Adult care homes and nursing homes are both senior housing options that can provide a high level of care. There are some significant differences between the two, however, like size, staffing ratios, and cost. If you are trying to decide which type of long-term care facility is best for your loved one, this article about the differences between adult care homes and nursing homes should help.
In this article, we’ll explore the differences and similarities between adult care homes and nursing homes, as well as the services they provide, the staff and training requirements, costs, and the pros and cons of each.
By the end of this article, you’ll have all the information you need to make an informed decision about which type of senior care facility is right for your loved one.
Types of Adult Care Homes and Nursing Homes
Adult care homes come in a variety of levels and resident capacities. Adult care homes (also known as adult family homes or adult care homes) range in the kinds of services they provide and the types of care they can offer based on the experience of the staff and the location of the home.
Each state in the US has different licensing requirements and capacity restrictions for adult care homes. The types of care typically offered in adult care homes include assistance with activities of daily living (ADLs), such as bathing, dressing, and eating, as well as help with mental and physical health needs.
Care options typically offered in adult care homes include 24-hour support, assistance with medication management, activities of daily living, and assistance with social and recreational activities. Adult care homes generally have a lower monthly cost than nursing homes.
Nursing homes primarily offer two levels of care: custodial care and skilled nursing care.
In custodial care (also known as ICF or Intermediate Care Facility) the resident receives care 24/7 for long-term, chronic medical conditions. Residents may have their own rooms, but it’s more common to see shared rooms.
In skilled nursing care (SNF), the resident is receiving care from skilled professionals like nurses, physical and occupational therapists, or IV medications. The intention of skilled nursing care is that it’s short-term and is meant for rehabilitation, not long-term stays. This is the only level of senior care covered by Medicare.
Services and Care Offered in Adult Care Homes vs Nursing Homes
Adult care homes and nursing homes may offer similar services but in vastly different settings. Adult care homes tend to be in a home setting with private bedrooms and a small number of other residents. For example, in Oregon, the maximum number of residents in an adult family home is 5, in Washington state, the maximum number is 6.
Nursing home settings tend to be much larger in building size, number of staff, and number of other residents. Staff will change every 8-hour shift and there is awake night-time staff.
Nursing homes provide a wide range of services and care, as shown in the table below.
| Service | Adult Care Homes | Nursing Homes |
|---|---|---|
| Toileting | Yes | Yes |
| Grooming | Yes | Yes |
| Feeding by Mouth | Yes | Yes |
| IV Medications | No | Yes |
| Wound Care | Maybe* | Yes |
| Night Care | Maybe | Yes |
| Diabetic Care | Maybe | Yes |
| Dementia Care | Yes | Yes |
| Exit Seeking | No | Maybe |
| Challenging Behaviors | Maybe | Yes |
Staffing and Training Requirements
Staffing and training requirements for adult care homes and nursing homes are different. Adult care homes typically have one or two primary caregivers (depending on the size of the home), and one or two caregiving aides who all share daily duties.
Nursing homes have more staff, such as nurses, social workers, and skilled therapists. Staffing and training requirements also vary by state.
Costs and Payment Options
Costs for adult care homes and nursing homes all range depending on the location and needs of a resident.
Adult care homes typically have lower costs than nursing homes. The average monthly cost for an adult family home is $5,000, while the average monthly cost for a nursing home is $8,390.
Pros and Cons of Adult Care Homes
With any level of senior care, there are pros and cons. It’s important to consider how important these are to your loved one when thinking about which type of senior care will meet their needs.
Pros of Adult Care Homes
Adult care homes have the advantage of providing more individualized care than nursing homes and will have higher staffing ratios (number of residents per caregiver) than nursing homes.
Adult care homes typically have lower costs, and they can offer more personalized care. They are also often easier to access since they are located in residential communities. Adult care homes tend to have better home-cooked meals vs nursing homes bulk-purchased food since meals are cooked daily for a small number of people.
Cons of Adult Care Homes
Adult care homes have several disadvantages compared to nursing homes. Adult care homes are typically smaller in size, and they may not have the same level of amenities and services as nursing homes. Transportation and a wide variety of social activities are a challenge for a small adult care home to provide.
Adult care homes may not offer 24/7 AWAKE care which can be a challenge if a resident is frequently needing care, medications, or falls at night.
Adult family homes are often unable to care for someone with challenging behaviors, residents who are exit-seeking, or people who need extensive nursing oversight.
Pros and Cons of Nursing Homes
Pros of Nursing Homes
There are several pros and cons when it comes to nursing homes. Nursing homes typically have higher costs than adult care homes, at the same time, they may offer more comprehensive care.
One of the biggest benefits of nursing homes vs adult care homes is that they offer 24/7 awake care. This means that residents can always be monitored and cared for, even at night. Nursing homes also have a staff of highly trained and experienced professionals who are able to provide residents with the level of care they need.
Cons of Nursing Homes
There are disadvantages to nursing homes. For those on a budget, nursing homes are much more expensive than adult care homes. Nursing homes tend to have plenty of shared rooms, it can be difficult (and expensive!) to find a private room in a nursing home. If there aren’t many private rooms in a nursing home, they may be reserved for residents on hospice or for residents who have behaviors that are not ideal for having a roommate.
Other major complaints of nursing homes include feeling institutional, constant noise, poor quality of food, and high staff turnover.
Choosing the Right Type of Facility for Your Loved One
To make an informed decision about which type of facility is best for your loved one, it is important to understand the differences between adult care homes and nursing homes.
When it comes to the level of care residents receive, adult care homes or medical foster care homes typically offer more personalized care than nursing homes. This means that residents will have more one-on-one interaction with the staff, personalized and consistent care, and they will be able to participate in more intimate social activities.
If your loved one needs care, here are some considerations to think about when choosing between an adult care home and a nursing home:
- Are the services your loved one needs available in an adult care home?
- Do the staff have the experience and training to provide the level of care your loved one needs?
- Is the home located in a comfortable and accessible location?
- Will the cost of care be affordable?
- Will you be able to visit your loved one regularly?
- Will the home have the amenities and services your loved one needs?
Bottom Line: Making an Informed Decision
Deciding between an adult care home and a nursing home can be a difficult and emotional decision for families. Both types of senior care offer different levels of help and services, but each has a place in the long-term care continuum.
Adult care homes offer a more home-like environment with lower staff-to-resident ratios, and may be a good option for those who need assistance with activities of daily living.
Nursing homes will have more intensive medical care and supervision, making them a better choice for those with complex medical, night, and behavioral needs.
Ultimately, the decision will depend on the specific needs and preferences of the individual in question, as well as their financial situation and location. It is important to do thorough research, visit multiple facilities, and ask plenty of questions before making a decision.
No matter what type of senior care you choose, it is important to remember that your loved one’s safety and well-being should be the top priority. By taking the time to carefully consider all of the options and making an informed decision, you can help ensure that your loved one receives the care and support they need to live a comfortable and fulfilling life.
Frequently Asked Questions
This is a common question for families who are trying to decide which type of senior care facility is best for their loved ones. Adult care homes typically offer more personalized care in a home-like setting, while nursing homes offer more intensive medical care and supervision.
Our estimate for national median adult care home costs is $5,000 per month. The national median monthly cost for nursing homes is $8,390 for a semi-private room. Prices can vary widely depending on the location, services offered, and level of care needed. In general, nursing homes are more expensive than adult care homes due to the higher level of medical care and supervision provided.
Factors to consider when choosing a senior care facility include the individual’s medical needs, level of independence, and personal preferences. It can be helpful to tour multiple options and speak with staff members and residents to get a sense of the care and services offered.
Paying for long-term care can be a challenge for many people. Options for financing may include long-term care insurance, Medicare or Medicaid, and personal savings. It’s important to research and understand all the available options for paying for senior care and to plan ahead as much as possible.
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