Assisted Living vs. Nursing Home Care

Very often, the terms “assisted living” and “nursing homes” are used interchangeably. This, however, is a mistake because the two are actually very different. A person who is a candidate for one facility will not necessarily be a candidate for the other.

While in-home care for aging seniors can be more cost-effective, those that require extensive caregiving time will find that a nursing home or assisted living facility will be more cost-effective than attempting to create a nursing facility in the home. Despite the expense, however, most seniors would prefer to stay at home for as long as possible.

The term ‘assisted living’ allows the senior adult their own living space but provides a level of monitoring that most people can not afford in their own homes. The key benefit is that services are already in place if the individual’s health continues to deteriorate. Most facilities allow residents to start with the basic apartment and live independently with additional services such as cleaning, meal preparation or transportation if needed. When additional assistance becomes necessary, such as dressing, bathing or walking, help is available on site.

The average cost for an assisted living facility in the United States hovers around $3000 per month according to a 2007 survey conducted by MetLife. In some states, some of the assisted living services are covered under Medicaid, but most people pay for them through long-term care insurance policies or out-of-pocket.

Nursing home care is often the last step for individuals who require constant round-the-clock monitoring and medical care. If an individual’s health has deteriorated to the point where that much care is required at home it is no longer financially efficient to provide it. Annual costs for nursing homes can range from $50,000 to nearly $200,000 a year.

Although those costs are high, the cost of a home health aide 24 hours a day will range close to the same price. Costs on top of the home health aide will include room and board for the aid, covering shifts, housing and gas, and electric, all of which are covered under the cost of the nursing home. Once an individual’s assets have been exhausted Medicaid will pay for most nursing home care that accepts the plan.

In the past, families attempted to give away their parents’ assets a month or two before moving into a facility. However, current federal law now requires a five-year look-back period to prevent this type of activity from happening.

When choosing either an assisted living facility or a nursing home evaluate the care that is given and the facility itself to ensure that your loved one receives the best care possible. Talk to residents and their families and evaluate the facility with your nose. That means if it doesn’t smell good you can probably be sure that seniors are not as clean and the facility is not as well run as it should be.

Find out about the staff to resident ratio. While the published number may be one thing the reality may be another because nursing homes are chronically understaffed. Ask the nurse’s aide on shift and find out how many nurses there usually are staffed on the unit. One registered nurse for every 15 residents is the national average but many facilities often go above that number.

Pay attention to the details in the facility. Is it clean? Is the piano tuned? Are the cosmetics (wallpaper, paint, furniture) clean and well cared for? If the staff takes care of small things they probably also take care of the big ones.

It’s also important to remember that the care given to individuals in nursing homes and the assistance given to those at assisted care facilities is often the best when loved ones are present, visible, and stay involved.

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