When to Move From Assisted Living to Nursing Home

Nursing Home Law Center

It’s tough to think about moving a loved one from assisted living to a nursing home. Many families face this choice and are unsure of the right time to take that step, as it’s rarely triggered by a single event or sudden change but by a gradual realization that more comprehensive care is needed.

The signs indicating the need for this transition can be subtle at first, slowly becoming more apparent over time. These indicators vary from person to person, reflecting each individual’s unique needs and circumstances. 

While the decision may feel daunting, gaining a deeper understanding of skilled nursing care can provide valuable insights, helping families navigate this critical choice with confidence and clarity.

Difference: Assisted Living vs. Nursing Homes

Nursing homes and assisted living facilities can be part of continuing care retirement communities, but they have distinct characteristics. 

When comparing these two options, it’s essential to understand what each provides and their approach to intensive care. While both offer support, they differ significantly in the level of care provided and the overall living environment. 

Many family members wonder when the right time is to move from assisted living to a nursing home, and these key differences can help guide that decision.

Level of Care Provided

Assisted living communities can help with day-to-day tasks like bathing, dressing, and managing medications. They have staff available, but they’re not focused on medical care 24/7. Nursing homes, often called skilled nursing facilities, can handle more serious medical needs.

These nursing home facilities provide skilled nursing care with licensed nurses and certified nursing assistants always on hand to help with rehabilitation services, complex medical conditions, and managing medical equipment. For those who need regular monitoring or specialized treatment, a skilled nursing facility may be the better option.

Independence and Lifestyle

Assisted living facilities help residents maintain as much independence as possible. Older adults in these places have their own apartments, and there’s a strong focus on keeping daily living activities personal. Nursing homes, however, tend to be more structured, with a stronger focus on medical care and less emphasis on independent living.

Recognizing the Signs: When an Assisted Living Facility is No Longer Sufficient

At some point, assisted living communities might not be enough to meet your loved one’s needs. This reality can be tough, but knowing the signs that suggest a transition to a nursing home can help make the decision clearer.

Declining Health and Increased Medical Needs

If your loved one’s health is getting worse and they’re in and out of the hospital more often, assisted living facilities may not offer the level of care they need. 

Complex medical needs, such as managing chronic illnesses or needing frequent medical attention, might mean it’s time to consider skilled nursing facilities. These places provide 24/7 skilled nursing care that assisted living facilities cannot.

Difficulty with Activities of Daily Living (ADLs)

Struggling with basic tasks like bathing, dressing, or even getting around is another clear sign. Assisted living communities can help with daily living tasks, but more intensive support is needed when these tasks become increasingly difficult. Skilled nursing facilities are equipped to handle these challenges, with staff ready to assist with day-to-day needs.

Cognitive Decline and Memory Issues

As dementia or Alzheimer’s disease progresses, it can get more difficult for a person to handle their own care. Memory lapses and confusion can put them at risk in an assisted living setting. For those dealing with cognitive decline, a nursing home that provides specialized memory care may offer a safer and more structured environment.

Frequent Falls or Safety Concerns

Frequent falls or other safety concerns are common with aging, and they’re a big sign that more supervision might be needed. In a nursing home, there are staff around to provide help and prevent injuries, unlike in assisted living facilities where supervision might be limited. This extra support can make all the difference in ensuring your loved one’s safety.

Social Isolation and Lack of Engagement

When older adults start to feel isolated or disengaged in their current assisted living community, their well-being can suffer. Social isolation can lead to feelings of loneliness and depression.

Skilled nursing facilities often offer more activities, social events, and opportunities to engage with others, which can boost mental and emotional health in a senior living environment.

Making the Switch to Skilled Nursing Care: Factors to Consider

Deciding to move a loved family member from assisted living to a skilled nursing facility is never easy. There’s a lot to think about, and it’s not just about physical care needs.

Financial, emotional, and even legal factors come into play. Understanding these aspects can help ease the process and make the transition as smooth as possible for everyone involved.

Financial Considerations

One of the first things to consider is the cost difference between assisted living communities and nursing homes. Assisted living facilities generally provide help with daily living tasks, but their price tends to be lower than that of nursing homes because they don’t offer round-the-clock skilled nursing care.

On the other hand, nursing home costs are higher due to the level of medical care they provide. This nursing home care can include 24-hour care from registered nurses, palliative care, physical therapy, and occupational therapy, among many other skilled nursing services.

When considering this switch, it’s important to look into potential financial assistance programs. 

For example, Medicare may cover some short-term stays in nursing homes, while Medicaid can help with long-term care costs, depending on the state and the individual’s financial situation. It’s a good idea to check what insurance coverage is available or if government assistance programs might help cover the expenses.

Emotional and Psychological Impact

Moving from an assisted living community to a nursing home can be a tough adjustment, both emotionally and mentally. 

Assisted living residents often enjoy a sense of independence, and shifting to a more structured setting can feel like a big step. For family members, it can bring feelings of guilt or sadness, especially when they see their loved ones needing more specialized care.

The key here is open communication. It’s important for everyone involved to talk about the move and express their feelings. Whether it’s the older adult or other members of the family, sharing concerns, hopes, and fears can help with the emotional transition. Offering emotional support and keeping conversations open and honest can make the move easier for everyone.

Always remember the legal and financial aspects of things. Moving to a nursing home might be a good time to update important documents such as wills, powers of attorney, and advance directives.

These documents ensure your loved one’s wishes are clearly laid out. It’s also helpful to review any legal agreements with the nursing home to fully understand the services and care they’ll provide.

Seeking Guidance and Support

Making the decision to move a loved one from assisted living to a nursing home can feel overwhelming, but you don’t have to do it alone. There’s plenty of support to help make sure you’re making the best choice for your family. 

Whether it’s talking to healthcare providers or getting legal advice, there are key steps you can take to ensure your loved one is receiving the proper personal care.

Consulting with Healthcare Professionals

One of the first steps in this journey should be having an open conversation with your loved one’s doctor or healthcare provider. 

They know your family member’s medical history and current condition best, so they can offer valuable insights into whether a skilled nursing facility is the right fit. Skilled nursing facilities provide 24-hour medical care and support, which might be necessary if your loved one’s health is declining or their care needs are becoming too complex for assisted living.

It’s always a good idea to ask about the long-term options as well. Healthcare professionals can help assess whether the current assisted living community can continue to meet your loved one’s needs or if transitioning to a nursing home would provide better care, especially if specialized medical care or therapy is needed.

Touring Skilled Nursing Facilities and Comparing Options

Once you’ve consulted with healthcare providers, it’s time to explore different nursing homes. 

Touring skilled nursing facilities in person can give you a better sense of the environment, the medical staff, and the extensive care they offer. Every residential facility is different, so ask about the skilled services they provide and if they have specialized memory care units (if needed).

Don’t be afraid to ask questions about staff qualifications, how many registered nurses or other healthcare professionals are available, and what activities or social programs they have. 

Comparing several nursing homes for senior care can help you find the best fit. Take your time and involve your loved one in the decision if possible. After all, this will be their new home, and comfort is key.

If you have any questions about the legal aspects of transitioning to a nursing home, it’s a good idea to reach out to an elder law attorney. They can help you understand your loved one’s rights in a senior care facility and assist with any concerns related to the transition process.

Whether it’s about signing legal documents or understanding financial responsibilities, having legal guidance can offer peace of mind. This is also a good time to review or update any legal paperwork, such as a power of attorney or healthcare directives, to make sure everything is in order before the move.

Contact a Nursing Home Attorney Today!

Deciding when to move from assisted living to a nursing home is never easy, but understanding the main factors can help. Consider your loved one’s medical needs, their ability to handle daily living tasks, and how much support they need.

Emotional support and open conversations within the family are key during this transition. Financial planning and, if necessary, legal considerations like updating documents are also important steps.

If you need help with this process, our team at the Nursing Home Law Center is here for you. Call us at (800) 926-7565 or fill out our contact form.

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