Comparing Assisted Living vs. Nursing Homes vs. Independent Senior Housing

From assisted living facilities to independent senior housing and more, we break down all of the options.
May 6, 2024
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If you’ve determined that it’s time for you or a loved one to move to a new community, there are tons of options to choose from. And while it may seem confusing to navigate at first, once you understand what’s out there, you can find one that provides exactly the type of care you need.

Where to Begin

As a first step, you’ll want to know what the options are. From there, you can begin to match your priorities and preferences to what each offers.

Outside of aging in your home, here are the main living options for older adults:

  • Independent Senior Housing
  • Naturally Occurring Retirement Communities (NORCs)
  • Continuing Care Retirement Communities (CCRC)
  • Assisted Living Facilities
  • Nursing Homes (also referred to as Skilled Nursing Facility, Long Term Care Facility, Custodial Care, Home for the Aged, Rehabilitation Center)

Comparing Each Option

Independent Senior Housing

Independent senior homes are developments designed specifically for older adults. They’re set up to support the lifestyle an older adult wants as they age.

They’re typically built by for-profit companies and real estate developers. Sometimes, you can find government-subsidized housing for middle- or lower-income adults whose income cannot support local rents.

Naturally Occurring Retirement Communities (NORCs)

Naturally Occurring Retirement Communities are communities where many older individuals have lived for years, and, as they’ve aged, they’ve decided to “stay put” in their apartment building or housing complex to remain socially integrated. These communities set themselves apart by providing “aging-friendly” services, such as a transportation van for grocery shopping or a blood pressure clinic on-site. Beacon Hill Village in Boston is one example.

Many NORCs have housing that is sponsored or supported by a local not-for-profit agency or local government. These communities prioritize older adults and want them to stay there as they age.

Continuing Care Retirement Communities (CCRC)

In a Continuing Care Retirement Community, all levels of care are offered. On one end of the spectrum, they serve high-functioning older adults who are completely independent, and their homes can in every way resemble a private home. On the other end, they can also have a skilled nursing facility on-site to support those who are medically frail.

There are typically communal areas for recreational meals and other services offered, like housekeeping, but it’s up to a resident’s discretion if they’d like to participate.

For patients who need more support, there’s often assisted living in the facility where residents have all meals provided and get help with basic care needs. There’s also often traditional skilled nursing care where residents who are highly impaired can get support.

Families of all ages can live together in some CCRCs. Many offer all-day supervision for older adults living in the community if an adult child wants to live with their parent but needs some additional support.

Assisted Living Facilities

Assisted Living Facilities are ideal for those who need a little bit of support. This often means light supervision, basic housekeeping services, assistance getting around, and someone to respond immediately in the event of an emergency, such as a fall or an unexpected acute illness.

Some residents also need help preparing meals, bathing, and grooming, but typically, they do not need extensive minute-to-minute assistance. Some families will hire additional home health aides in this setting to augment services.

Nursing Homes

Nursing Homes are facilities that provide the highest level of support. Typically, they’re for residents who are unable to perform Activities of Daily Living (ADLs) independently, like bathing, grooming, or preparing a meal.

Often, people with safety or behavioral difficulties from dementia or another disease need the assistance of a nursing home. Alternatively, nursing homes can be used as a place for rehabilitation or extended recovery after a hospital stay.

Typical Resident Characteristics

Here are the characteristics most typical of the residents who live in each facility.

Living Option Level of Care Resident Profile
Independent Senior Housing Low
  • Those who want to maintain an active lifestyle
  • Middle- or lower-income individuals
Naturally Occurring Retirement Communities (NORCs) Low
  • Those who wish to stay socially integrated within their current living facility
  • Appreciate “aging friendly” services like transportation to shopping and appointments
Continuing Care Retirement Communities (CCRC) Low
  • Appropriate for both high-functioning older adults as well as those who are medically frail
Assisted Living Facilities Medium
  • May need assistance with some day-to-day tasks like meal preparation, handling money, cooking
  • ALF’s typically offer a range of levels of support depending on needs
Nursing Homes High
  • Unable to perform activities of daily living
  • Experience safety or behavioral difficulties
  • Rehabilitating after a hospital stay

How to Find the Best Fit

Choosing the best living option is a “head and heart” process. To get started, the first step is to understand your care needs and how they may change in the short and long term. Our guide on choosing the best living option can help you navigate the process.

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