may also offer private or semiprivate rooms, typically do not include kitchenettes, as residents usually aren’t capable of cooking for themselves. They may also have some common areas, but these will be limited, and usually, there are small or no outside common areas.

Number of Residents

The number of residents and size of facilities are different when weighing assisted living vs nursing homes. For example, assisted living communities vary between small and large, but generally average of 30-50. Conversely, nursing homes are usually large and accommodate an average of 100 residents.


In general, nursing homes cost more money because they offer more extensive care. According to Paying for Senior Care, a nursing home costs around $7,500 per month, whereas an assisted living community will cost around $4,000 per month for residents without dementia.

Payment options also differ. Medicaid will pay for nursing home care, but only after beneficiaries spend down their assets. Assisted living is predominately paid for out-of-pocket. However, financial assistance is available from VA pensions or in some limited circumstances (and only in some states), Medicaid. If you or your loved one have long-term care insurance, it may cover some or all of the costs as well, depending on your plan.

Which Senior Living Option Is Right for You?

Whether you’re looking for yourself or a loved one, you may wonder which of these options is best for you.

Assisted living is the right choice if the person:

  • Requires some personal care but is open to help, can walk and get around, and can still manage many facets of daily living on their own.
  • Is no longer capable of living on their own but wants to maintain an active, social lifestyle.
  • May require minor nursing assistance or medication but doesn’t require full-time care.

A nursing home is the right choice if the person:

  • Requires full-time monitoring and medical assistance.
  • Needs day-to-day care and help with the activities of daily living, like bathing and dressing.
  • Suffers from severe, debilitating physical or cognitive health conditions.
  • May be bedridden or bound to a wheelchair without the ability to move independently.

Interestingly the choice between assisted living and a nursing home is a relatively easy one based on the person’s current care needs. However, those who choose assisted living may be concerned that they’ll require nursing home care in the future. That’s where continuing care retirement communities like Arbors of Hop Brook come in. Offering retirement living, assisted living, and nursing home options all on the same campus is very valuable. For example, living at a CCRC, residents can move to other types of senior living as their care needs change. Plus, they alter their care without leaving the familiar surroundings they’ve come to call home. Explore our floor plans and take a virtual tour. Then, schedule an in-person tour to explore the active, vibrant lifestyle that residents of Arbors of Hop Brook enjoy.

Common FAQs About Assisted Living vs Nursing Homes

What activities and social opportunities are available in assisted living and nursing homes?

Assisted living communities typically offer a wide range of activities such as exercise classes, arts and crafts, social events, and outings. Nursing homes also provide activities but may focus more on therapeutic and rehabilitation activities tailored to residents’ specific needs.

How do visiting hours and policies differ between assisted living and nursing homes?

Assisted living facilities usually have flexible visiting hours to encourage family and friends to visit frequently. Nursing homes may have structured visiting hours to accommodate the medical care schedule of residents. However, frequently nursing homes often try to be flexible for family visits.

Can residents bring personal belongings and furniture to assisted living or nursing homes?

In assisted living, residents are often encouraged to bring personal belongings and furniture to make their space feel like home. Nursing homes may have more limitations due to space and medical equipment needs, but personal items are still allowed to some extent to create a comfortable environment.

What kind of medical care is available in assisted living compared to nursing homes?

Assisted living provides basic medical monitoring and assistance with daily activities. Conversely, nursing homes offer more medical care, including skilled nursing care, medication management, and access to medical professionals for more complex health issues.

How do I determine which option is best for my loved one?

Choosing between assisted living vs nursing homes depends on personal needs. From the level of care needed and medical requirements to personal preferences and financial considerations, the best option is likely evident after some due diligence. It’s important to assess the individual’s health, independence level, and social needs. Also, visit various facilities to understand the environment and services offered (in particular, how service may change as one ages or experiences any health setbacks).