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I couldn't agree more.. these two long term care settings provides different services. An assisted living facility is more like a home away from home providing custodial care or help for daily activities while a nursing facility is more preferred by ltc recipients who needs advance medical supervision. The cost of nursing home is also more expensive than assisted living facilities. Here's a more comprehensive guide to different long term care settings: http://goo.gl/etCNCh
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Blannie provides a good answer. AL facilities provide basic assistance, no real skilled nursing care. In fact if you need those services such as aid with bathing, toileting, getting in out of bed etc, most will require you to hire additional help or services outside of what you are paying.

NH is skilled nursing care and they can take care of nearly all needs although resident needs hospitalization, they will be transported to hospital, stabilized and returned to NH.

Some residential care facilities offer a range from senior independent living, to rehab, to AL to memory care to NH where all are on one campus and you can move from one to the other within the same complex as needs change.

Visit many, research ratings, visit often and observe, get recommendations and talk with families who have loved ones there to get a feel for the facility and care offered.
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Here's my take on it. My mom lives in an independent living facility, in a 2-room apartment. In another part of the building, there's assisted living. Those folks have an apartment that they can decorate and furnish with their own furniture, just like my mom can in independent living. The folks in assisted living just need more daily care, with things like getting dressed and taking their meds on time, and maybe to get to and from the dining room. They don't need constant medical oversight and intervention. Assisted living is more like an apartment with help from staff for the activities of daily living (ADLs) like bathing, medication, transportation.

Upstairs from assisted living is the skilled nursing part of the facility. This would be more like a nursing home. The patients there (my dad was there the last three months of his life) need help with just about everything. They need more medical care and/or maybe hospice care. That place is more like a hospital, with more skilled nursing staff and doctors visiting. Probably not their own furniture, as it's more like a hospital with hospital equipment.

I recently volunteered on Christmas day at a nearby Lutheran nursing home. I had never been there before and I felt like it was a great facility. The staff all knew the clients' names and were very personable with each of them. I helped get people together for a Christmas service by the Lutheran minister. I would have felt very comfortable having my mom at that facility. I'm not Lutheran and am not pushing for that, but just noting that not every nursing home is awful. The one I saw seemed pretty darned clean with a very caring and involved staff on Christmas day. I would have thought Christmas day would have been one of the worst days for adequate staff. Some nursing homes are awful, but some are pretty nice. And if your mom and dad aren't ready for a nursing home, check out assisted living. Visit a few in your area. Usually they'll let you eat a meal in the dining room to check out their food (which is always a good idea). Ask people around the facility what they think about it. Try to do that without having the marketing person nearby, so that residents will be more open about their feelings.
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