A Guide to Making Cancer Care Decisions for Older Adults
Reviewed by: Deidre Sommerer, LPN, MS, CMC, CDP Published/updated: September 15, 202...
Seniors are more likely than any other age group to be diagnosed with a chronic condition. The National Institute on Aging reports that an estimated 85 percent of older adults have been diagnosed with at least one chronic health condition, and 60 percent live with two or more chronic conditions. On top of that, many seniors face other health problems common with aging, such as loss of mobility and cognitive impairments.
When a senior’s health condition becomes debilitating, a nursing home can be the right environment. Nursing homes are the only type of senior living facility to offer regular access to high-level medical care from nurses and physicians, making it an essential move for some seniors. According to the CDC, 1.3 million Americans reside in skilled nursing homes.
Nursing homes meet a particular need and are not the right senior housing choice for everyone. In this guide, we’ll provide some more information on skilled nursing care and where it fits into the spectrum of senior living. We’ll also explain who is a good fit for skilled nursing care, financial assistance options to pay for nursing homes, and answer some frequently asked questions about skilled nursing facilities.
Nursing homes are residential care facilities that offer around-the-clock, skilled medical care. These skilled nursing facilities are designed to meet the needs of those with consistent, high-level care needs and those in recovery from an illness or injury, such as a stroke or respiratory virus. Nursing homes are often the next step after someone has been treated in the hospital for injury or illness, making them a good place for those who do not require hospitalization but do need regular care and assistance. They can also be beneficial for those living with a terminal illness who need medical assistance to be readily available at all times.
Nursing homes focus on resident health more than the overall lifestyle. Thus, nursing homes tend to have fewer lifestyle services and amenities than assisted living communities. Nursing homes may still offer some basic activities or amenities for the use of rehabilitation patients, such as a swimming pool.
Nursing homes focus on high-level medical care, but they still offer a spectrum of care and services. Below, we break down the types of care provided at nursing homes into three categories.
Unlike other types of senior living like assisted living, nursing homes do not offer many lifestyle services. Residents of nursing homes are less likely to be able to participate due to their high-level medical needs, and the focus in these facilities is on providing all residents with the best care possible. However, some skilled nursing facilities may offer some lifestyle services and amenities such as laundry services, concerts from visiting musicians, and some activities intended to engage and stimulate residents.
Nursing homes are designed for people who need around-the-clock care available to them, but who do not need to be in a hospital. As the highest level of care in the spectrum of senior care, residents of nursing homes typically have the most severe illnesses or impairments compared to seniors in other types of senior living. Below, we provide some examples of a good fit for nursing homes and the skilled care they offer.
Nursing home care is essential for some seniors, but it should not be a “catch-all” when selecting senior housing for a loved one. There is a range of residential senior care options that can meet a scale of different needs and levels of care. Below, we explain when someone should not be in nursing care and an alternative suggestion.
According to Genworth Financial Cost of Care Survey 2020, nursing home care costs an average of $7,756 per month for a shared room and $8,821 per month for a private room, making it the most expensive type of senior care in the United States. Keep in mind that one’s nursing home care costs can vary dramatically based on location and the kind of services one receives.
For example, someone living in a nursing home to monitor a chronic condition may have very different costs than someone receiving daily physical therapy if the facility charges per service. Be sure you have a clear understanding of what is or is not included in a facility’s monthly cost and the fees for additional care before moving yourself or a loved one into a nursing home.
Due to the high cost of nursing homes, many seniors and their families need at least some assistance paying for the care. Below, we explain some of the most common financial assistance programs available for nursing care.
Medicare does sometimes cover part of the cost of nursing home care, but there are limitations. Medicare Part A will cover one’s stay in a skilled nursing facility if it follows a qualifying hospital stay of at least three days and one’s physician deems daily skilled care necessary. Under these conditions, Medicare covers 100% of nursing home costs for days 1-20, and a portion of the costs through day 100 of the stay. After the first 100 days, Medicare does not offer any coverage for nursing home care. Note that Medicare does not provide any coverage for nursing care if the senior wasn’t first treated in the hospital, and one must receive care in a Medicare-approved nursing home.
Medicaid provides the most comprehensive coverage of skilled nursing services of the available public financial assistance programs. The program covers almost all nursing home costs for seniors who qualify for Medicaid, including care, room, and board, with no time limit on benefits. The exception is extra services unrelated to one’s medical care like a hair cut or transportation to visit family. Seniors will have to pay for these extra services out-of-pocket.
Because Medicaid is a jointly-operated program between federal and state governments, eligibility and some benefits can vary slightly between different states. If you intend to use Medicaid to help you pay for skilled nursing care, be sure to carefully review your state’s eligibility requirements and nursing home coverage on the official Medicaid website.
The Department of Veterans Affairs offers several financial assistance programs to help veterans and their spouses pay for long-term care. The most widely applicable is the Aid and Attendance (A&A) benefit, a monthly benefit amount that some veterans may receive in addition to their VA pension. Recipients may use their monthly A&A funds towards paying for long-term care in the setting of their choice, including a skilled nursing facility. More eligibility information is available on the VA website, but most veterans who need a nursing home level of care and receive a VA pension will be eligible.
The VA also operates some of its own nursing homes where veterans and their spouses can receive skilled nursing care. The VA will pay for some of these services for those enrolled in VA health care, but individuals will be responsible for some of the cost. You can find more information about these VA-run nursing homes on the VA website.
Long-term care (LTC) insurance is a specific type of health insurance covering long-term care services, in most cases including nursing home care. LTC insurance policies all have their own benefit terms and amounts, so it is not guaranteed that skilled nursing care is covered, or that the full cost will be covered. Be sure to read the specifics of the policy to understand how much of the cost, if any, you’ll be responsible for paying. Additionally, note that most seniors are not eligible to sign up for a new LTC insurance policy, so this option only applies to those who already have a policy.
Some seniors and their families decide to cash-out or receive a settlement for the senior’s life insurance policy early as a means to pay for long-term care. Some insurance companies may allow policyholders to access their death benefit early, while others may need to turn to a third-party settlement service. In all cases, the cash sum that one receives will be less than the original total death benefit. However, it sometimes makes more financial sense to access the money now when facing high long-term care costs. If considering using a life insurance policy to pay for long-term care, be sure to discuss it with your financial advisor or another knowledgeable party.
Reverse mortgages are loans that one can take out against the equity they have in their home, essentially converting some of the home’s value into cash. These short-term loans can be especially useful for paying for long-term care when the senior is transitioning directly from the home they own. Reverse mortgages do need to be repaid within a specified time frame, usually one year. Still, they can be an excellent source of funding for nursing home care and eliminate the need to rush to sell one’s home before moving to senior living.
There are over 15,000 nursing homes in the United States, which can make the process of finding one for yourself or your loved one overwhelming. To start your search, enter your zip code in the search tool at the top of this page. You’ll see the senior living options in your area, including information on services and types of care offered, amenities, location, and view photos. To narrow your search down further, you can also use the Medicare nursing home comparison tool. The search tool allows you to view all of the nursing homes in your area, plus quality markers for all of the communities. You can also search for a specific nursing home to view its quality ratings from Medicare.
Once you’ve chosen your favorite nursing home options in your area, use SeniorHousingNet’s Nursing Home Community Checklist to narrow your choices down further. The checklist highlights things you should be aware of as you compare different options to help you find the right fit for yourself or your loved one. If you’d like more guidance, call 800-304-7152 to speak with a senior care advisor for free. An advisor can provide you with more information on nursing homes in your city or a specific community you’re interested in, as well as answer any other questions you may have about senior living options in your area.
Are Nursing Homes and Skilled Nursing Facilities the Same Thing?
Yes, nursing homes and skilled nursing facilities are the same thing. In the senior care industry, the terms are often used interchangeably. However, when looking into a care facility for a loved one, be sure to ask explicitly what kind and level of care they offer to confirm that it meets you or your loved one’s needs.
How Much Do Nursing Homes Cost?
According to Genworth Financial, the average cost of a semi-private room in a nursing home is $7,756 per month. A private room in a nursing home costs an average of $8,821. These figures are the national average, so costs may be much higher or lower in your area. Additionally, some nursing homes may charge per-service, so costs can be very different depending on the care and services one receives.
What Is the Main Purpose of a Nursing Home?
The main purpose of a nursing home is to provide consistent, high-level medical care to patients who need skilled care but no longer need to be in the hospital. Unlike some other types of senior living, nursing homes do not provide many activities or community living. Rather, the focus is on ensuring that residents receive all of the care they need.
What Is the Difference Between Assisted Living and Nursing Home?
The main difference between assisted living facilities and nursing homes is that nursing homes provide residents with skilled medical care while assisted living facilities do not. Assisted living is intended for those who need some assistance with personal care, but who do not have high-level medical needs or need regular medical care. Additionally, some nursing homes offer short-term rehabilitation services, while assisted living facilities tend to not have short-term residents.
When Should a Person Go Into a Nursing Home?
A person should go into a nursing home when they need regular medical care and/or are living with a chronic condition or illness that can not be properly managed in another environment. Some signs that it’s time for a person to go into a nursing home include loss of mobility, the worsening of a medical condition, inability to keep up with one’s medication schedule, and inability to care for oneself independently. However, each person and situation is different. If you’re unsure if your loved one should move to a nursing home, talk to their physician and/or caregiver.