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Are There Different Levels Of Assisted Living Or Nursing Home Care?

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One thing to be aware of is that there are different levels of care in both nursing homes and assisted living facilities. The level of care that older adults receive is dependent on their individual physical and cognitive needs.

What’s the difference in these levels of care? – The type and degree of care that a senior receives in assisted living facilities and nursing homes can include short term rehabilitation, assistance as needed, skilled nursing care, memory care and 24 hour medical care.

What Is Assisted Living?

Assisted living definition:

Assisted living is for people who need help with daily care, but not as much help as a nursing home provides. Assisted living facilities range in size from as few as 25 residents to 120 or more. Typically, a few “levels of care” are offered, with residents paying more for higher levels of care.

Generally, residents in an assisted living facility have their own apartments (one or two bedrooms) with a kitchenette and living room area.

So, what does assisted living provide?

The facility provides common areas for recreational activities, entertainment, dining, etc. Meals are also served in an assisted living community, along with some personal care, help with medication management, housekeeping and laundry and of course, 24-hour care, supervision, and security.

What Is A Skilled Nursing Facility?

Nursing homes, also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus on medical care more than most assisted living facilities. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, are also available.

These skilled nursing facilities offer both permanent and temporary housing. Some residents require a short stay to take advantage of skilled care and rehabilitation services whereas others require long term care.

Knowing the differences between these two types of senior housing options can help family members choose the best type of facility for themselves or a loved one.

You can read more about an assisted living vs nursing home (differences and similarities) here.

Levels Of Assisted Living

Basically, there are three levels of assisted living. This is due to the somewhat more relaxed regulations that govern assisted living, especially when compared to nursing homes, which have stricter rules.

These 3 levels of care are:

  • Low assisted living care
  • High assisted living care
  • Memory care

If a senior is in an assisted living facility, it is assumed they have at least a decent degree of mobility. Their behavioral problems are minimal, even if they may have dementia or Alzheimer’s. The person is also receptive to help, but can take care of themselves to a degree.

Low Assisted Living Care

For a senior to enter the lower level of care in an assisted living facility, they must be quite healthy.

They can walk or use a wheelchair or another assistive device. They can speak, their memories are clear, and they can do many things for themselves, just not everything. For example, maybe they can’t shower by themselves or tie their own shoes anymore.

For these seniors, a nurse or staff members would be available to assist them, on an as needed basis. Medical professionals would also be on hand to administer medications and do basic tests like blood sugar monitoring.

High Assisted Living Care

Seniors that need high-level care at an assisted living facility have greater general care needs and require more supportive services.

They may struggle to walk or get around. They can do even fewer daily activities on their own, such as going to the bathroom, showering, or dressing.

While the early signs of Alzheimer’s or dementia may have begun to manifest, these seniors do not yet qualify for memory care.

A senior who needs high level assisted living care may be more likely to slip and fall, they might have chronic pain, or they could otherwise need more frequent monitoring.

Memory Care

Those seniors with dementia, Alzheimer’s, or another cognitive condition that affects their memory would need their own level of care from a facility that focuses on memory care. These types of facilities provide a safe environment and ’round the clock care.

Everything around the memory care programs are designed to give the person autonomy while making them feel like they can’t fail, even if their memory isn’t as sharp as it once was.

Levels Of Care In Nursing Homes

According to, “Nursing homes offer the most extensive care a person can get outside a hospital.”

Although there are different categories of nursing homes and these often vary from state to state, they boil down to three main levels of care:

  • Intermediate care
  • Skilled nursing care
  • Rehabilitation care

With intermediate care, the senior generally needs some type of medical care along with 24-hour supervision. They also need help with activities of daily living (ADLs), such as getting dressed, taking medication, bathing, and/or toileting.

Skilled nursing care is for seniors who need help with ADLs and who also have medical concerns that require professional nursing intervention (example: skilled nurses to take care of intravenous feeding or IV medications or taking care of a colostomy bag).

WebMD notes that, “Skilled care also includes services provided by specially trained professionals, such as physical, occupational, and respiratory therapists.”

Rehabilitation care is for those recovering from an illness, an injury or who need help with a disability. The person would usually only live in one of these facilities temporarily while they receive short term care.

When Should You Move From Assisted Living To A Nursing Home?

Generally – a resident moves from an assisted living facility to a nursing home if they require medical attention for a serious health condition.

This could include requiring care if they have suffered a stroke, or have severe dementia or Alzheimer’s or Parkinson’s disease, etc.

Assisted living facilities do not often provide 24 hour nursing care for medical needs although residents can hire their own private nurse if they wish to and are able to do so.

There are basically 6 main reasons that a senior would move into a nursing home.

  • They are living alone, no family or friends that are able to help care for them but they do require care.
  • Their physical and/or cognitive disabilities are too difficult for a family or friend to manage.
  • They do not have the funds to pay for a private caretaker to come to their home part time or full time.
  • They require 24 hour medical care due to their cognitive and/or physical disabilities.
  • Family dynamics are too dysfunctional to provide care for the older adult.
  • It’s a temporary placement into a SNF (Skilled Nursing Facility) for rehabilitation.

Making the decision to move into a nursing home is not an easy one and I do recommend that you speak with administrators at several residential care facilities to find the best one for your needs.

You can read more about how to choose a nursing home here.

Have I Answered Your Questions About Nursing Home and Assisted Living Care Levels?

There are certainly many questions that anyone has about these types of senior housing and decisions are not easily made.

But gathering as much information as possible, knowing the type of care that is provided at each level and what you or your senior loved one needs can help to make the process much easier.

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