Clearing away confusion about assisted living

Jenny Wallis

Dear Jenny,

Could you help me understand the difference between a nursing home and an assisted living community? I thought they were the same, but recently I began some research for my parents and I’m confused.

There are two key differences between nursing homes, or more specifically skilled nursing facilities (SNFs), and assisted living communities, also known as residential care facilities (RCFs). The first difference is the level of care provided and the second and most pronounced difference is the setting or environment at each facility.

SNFs are designed for medical necessity with 24-hour licensed nursing care for services that are designed to help transition between the hospital and home. Typically SNFs are for people requiring temporary rehabilitation therapy services after surgery or injuries and as a medical model of care. SNFs often care for the very frail and frequently, as medical facilities, SNFs feel very institutional.

Assisted living, or RCFs, provide custodial care in a residential setting. Because RCFs are not a medical model, not only is the environment much more inviting, but they are often far less costly.

Custodial care is assistance with the routine activities of daily living (ADLs) that one normally does to get up and get started for the day: bathing, dressing, grooming, toileting, housekeeping, meals, and even transportation and medication management. RCFs are able to provide fairly advanced levels of assistance with things that are often commonly thought of as medical care; for example, some AL communities even offer diabetes management.

The other significant difference between the SNF and the RCF is the SNF is typically a semi-private room much like a hospital, whereas the RCF looks more like an apartment building and affords residents a private apartment as well as a full schedule of planned activities, gourmet meals and personal transportation. Instead of a hospital-like lounge area, assisted living has common areas with couches, fireplaces and gardens. Instead of a sterile cafeteria, dining areas resemble fine restaurants and often offer entertainment. RCFs are often equated to cruise ships for seniors that are permanently in port.

SNFs fulfill an important need in the continuum of care for seniors, and while they also offer long-term custodial care, few seniors need to remain in the SNF setting for that service with so many RCF options. Not all RCF residents need care or assistance, and some are there because they just want a simpler lifestyle without the worry of maintaining a home or garden, and they want the socialization of their peers.

If you have questions about senior care or helping an elderly loved one, contact Jenny Wallis, community marketing director at Villa Bonita Senior Living, at (619) 739-4400 or by e-mail at villabonitamkg2@islllc.com. Villa Bonita Senior Living is an assisted living community licensed by the California Department of Social Services, located at 3434 Bonita Road, Chula Vista. You can also visit Villa Bonita online at www.villabonitaseniorliving.com.