Assisted Living or a Nursing Home? Making the Decision Regarding Where Your Elderly Loved One Lives

Assisted Living or a Nursing Home

Many elderly people begin living in assisted living facilities before they are ready to move to a nursing home. An assisted living facility will provide assistance with certain day-to-day activities such as cooking and laundry; however, such a facility is usually not equipped to provide the more intensive care that a nursing home provides.

When making the determination as to where your elderly loved one will live, there are a few things to keep in mind. The first is basic issues of contract law; the second, the practical reality of your loved one’s situation.

Can an assisted living facility force your elderly loved one to move to a nursing home?

When the health of an elderly person begins to deteriorate, there will come a point where he or she needs to transition from an assisted living facility to a nursing home. In spite of consumers’ clear preferences for assisted living, as noted in a study published by the Health Research and Educational Trust’s Health Services Research journal, the issue of who gets to make that decision is one which will often be spelled out in the contract or agreement that you (or your elderly loved one) signed at the beginning of the relationship with the assisted living facility.

Assuming that there is no statute requiring the assisted living facility to allow the elderly loved one to stay—and there won’t be, as such a statute would violate the Thirteenth Amendment prohibition of involuntary servitude—what will control the nature of the relationship will be the contract or agreement between the parties.

Check the agreement for terms that set out when and how the assisted living facility may end the relationship. Ultimately, while the assisted living facility cannot force your elderly loved one to move into a nursing home, most of them will probably be able to terminate the rental on the basis that they are not able to provide the necessary care for the elderly person.

Look at the terms under which the assisted living facility can ask your elderly loved one to leave. Have those terms been met? If not, you may have a case against the facility, and you can at the very least force the facility to pay the difference between what you would have paid them and what you are required to pay a new assisted living facility to provide similar accommodations.

Of course, as any attorney will tell you, it’s always better to reach an understanding with the other side as opposed to taking the matter to litigation, which can be a costly and slow process. Rather than attempting to force the assisted living facility to pay for any financial harm you suffer when relocating your elderly loved one, it would probably be best to sit down with the administration and talk through the situation with them.

If the condition of your loved one is borderline—meaning that the terms under which they can ask your loved one to leave have not been clearly met—you may be able to work out an arrangement under which your loved one is allowed to remain if you provide a little bit of extra care.

Practical considerations

If your loved one is approaching the point of legitimately needing to be in a nursing home, it may be best to have an honest conversation about it. While it is admirable to want to keep an elderly loved one in an assisted living facility, the reality of the matter may be that he or she may be better cared for in a nursing home.

Take an honest look at the situation and discuss it with the other caregivers, if there are any. It may be that by making the move to a nursing home, you can ensure that your loved one is provided with the level of care he or she really does need.


While you probably cannot force an assisted living facility to keep your loved one, you may have some contractual remedies available to you depending on the terms of the contract or agreement governing his or her stay. However, rather than engaging in a lengthy and expensive court battle, it may be better to sit down and talk with the administration to see if the parties can come to an agreement.

Finally, when looking at your loved one’s situation, be honest with yourself about his or her needs. It is good to want the best for your loved one; it is also good to know when it really is time to move on to a nursing home.



Grabowski, D. C., Stevenson, D. G., & Cornell, P. Y. (2012). Assisted living expansion and the market for nursing home care. Health services research, 47(6),2296-2315. Health Research and Educational Trust. .

Rosenblatt, Carolyn. Assisted Living or Nursing Home? Available at Last visited November 25, 2015.