Selecting an appropriate living arrangement for older adults is a significant decision. Assisted living communities and skilled nursing facilities are two popular options. Understanding their features is critical for ensuring the well-being and happiness of elderly loved ones.

assisted living vs. skilled nursing care

What is Assisted Living?

Assisted living communities provide a residential setting for older adults who need minor medical supervision and assistance with daily living. Most assisted living facilities offer:

  • Medication management
  • On-site primary care physician visits
  • Dedicated caregivers
  • Help with daily living activities
  • Maintenance-free lifestyle
  • Opportunities to socialize
  • Private rooms where residents can bring their own furniture
  • Physical, Occupational, Respiratory Speech and Behavioral Therapy
  • Podiatry
  • X-ray
  • Hospice

What is Skilled Nursing?

On the other hand, a skilled nursing facility is a medical setting for individuals who require complex medical care. Skilled nursing services are rendered by registered nurses, licensed practical nurses, and other trained medical professionals. Typically, skilled nursing facilities offer:

  • At least eight hours of nursing care daily
  • Rehabilitation services, including physical, occupational, and respiratory therapy
  • Daily therapy services
  • Specialized care for significant health events


Image of a registered nurse providing medical assistance

Key Differences Between Assisted Living and Skilled Nursing

Level of Care

When choosing between assisted living and skilled nursing, understanding the level of care required by your loved one is a critical factor. The level of care offered in these two settings varies significantly, and aligning the choice with the needs of your elderly family member is essential for their well-being.

Assisted Living Residents

In assisted living communities, residents usually are in relatively good health but require some assistance with activities of daily living. Here’s what you can expect in terms of care in an assisted living facility:

  • Assistance with Daily Activities: This includes help with bathing, dressing, grooming, and medication management.
  • Medical Supervision: While not equipped for complex medical care, most assisted living facilities have physicians, registered nurses, licensed practical nurses, and medication aides to oversee minor medical needs.
  • Social and Recreational Activities: As previously mentioned, assisted living residents have access to a range of social and recreational activities to keep them engaged and socially connected.
  • Independent Living: Residents in assisted living often have more freedom in their daily schedules and can maintain a sense of independence.

Skilled Nursing Residents/Patients

On the contrary, skilled nursing facilities cater to individuals who need a higher level of care, often due to significant health issues. Here’s what skilled nursing offers:

  • Complex Medical Care: Skilled nursing facilities have trained medical professionals, including registered nurses, on staff at least eight hours a day. They are equipped to handle more complex medical needs such as wound care, intravenous therapies, and respiratory therapy.
  • Rehabilitation Services: For individuals recovering from surgery or a significant health event, skilled nursing facilities often provide physical, occupational, and other therapies.
  • Constant Monitoring: Patients in skilled nursing require constant monitoring and care. 
  • Structured Environment: Skilled nursing facilities have a more structured environment with set schedules for meals, therapies, and other activities.

In summary, assisted living is suitable for individuals who are mostly independent but need some assistance with daily activities and minor medical supervision. In contrast, a skilled nursing facility is more appropriate for those who have complex medical needs and require constant care and monitoring by healthcare professionals.

Living Arrangements

Most assisted living communities aim to create a home-like environment. Residents typically have a private room. The rooms in assisted living communities allow residents to bring their own furniture and personalize their space. 

Skilled nursing facilities, on the other hand, have a layout that’s more akin to a medical facility. The rooms are usually shared, with two or more patients per room. These rooms are typically furnished with necessary medical equipment, and the overall ambiance is more clinical. Private rooms are available but tend to be more costly.

Social Environment and Recreational Activities

In assisted living communities, a large focus is placed on the social environment. These communities usually have a busy calendar of activities ranging from games, art classes, and educational lectures. Moreover, they often have common areas such as gardens, libraries, and activity rooms. Residents can attend church services, celebrate holidays, and invite family for visits.

In contrast, skilled nursing communities are more focused on providing medical care. Though they also offer activities, it’s not as extensive as in assisted living. Activities in skilled nursing facilities are often more therapy-oriented, such as mild physical exercises and cognitive activities.

Staffing and Medical Care

Assisted living communities have a range of staff, including physicians, caregivers, licensed practical nurses, and registered nurses that visit the facility. The caregivers assist residents with activities of daily living such as bathing, dressing, and medication management. However, they do not provide complex medical care.

Skilled nursing facilities have a more diverse and specialized medical staff. This includes registered nurses, physicians, physical therapists, occupational therapists, and other healthcare professionals. They provide complex medical care, including wound care, intravenous therapy, and monitoring of vital signs.

Location and Accessibility

Assisted living communities are often nestled within residential neighborhoods, making them feel more like home. 

Skilled nursing facilities may be standalone or part of a larger hospital or medical center. This makes them more institutional in feel. They are often situated closer to hospitals due to the nature of care provided.

By understanding these differences in living arrangements, social environments, staffing, and locations, families can make more informed choices that align with the needs and preferences of their elderly loved ones.

Assisted living services at senior living communities

Making the Decision

Assessing Individual Needs

The first step in making the decision is to assess the individual needs of your loved one. It’s essential to evaluate their medical requirements and the level of assistance they need in daily living activities. Consider consulting a geriatric care manager or engaging the services of home health agencies for a professional assessment. It is also advisable to talk to your loved one’s physician to understand their health condition and any future considerations.

Points to assess:

  • Mobility and physical abilities
  • Medication and healthcare needs
  • Cognitive function
  • Social and recreational preferences
  • Dietary requirements

Planning a Visit

Visiting potential assisted living communities and skilled nursing facilities is vital. Take tours and observe the environment, staff interactions, and facilities. Here are key factors to consider during your visit:

  • Cleanliness and Maintenance: Is the facility clean and well-maintained?
  • Staff: Are they friendly and engaging? Do they seem knowledgeable?
  • Residents: Talk to current residents about their experience.
  • Activities: Ask to see the activity calendar and observe if residents are engaged.
  • Meals: Check the dining area and, if possible, arrange to have a meal.
  • Safety Measures: Check for safety features such as grab bars and emergency call systems.

Legal and Financial Preparations

Understanding and preparing for the legal and financial aspects is essential. Discuss the various payment options and understand what is included in the fees. Review contracts thoroughly. Consult a financial planner or elder law attorney if needed. It is also important to discuss legal documents such as power of attorney and living wills.

Communicating with Family

This decision affects not just the elderly person but also the whole family. It’s important to keep open communication lines with family members. Discuss the options, preferences, and concerns openly. It is essential that family members feel involved and support the decision, as their ongoing engagement can be vital for the well-being of the elderly person transitioning to a new living arrangement.

In conclusion, making the decision between assisted living and skilled nursing should be a well-thought-out process, considering the needs and preferences of the elderly loved one and involving family support. Taking the time to assess, visit, prepare, and communicate can lead to a decision that ensures the happiness and well-being of your loved one.

Discover Personalized Care at Bel Air Assisted Living Community

For those considering assisted living, Bel Air Assisted Living in Maryland offers a uniquely personalized experience. Here, residents aren’t just numbers; they are valued individuals. Unlike larger facilities, Bel Air focuses on creating a warm, luxurious living that feels like home.

What sets Bel Air Assisted Living apart?

  • Homely Environment: The residence boasts a cozy atmosphere ensuring that everyone feels individually catered to.
  • Top-Notch Amenities: Residents can enjoy cable TV, en-suite rooms, and an array of daily activities.
  • Medical and Personal Services: Bel Air offers on-site assistance with medication management and a multitude of medical and personal services.
  • High Staffing Levels: With staffing levels exceeding Maryland’s requirements for assisted living staffing, Bel Air ensures that residents receive timely and specialized attention.

Don’t miss the opportunity to give your loved ones the personalized care they deserve. Take the first step to experience the Bel Air difference. Schedule a tour today and witness firsthand why residents love calling Bel Air Assisted Living their home.