What is the difference between assisted living and nursing home?

Two years ago, when my father had a stroke, that followed 2 years of fighting colon cancer, the doctor told us that it was time for hospice care...the hospital almost tossed him on the street the next day. I had to find him a place quickly, and chose what was billed as an assisted living place, but turned out to be a nursing home. Dad, who was sharp as a tack until 2 days before he died, was put into half of a hospital room, with a curtain between him and the neighbor, who kept the TV on almost 24/7, at full volume, and would snooze, then wake up if I turned it off, to turn it back on. He had the window, so Dad had only a view of his own closet. He was bed-ridden, and had to ring for a nurse to change him, or to help him dress, or get into his wheelchair, or to help him downstairs, so he could have a smoke. I paid $6,000 of my parents' money, for him to be there for a month, while we decided what to do next,. Within the first 2 weeks, he would beg me to bring him his gun, so he could kill himself. The nurses were over-worked and understaffed, so they ignored when he rang his bell, and left him in a dirty diaper for hours. They ignored his plaintiff requests to go outside, and one nice day, he spent 3 hours sitting in front of the elevator, and none of them would take him downstairs for some fresh air...but the night male nurse discovered he smoked, and took to stealing my dad's cigarettes during his shift. It was a TERRIBLE place! I moved him out after 3 weeks, and they refused to refund the 4th week's rent, telling me "it wasn't their fault" that I changed my mind! HUH?

Meanwhile I found an assisted living place, out of the city (Chicago), in the suburb I live in...a Sunrise Community. I was able to put Dad in a studio apartment, with a hospice-supplied bed, but his own furniture, including his computer, in the room with him; and the window was right next to his bed, so he could always look out! And I moved Mom, who had developed dementia (Dad covered for her for years, I think), into a studio across the hall, and paid the same amount of money for both studios, that I had paid per month for half of a room in that nasty nursing home!

Dad passed soon after that, but Mom is still there. She has her own furniture, TV, and a tiny 1-bedroom apartment, with a bedroom and a living/sitting room, and a bathroom. She gets cleaning service, laundry service, and 3 meals a day served in the dining room, which is like a restaurant, only you never need money down there...and no tipping is EVER allowed! I pay extra for the 24/7 nurses to give her the 6 meds, since she either forgot them, or took more than one day's worth in one day. But she has made friends, looks forward to 3 times weekly BINGO, and they have a lending library, so she can read. There are lots of rockers out front, and only 2 floors of apartments, so there is LOTS of personalized care! Mom is truly happy where she is, and so am I! I sold her house, though at a bit of a loss, but I have the money in the bank, and will try to make it last as long as she does.

So to answer the question, nursing homes, which take Medicaid, are generally under-staffed and over-worked, and provide little or grudging or no care. And you have to get on a waiting list to get in on the Medicaid pay-plan, other wise you have to private pay, and still get lousy service, as we did for my Dad. Assisted living places DO NOT take Medicaid, and are private pay only...but the people who work at the Sunrise Communities are angels, who treat the elderly with love and respect, even when they are being difficult. And yes, there is a "Reminiscence" area in the back, where Mom may need to move eventually, but she will still have her furniture, clothing, and other things important to her, with her, and she will always have a window!