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50+: Live Better, Longer

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Shopping for Assisted Living

Assisted Living Primer

Assisted Living vs. Nursing continued...

He says it all comes down to "customer focus."

"Nursing facilities have had a tendency to look at the government as their customer," he says. That's because Medicare and Medicaid usually pick up a resident's tab.

In his opinion, nursing homes are not able to cater to a resident's individual preferences because they are overregulated by the federal government. These regulations decide when residents take their meals and even how often they bathe. Assisted living, he says, allows residents to make these decisions for themselves: It's a matter of being asked vs. being told.

Of course, nursing home regulations are in place to protect residents' rights and ensure that they aren't neglected. Some are not able to make decisions for themselves -- people with advanced Alzheimer's disease, for example. Nevertheless, "sometimes less care is better than more care," Willging says.

"Nursing home regulations were just a disaster," Schurman says, referring to the Nursing Home Reform Act, passed by Congress in 1987. The goal of the ALW, he says, is to come up with regulations for assisted living that ensure high quality, but are more flexible.

In terms of cost, the difference between nursing-home care and assisted living is "really not all that significant," Willging says.

Jones says that although Medicare and Medicaid often pay for nursing-home care -- whereas assisted living is generally paid for out-of-pocket -- those who would be best served by assisted living may not qualify for government support. They would have to pay for either option.

Another key difference between assisted living and nursing homes is that assisted-living facilities offer a more home-like atmosphere. Willging says that "sounds like a hackneyed phrase, but it's really not."

Jones agrees that assisted-living facilities have done a good job of making things feel homier.

Choose Wisely

"You -- the family, the child -- know better than anybody what makes mom happy," Willging says.

Have a talk with her about what she would want in an assisted-living arrangement, and then visit several facilities. Don't just let your fingers do the walking: Some real legwork is in order. "Essentially, you want to look at the facility," Willging says.

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