Nursing Homes vs. Rehab Facilities: Substance Abuse Treatment for the Elderly
Rates of alcohol or other drug use among older adults weren’t historically very high in comparison to younger adults. That’s why they are less likely to be correctly diagnosed and offered addiction treatment, services, or referrals. There also wasn’t a large number of older adults in substance abuse treatment programs. However, substance abuse among older people went underidentified for decades.1
This population is particularly vulnerable to the negative effects of various substances and their misuse, as well as adverse interactions with prescription medications. These factors can increase their risk of death and other physical harm.2
Alcohol is the most misused substance among older adults, followed by heroin.3 Fortunately, addiction treatment has proven to be successful for older adults, particularly when the approach is tailored to their needs. Interventions at skilled nursing and rehabilitation facilities adapted to the physical, cognitive, and psychosocial needs of older patients are likely to be effective.2
How Do Drug and Alcohol Rehab Facilities Work?
Substance abuse rehabilitation centers offer various treatment options to people seeking professional help with their drug, alcohol, or prescription medication addiction. High-quality, licensed rehab centers tailor their treatment approaches to each individual’s needs and offer different options based on professional assessment during the intake process.4
Effective treatment addresses all the patient’s needs, not just their drug use. There are usually specific programs for particular groups of patients, like those suffering from co-occurring mental health disorders or other ailments.4
What Advantages & Disadvantages Do Rehab Facilities Offer?
The main benefits of drug rehab centers include:5
- Individually tailored plans and approaches are chosen specifically to fit each patient’s needs.
- All elements of treatment are scientifically proven to be effective and evidence-based.
- Various treatment modalities, including individual and group counseling, workshops, and medication.
- A comfortable setting where individuals can focus on their recovery.
The cons, for some people, particularly older patients, might include:6
- The taboo nature of addiction and any mental health issues.
- They might feel ashamed or hesitant to admit that they need this kind of help.
- Older people are also less willing to leave their homes, so this might be an obstacle to getting inpatient treatment.
How Do Nursing Homes Work?
This type of facility provides care to people who do not require hospitalization but are unable to take care of themselves at home. There is 24-hour access to skilled nurses and nursing aides. They provide supervision, meals, and help with everyday activities.7
Some nursing homes have a hospital-like setting, with available medical care and certain types of rehabilitation for the elderly. Other facilities aim to create a homey environment. They might not follow a set schedule every day, and staff members develop friendly relationships with individuals staying there.8
A lot of residents at a nursing home stay there permanently due to lasting mental or physical conditions requiring ongoing supervision. However, there are also cases of shorter stays for some people who need help recovering after a hospital stay and can return home.9
What Are the Advantages & Disadvantages of Nursing Homes?
Nursing homes offer the following advantages:10
- Nursing homes are easily accessible and widespread, which makes visits much easier.
- Family members are encouraged to visit their loved ones and be involved in their care.
- They can help with some daily activities and help communicate the needs of the residents.
Medical services vary significantly among nursing homes, but usually include:10
- Skilled nursing care.
- Orthopedic care and support after surgery.
- Physical, occupational, and speech therapy.
- Intravenous therapy and antibiotics.
- Wound care.
The most common drawbacks of nursing homes include:
- The adjustment to living away from home. This change is particularly hard for older patients as it might take some time to get used to the unfamiliar environment and become comfortable.11
- Nursing homes are not hospitals or addiction treatment centers, so they don’t provide the same level of care in terms of testing, evaluations by physicians, or addiction specialists.10
- Some nursing homes don’t have direct access to potentially necessary medication in their facility and they usually can’t offer inpatient substance abuse treatment.10
What Do Skilled Nursing Facilities Do?
Skilled nursing and rehabilitation centers offer short-term medical care and housing to seniors. The level of care in such a center includes 24-hour skilled nursing and rehabilitation services, as well as assistance with daily living activities.7
Skilled nursing facilities are staffed with licensed and registered nurses, certified nursing assistants, as well as therapists and specialists. An individually tailored care plan is usually developed for each patient after the assessment of their health and rehab requirements.7
Even though short-term stays are more common, they provide long-term stays for patients who can’t safely receive care at home or are not expected to recover the ability to care for themselves.11
How Do Nursing Homes Differ From Skilled Nursing Facilities?
Skilled nursing facilities typically offer shorter-term specialized and licensed medical care, usually following a hospital visit. Nursing homes, however, focus on long-term care for residents who need daily non-medical assistance.12
The most significant difference is the range and depth of medical services. Nursing homes staff (usually nurses’ aides) provide meals, do laundry, clean rooms, and dispense medications. Sometimes there are doctors on staff, but not necessarily.12
In skilled nursing facilities, doctors, nurses, and other medical personnel, (physical therapists, for example) are usually present. Also, skilled nursing care is mostly covered by Medicare while long-term care services in nursing homes are not.12
An Overview of Alcohol Abuse in Seniors
Older adults are more likely to abuse alcohol than other substances. Alcohol use has been increasing in the population over 60 during the past two decades.13 In particular, there’s a surprising number of elder women struggling with alcohol abuse.14
This is particularly concerning since older individuals’ bodies don’t metabolize alcohol as efficiently as those of younger people. This leads to an increased risk of both cognitive and physical issues, like confusion and falls.2
It’s important to understand the difference between moderate and high-risk drinking. This can give you further insight into all the harmful effects of alcohol misuse and available treatment options since, for individuals struggling with alcoholism, nursing homes may not be an appropriate solution. Most older adults take at least one medication and many take more than one. Therefore, interactions between alcohol and these drugs must be taken into consideration and treated accordingly.2
An Overview of Drug Abuse Among the Elderly
Older adults can and do develop an addiction to illicit drugs or prescription medication. Many of them take multiple medications, so potential harm can arise from their nonmedical use. This includes overdose and potentially deadly or otherwise harmful interactions between prescription medications, drugs, and alcohol. This can increase the risk of physical, mental, or cognitive problems.2
One of the greatest risks for the elderly is opioid addiction, due to the high prevalence of chronic pain in this population. However multiple treatment approaches were proven to be effective for older adults. After the initial screening, they can be referred to the appropriate SUD treatment program.2
Are There Inpatient Rehab Facilities for the Elderly?
When comparing skilled nursing facility vs. rehab, it’s worth noting that the same level of elderly care options is also available at an inpatient rehab facility. However, inpatient rehab programs focus their approach on acute care for senior adults who require more intensive treatment for their addiction issues. Not unlike skilled nursing homes, inpatient rehab centers provide meals, personal care, and help with everyday activities.3
When looking into inpatient rehab facilities, you should also be familiar with the following:
- Inpatient and residential programs can provide an environment that should be easy for older adults to navigate.3
- Facilities are accessible to patients with disabilities and usually have other accommodation options older clients might require.3
- They might have a slower program pace or modify their services to accommodate vision, hearing, and cognitive problems typical in older patients.3
- Inpatient treatment programs for older adults use age-sensitive practices and approaches.2
- Many inpatient rehab centers accommodate patients with co-occurring health or mental health issues.2
- Short-term rehab facilities offer inpatient treatment limited to medically supervised withdrawal (detox), followed by outpatient treatment. 2
- Well-equipped alcohol and drug rehabilitation centers for the elderly are staffed with medical specialists covering various areas of expertise and can replace nursing homes until addicted patients recover from addiction.2
For more information, you can contact a trusted treatment provider such as American Addiction Centers to discuss the needs of your loved one and the level of care ACC can provide.
What Should I Know About Senior Outpatient Facilities for Drug & Alcohol Abuse?
Older adults with SUDs can benefit from a wide range of age-sensitive and age-specific treatment services across the continuum of care, including outpatient treatment and recovery management techniques.2
Outpatient programs provide services during daytime hours and can assist older clients with transportation. They are usually cost-effective, low-intensity, and efficient. Treatment approaches that work best for older adults with alcohol addiction who need more intensive treatment are:2
- Cognitive-behavioral therapy.
- 12-Step facilitation.
- Pharmacological interventions.
Outpatient rehab centers can provide addiction treatment services to senior citizens who are still living at home. Some programs offer in-home support services or telehealth to homebound older adults. Some rehab centers can even provide treatment while the patient is staying in the nursing home.7
Contact ACC to find the best rehab near you and get more information on outpatient options and how they can accommodate the needs of your loved one.
Treatment for Co-Occurring Disorders in the Elderly
Aside from growing rates of illicit drug use among older adults, rates of co-occurring mental disorders are also high.2 SUDs often co-occur with dementia and other age-related cognitive decline issues. Alcohol misuse and depression are a common combination among older adults with both substance abuse and mental health issues. These two co-occurring disorders can lead to serious physical and behavioral health consequences.2
Both screening and assessment methods should be adapted to older adults. Age-appropriate screening tools, interventions, and addiction treatments are available for older adults struggling with alcohol use, illicit drug use, or nonmedical prescription medication use.2
Common comorbid mental and physical conditions in this population are:2
- Chronic pain.
- Bipolar disorder.
- Dementia and memory problems, such as Alzheimer’s disease.
Finding Seniors’ Substance Abuse Rehabilitation Centers and Nursing Homes Near Me
To provide the best possible care for your senior loved one and make the right decision, make sure to understand relevant differences between these rehab options and discuss the benefits of each with a doctor or other specialists. Whilst a nursing home near your current home may seem convenient, a tailored recovery program to meet your individual needs should also be considered. Nursing homes mainly attend to patients in need of long-term or end-of-life care, while rehab centers focus on helping them transition back to their everyday lives. Nursing homes and rehab facilities provide many of the same services, but the intensity of programs and some rehabilitation options may differ.12
The following AAC treatment centers offer specific rehabilitation treatment and services that might be suitable for older adults with substance abuse issues:
- Telehealth services and specialized treatment options for veterans in Riverview, FL.
- Treatment for medically compromised patients in Grand Prairie, TX, as well as patients with significant health needs.
- Customized treatment plans for veterans and other specific populations in Lafayette, NJ.
- Wide variety of specialized treatment programs in Las Vegas, NV, suitable for particular populations, co-occurring disorders, and veterans.
- Expert staff in Worcester, MA equipped to handle a variety of medical challenges, co-occurring cardiac conditions, respiratory conditions, and patients restricted to a wheelchair.
You can call our helpline and talk to an admissions navigator who can provide you with general information to questions about substance abuse, evaluate the situation and explain what you can expect when joining treatment, and present you with options best suited to the needs of your older family member.
Additionally, you can explore the AAC rehab center directory to search for nearby facilities by location or verify your insurance coverage by submitting an online form.
Factors to Consider Aside From Location
Even though the choice of a rehab facility is often influenced by proximity to home, some people might be willing to travel out of state if recommended by their doctor or other trusted professional. If needed, you can consult with a trained interventionist who can help you talk to a senior loved one about getting professional treatment.7
Key factors to take into consideration when choosing a facility for older adults with substance abuse issues is the continuum of care that can range from least to most intensive. Aside from brief interventions, there are outpatient or intensive outpatient options, as well as inpatient detoxification and rehabilitation, including pharmacotherapy and psychosocial interventions. The cost of these different options may vary significantly.2
Aside from achieving abstinence, the treatment should focus on improving quality of life and reducing the risk of relapse by helping older adults maintain motivation to change risk behaviors. Families of users can also get referrals to support groups to help them deal with their loved ones’ addiction. Lasting recovery is generally achieved by participating in an aftercare program, including sober living and transitional housing options and other resources like addiction help hotlines in case of acute crisis.2
Does Insurance Cover Nursing Homes and Rehab Facilities?
Medicare does not cover long-term care (like nursing homes) but it does cover medical supplies a senior might need while in the nursing home. However, Medicare can cover skilled rehab facilities after a qualifying hospitalization.15
A long-term care insurance policy can help pay for many types of long-term care, including skilled and non-skilled care. Private medical insurance plans usually provide benefits for services not paid in full by Medicare. However, private pay is, in some cases, the only option for a long-term stay at a nursing home.15
A stay at a rehab facility and treatment of substance abuse disorders, as well as potential co-occurring mental health issues, are covered by most health insurance providers, in full or partially.15 You can easily check your coverage online by filling out and submitting an online form on our website or calling our helpline and talking to one of our admissions navigators.
Frequently Asked Questions