A Detailed Guide On When To Move From Assisted Living To A Nursing Home

Certified Senior Advisor (CSA)®
Assistive Technology Professional

Seniors who eventually need additional care may consider moving to a nursing home. The move from assisted living to a nursing home might be necessary when your loved one has an increased amount of time spent at the hospital. In this article, we will guide you and your elderly loved ones on when to move from assisted living to a nursing home.

When To Move From Assisted Living To A Nursing Home
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Seniors residing in assisted living may have a positive outlook on life as they feel secure and receive all the assistance and support they require.

In some cases, these seniors and their families may even feel like they will never need more care, as they already have everything they need in assisted living. However, there always comes a time when such seniors need additional care, like that provided in a nursing home. 

Nursing care may be necessary when it comes to providing more stability and care for seniors who would otherwise spend more time in a hospital.

As such, a move from assisted living to a nursing home may become necessary for seniors who appear to spend an increasing amount of time at the hospital or have suffered a serious infection, among others. 

If your elderly loved one is currently in assisted living, read on below to find out whether it’s time to move them to a nursing home.

What Types of Care Do Assisted Living Facilities Provide?

Designed to be a home-like setting that promotes a feeling of independence, assisted living is a type of housing developed for people who need various levels of personal and medical care.

The services offered by an assisted living community are meant to help residents with their activities of daily living. These facilities can comprise shared quarters, apartments, and/or individual rooms.

Some of the types of care/services provided by assisted living include: 

  • Some medical services
  • Medication monitoring
  • Housekeeping and laundry
  • One to three meals per day
  • 24-hour emergency care
  • Social and recreational activities
  • Transferring to bed/chair, etc
  • Personal care, including grooming, bathing, and dressing

To make sure that you get the care you need, it is recommended that you take the time to consider your needs before choosing an assisted living facility.

What Types of Care Do Nursing Homes Provide Their Residents?

Seniors are normally housed in nursing homes for the heist level of care outside a hospital setting. These facilities normally provide what is referred to as custodial services.

This term refers to various care services that include helping seniors with grooming and dressing, getting out of bed, and assistance with eating. 

However, unlike other senior housing facilities, nursing homes also provide a substantially high level of medical care. While a nurse or other medical professional is always present within the premises, a qualified/licensed physician monitors each resident’s care.

In addition to the availability of skilled nursing care around the clock, nursing homes also have other medical professionals on-site, like physical or occupational therapists.

This makes it possible for nursing homes to provide medical procedures and therapies that would not be possible at other senior housing facilities.

Some examples of services provided in nursing homes include:

  • Skilled nursing care
  • Post-surgery support
  • Intravenous therapy and antibiotics
  • Respiratory treatments
  • Wound care
  • Orthopedic care – care for bone, joint, and muscle issues
  • Speech, occupational, and physical therapy
  • Personal care – bathing, dressing, and assistance with eating, among others
when to move from assisted living to a nursing home differences
Learn more about the differences between assisted living and a nursing home.

What Are the Differences Between Assisted Living and a Nursing Home?

The main difference between assisted living and a nursing home comes in the fact that assisted living is basically a residential environment, while a nursing home (also referred to as a skilled medical facility) is considered to be a medical environment.

You may initially meet the qualifications for an assisted living community. But, due to your current health, you may need more care than a nursing home can provide.

Here’s a detailed list of some of the main differences between the two:

Living Space

In assisted living, individuals normally reside in shared or individual apartments with living rooms, bedrooms, and kitchens. Common areas can be used for shared activities and meals, among others.

Nursing homes normally house individuals in individual or shared rooms with an en-suite bathroom. There are also common areas designed to be used for shared meals and various activities. 

Medical Services 

People living in assisted living are considered to be generally of good health. As such, residents of these facilities receive medical services based on their individual requirements. 

On the other hand, nursing homes provide 24-hour medical care – with on-site nursing staff assisting individuals suffering from chronic illnesses. These facilities also provide various treatment therapies to their residents.

Assistance with Daily Activities

Various assistance services are provided to the residents of assisted living, including bathing and dressing, among others. Residents who need meal preparation, laundry, and housekeeping services can also get them. 

On the flip side, most people living in nursing homes need more help when caring for their daily needs. The staff handle meal preparation, cleaning, and laundry, in addition to helping residents take their medication, use the bathroom, bathe, and dress.


Residents can prepare their own meals in their apartment kitchens in assisted living facilities. Alternatively, they can get food delivered to them at a fee in some facilities. Dining spaces may also be open throughout the day, serving meals at given intervals.

On the other hand, meals are prepared by dieticians in nursing homes. Meals may be served in dining spaces or delivered to a patient’s room, depending on their mobility and preferences. 

Recreational Activities 

Assisted living facilities provide residents with a long list of varied recreational activities. Residents can socialize or participate in creative expression and physical activities, among others, regularly.

The recreational activities available in nursing homes tend to be slightly limited. Furthermore, these activities are normally supervised by physical therapists looking to help seniors avoid falls, enhance mobility, and build strength.


The estimated cost of assisted living is roughly half that of a nursing home, according to the American Health Care Association. 

Insurance Coverage

Generally, Medicare does not cover the cost of assisted living. However, some costs may be covered under a long-term plan – the extent of cover varies depending on the details of each policy. 

However, Medicare does cover some nursing home costs – especially if you are there recovering from an injury, surgery, or medical condition. If your stay exceeds 20 days, you may need to cover some nursing home costs yourself. 

RELATED: Moving from Assisted Living to Memory Care

What Are Some Signs That It Is Time to Move From Assisted Living to Nursing Home Care?

If you need 24-hour care or your health is deteriorating and assisted living isn’t enough, you might be better served by moving from assisted living to a nursing home.

Here’s a list of some of the signs that you are ready to make this move: 

Regular Trips to the Hospital

Nursing homes are considered to be medical environments. For seniors who are increasingly in and out of the hospital, these facilities can provide the care they need without having to make regular visits to the hospital.

Complicated Medical Needs

Some medical issues require additional oversight and care. In such cases, assisted living facilities are poorly suited to meet complicated medical needs, even with time-limited home health. 

24-Hour Nursing Care

Nurses in assisted living facilities cannot provide round-the-clock care to a resident. Their work mainly entails providing general assessments of medical conditions and management of medication.

On the other hand, nursing home nurses oversee residents’ conditions and medical care. They also work closely with licensed physicians and other medical professionals to plan and provide the necessary care for each patient. 

Dietary Restrictions

Seniors with Alzheimer’s and other neurological conditions commonly suffer from swallowing issues. These issues can lead to dietary restrictions requiring a very specific modified diet – which can easily be implemented at a nursing home.

Limited Financial Resources

If you can no longer afford assisted living, you can still get the care you need at a nursing home, as long as you meet the criteria of needing nursing care.

In addition to the above signs, it might also be time to move to a nursing home if you need closer attention and care, as well as lift and stand devices or two-person assistance.

when to move from assisted living to a nursing home transition
Make sure to help your loved ones in their transition from assisted living to a nursing home.

How to Make the Transition From Assisted Living to a Nursing Home Easier

Use these tips to make your aging loved one’s transition to a nursing home easier. 

Take the Time to Find the Right Community

If you want to ease your loved one’s transition, work hard to find them the right community. Take the time to meet the staff, explore the facility and find out how things work before signing your loved one up.

Get Your Loved One Involved In The Process

Avoid making your loved ones feel powerless by getting them involved in the process of finding the right community.

Be There

Most aging adults fear being isolated from their loved ones when moving to a nursing home. As such, you should maintain close contact with your loved one through regular visits.

You should also find ways of facilitating outside socialization with old contacts.

Encourage Them to Get Involved

Getting your loved one to get involved in the activities provided at the nursing home will also go a long way toward facilitating a smoother transition.

Give It a Homey Feel

Making your loved one feel at home in their new accommodations will definitely make for a smooth transition. You can use cherished possessions from their assisted living apartment to decorate their nursing home space and make it feel homier.

How to Find the Best Nursing Home for Your Loved One

Define Your Needs

Find out what matters most to you/your elderly loved one. Is it meals, special care for dementia patients, nursing care, physical therapy, hospice care, or a religious connection? 

Get Some Suggestions

Get some suggestions from social workers, close friends, relatives, and even healthcare providers – and come up with a shortlist. 

Reach Out to Nursing Homes on Your Shortlist

Call the homes on your list and enquire about the costs, waiting lists, and the number of people housed therein. You should also make an in-person visit to each facility and visually assess what’s on offer.

Ask Questions During Your Visit

Don’t be afraid to ask any question that comes to mind during your visit – including asking staff to explain various odors that might seem out of place. 

Make an Impromptu Visit

To get a different feel of the facility, schedule an impromptu visit on another day of the week and see how things run. 

Carefully Read Through the Contract

Before signing up for any nursing home, take some time to review the contract and seek any clarifications from the nursing home director, if necessary. You can also ask some close to you to go through the contract before you sign it as well. 


It is important to ensure that your elderly loved one gets the assistance and care they need as they continue to grow older.

After reading the above, you should be able to know when it’s time to move from assisted living to a nursing home. And with it, ensure that your elderly loved one is in the best possible hands, as needed, at all times.

Certified Senior Advisor (CSA)®
Assistive Technology Professional

Scott Grant has spent more than 20 years serving seniors and the elderly in the home medical equipment industry. He has worked as a manufacturer's rep for the top medical equipment companies and a custom wheelchair specialist at a durable medical equipment (DME) provider in WV. He is father to 4 beautiful daughters and has three terrific grandkids. When not promoting better living for older adults, he enjoys outdoor activities including hiking and kayaking and early morning runs.

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