What Do Nurses Do at Assisted Living Facilities?

Different types of senior care address different needs: their levels of care vary from little to no care at an independent living community, to skilled nursing facilities (SNFs) where seniors can receive medical care daily. Moreover, different states have different terminology and regulations for these facilities; what you might find is the standard of care in an Oregon assisted living community might look a little different from that of one in Arizona. 

So, do nurses work at assisted living facilities? Or, are they staffed with caregivers? What do nurses do at assisted living facilities when they are employed there? We’ll help answer these questions so that you can have a better understanding of who might be taking care of your older loved one when they move into a community. But, of course, that is a question assisted living communities should be able to answer for you when you visit them.

Do nurses work at assisted living facilities?

Yes, nurses do work in assisted living communities, but they might be coordinating care rather than providing direct, hands-on care to residents, especially if they’re an RN:

• RN: A Registered Nurse has a higher level of education than LPNs or CNAs, and can administer medications, perform diagnostic tests, and work with doctors, families, and other nursing staff to coordinate care.
• LPN: Licensed Practical Nurses can provide basic medical care, help patients with activities of daily living (ADLs) (bathing, dressing, toileting, etc.), and report patient vital signs to doctors and other nursing staff.
• CNA: A Certified Nursing Assistant has less formal training than either RNs or LPNs, but can help patients with ADLs, and are the most common type of nurse found in long-term care facilities like assisted living communities.

So while a caregiver or CNA might help assisted living residents with ADLs, like getting out of bed and dressing, an RN might assess new residents, coordinate with hospitals and medical providers, and help create healthcare and service plans for each resident depending on their unique needs. Nurses might also help organize activities to promote health and manage chronic diseases within the community. An assisted living community’s staff is often mostly made up of caregivers or CNAs with perhaps one (or several, depending on the community’s size) RNs to oversee operations and care plans.

Usually, assisted living facilities are not able to provide medical care to their residents. For example, a caregiver cannot typically give a resident an insulin shot to help regulate their diabetes, but they can provide a reminder that it’s time for that shot (this is usually referred to as “medication management”). In some states and some facilities, however, you might find nurses that can administer injected medications or perform other types of light medical care: it just depends on the facility and the regulations in their area.

You might also find assisted living communities that allow outside nursing services to visit residents (at the resident’s cost), especially if it’s only for a short period of time — after a surgery, for example. While most communities must be conscious of whether a resident needs more care than they can provide, many will try to avoid uprooting a resident if their heightened care needs are expected to only last a little while. In a similar vein, assisted living communities will not generally remove residents who need hospice care, understanding that the stress of moving at that time would be an undue burden on the resident and their family.

Nurse responsibilities in assisted living

To sum up, nurses, depending on their level of certification, can be responsible for supporting assisted living residents in the following ways:

• Assessing residents’ overall health as well as creating and overseeing care plans
• Acting as a liaison between residents, the community, physicians, and residents’ family members
• Supervising other nursing staff
• Providing personal care (help with ADLs)
• Medication management
• Organizing wellness programming for residents

Are you thinking of pursuing a career in assisted living nursing?

Working with seniors can be a gratifying experience, especially in long-term care settings where you can really get to know residents. For more information about what qualifications you might need to pursue this career path, look into the programs that community colleges, colleges, and universities might have to offer near you. You might find a number of online certification and degree programs, which can sometimes have issues with accreditation. Do your homework before enrolling in one. 

Like all healthcare professionals, as a nurse you'll have a lot of choices available to you, from hospital to private practice settings. Geriatric care services can be a rewarding career, as well as a growing field as our population is aging rapidly. And, if the day-to-day of a senior living is a little too placid for you, in-home care companies send nurses to seniors' homes.

"Nursing homes" vs. assisted living

Although many people use the term "nursing home" to refer to senior living communities, it is no longer used as often by communities themselves, as it isn't very accurate. After all, nurses work in many different aged care settings, and only skilled nursing facilities (SNFs) offer full-time medical care. Nurses can choose to work at assisted living communities (generally considered a lower, or less acute, level of care), SNFs (acute care), or they can specialize in certain types of care, such as memory care for people with dementia or Alzheimer's. Though the terminology has changed, the role of nurses in assisted living and other types of senior living remains vital to the health and happiness of older adults.

Works consulted:

U.S Census Bureau. “65 and Older Population Grows Rapidly as Baby Boomers Age.” June 25, 2020. https://www.census.gov/newsroom/press-releases/2020/65-older-population-grows.html.