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Nursing Home vs. Rehab for Alcohol and Drug Treatment: Which Is Right for You?

Finding long-term care is critical for yourself or an elderly loved one, especially when it comes to treating a substance use disorder (SUD). Patients and their families deserve a smooth transition into a treatment facility but making the choice between a nursing home or rehab for the elderly can be difficult.

To help ease the decision-making process, take a closer look at the differences between nursing homes and rehabilitation centers below. While you may need time to consider your options, your informed decision can make the transition into a nursing home or rehab easier.

Does My Insurance Cover Long-Term Rehab Treatment?

Before you commit to a specific location, you can check your insurance by calling your provider or checking online through our portal. You will be asked to provide the name of your insurance carrier as well as your policy membership identification.

Health insurance often covers at least part, if not all, of a stay in a rehabilitation facility. Private pay and personal loans can be applied to help cover any gaps in insurance. Medicare will pay for inpatient or outpatient substance use disorder treatment.1 Medicare Part A covers inpatient substance abuse treatment, and Medicare Part B pays for outpatient services rendered by a hospital’s outpatient department or clinic.

Remember, it is important to check your coverage before you decide on a treatment program for yourself or your loved one. Knowing how much is covered can lessen the stress of starting treatment.

Alcoholism in the Elderly

Alcohol addiction is an underrecognized but common issue among older adults.2 Age-related changes in physiology coupled with heavy alcohol intake can cause elderly individuals to experience problems such as impaired balance, coordination, and judgment.2

Other effects of both short- and long-term alcohol use can include:3

  • Alcohol poisoning (a medical emergency resulting from high blood alcohol levels).
  • Cancer (breast, colon, esophagus, liver, mouth, throat, rectum, voice box).
  • Injuries (e.g., burns, drownings, falls, motor vehicle crashes).
  • Health problems (e.g., digestive issues, heart disease, high blood pressure, liver disease, stroke).
  • Mental health conditions (e.g., anxiety and depression).
  • Problems with learning and memory (e.g., dementia).
  • Risky sexual behaviors.
  • Social problems (including work, unemployment, friends, and family).
  • Violence (including suicide, homicide, sexual assault, and intimate partner violence).
  • Weakened immune system.

Substance Use in the Elderly

There is a misconception that older adults do not abuse any substances, and evidence suggests that substance abuse among older adults has been chronically under-reported for decades.5 Baby boomers (those who came of age in the 1960s and 1970s) grew up in a time when attitudes toward drug use were shifting. The rate of SUDs among this group has been consistently high as these individuals age.

In the United States, older adults commonly misuse illicit substances.6 The Baby Boomer generation presents a marked increase in psychoactive drug use over previous generations. This generation also tends to misuse prescription, nonprescription, and over-the-counter (OTC) medications.7

What Causes Alcohol and Drug Use in the Elderly?

Some people do not develop an SUD until later in life. But why is this the case? Late-onset substance use after age 65 often occurs as a response to some sort of negative life circumstance or event, such as: 8

  • The death of a spouse.
  • Health problems.
  • Loss of status within the community.
  • Retirement.

One factor to consider with late-onset SUD is how a person’s caregiver, clinician, or family members handle the person’s substance use. Families might view their loved one’s substance use as one of the few joys their elderly relative has left in the world. A lack of intervention can be detrimental to the individual’s well-being and keep them from getting help.

Nursing Homes vs. Rehab Centers

How do nursing homes and rehab centers differ? While you may be able to find a nursing home with an emphasis on treatment for an SUD, the care your elderly loved one will receive at a rehab center can differ greatly.

Nursing homes typically provide:9

  • 24-hour care with nursing care available as needed.
  • Three meals per day.
  • Daily care assistance.
  • Transportation into the community.
  • Rehabilitation services including occupational, physical, and speech therapy.
  • Short- or long-term stays.

Rehab centers cater to adults of all ages and offer specialized treatment plans to fit each person’s unique needs. Many are private rehab centers that are privately funded, mainly by the people who enroll and pay the admission fees.

Rehab facilities may provide:

Rehab centers tend to be geared toward a customized therapeutic experience. Nursing homes do not typically employ counselors who specialize in addiction treatment, but rehab centers do. At a rehab center, you or your loved one can receive customized care.

Inpatient Rehab Centers for the Elderly

Inpatient rehab offers 24-hour supervised care in a comfortable, safe setting.  This type of rehab provides intensive, structured care and therapy for SUDs and equips patients with the tools they need to manage their addiction.10 Inpatient rehab can take place after detox if detox is required. Inpatient rehab typically uses a variety of therapeutic approaches including individual and group therapy sessions.

Outpatient Rehab Centers for the Elderly

With outpatient rehab, patients live at home instead of at the rehab facility and go to treatment during the day. The levels of care vary in intensity, based on the person’s needs.10 Common levels of care in outpatient rehab include:

  • Standard outpatient.
  • Intensive outpatient (IOP).
  • Partial hospitalization (PHP).

Depending on an individual’s needs, they can attend therapy once a week or several times a week in individual or group therapy settings.10 Some may start in a PHP or IOP before transitioning to a standard outpatient program.11

Outpatient rehab may be a good option for someone who has gone through the detox process and stabilized and/or someone who is transitioning from inpatient rehab.

Dual-Diagnosis Treatment for the Elderly

In inpatient or outpatient rehab, clients can be assessed and treated for dual diagnosis. A dual diagnosis means that someone has two or more conditions presenting at the same time or one after the other. SUD and mental health conditions, such as anxiety or depression, are common comorbidities. Depression is one of the most prevalent mental health conditions to co-occur with substance use.12

A dual diagnosis rehab can help address both conditions.12 By treating both conditions, patients may have a better opportunity for recovery.13

Long-Term Rehab Treatment for the Elderly

Long-term rehab for an SUD involves longer participation in a treatment program, typically ranging from 120 to 180 days. Sometimes, these programs can go for a year or longer. Long-term rehab can help treat SUD through intensive, structured therapies.

Like other treatment programs, long-term rehab will typically follow a 4-step process that includes patient assessment, detox, addiction treatment, and aftercare.

The goals of long-term rehab include:14

  • Cultivating techniques for managing stress.
  • Establishing and connecting with sources of support.
  • Making healthy and safe choices.
  • Reducing or eliminating substance use.
  • Regaining confidence.
  • Reintegrating into society.
  • Removing access to illicit substances.
  • Understanding co-occurring mental health conditions.

Studies show that participants in long-term rehab tend to have better and more sustained results.15

How to Find Nursing Homes or Rehab Facilities for Substance Use Near Me

Is it time to look for a rehab nursing home or rehab facility? When you search for rehabs near me, you will find American Addiction Centers (AAC) facilities in the following locations:

  • California
  • Florida
  • Massachusetts
  • Mississippi
  • Nevada
  • New Jersey
  • Rhode Island
  • Texas

You can give call us at to discuss your specific needs. Or you can use our directory to search by location for the facility closest to you.

Recommended Rehab Treatment Articles

Sources:

  1. Center for Medicare Advocacy. (2021). Medicare coverage of mental health and substance abuse services.
  2. Rigler, S.K. (2000). Alcoholism in the elderly. American Family Physician, 61(6): 1710-1716.
  3. Smith J. W. (1995). Medical manifestations of alcoholism in the elderly. The International journal of the addictions, 30(13-14), 1749–1798.
  4. Centers for Disease Control and Prevention. (2021). Alcohol use and your health.
  5. Kuerbis, A., Sacco, P., Blazer, D., & Moore, A. (2014). Substance abuse among older adults. Clinical Geriatric Medicine, 30(3): 629-654.
  6. Degenhardt, L., Dierker, L., Chiu, W.T. et al. (2010). Evaluating the drug use “gateway” theory using cross-national data: consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys. Drug Alcohol Depend, 108(1-2): 84-97.
  7. Golden, A.G., Preston, R.A., Barnett, S. D., Llorente, M., Hamdan, K., & Silverman, M. A. (1999). Inappropriate medication prescribing in homebound older adults. Journal of the American Geriatrics Society, 47(8): 948-953.
  8. Benshoff, J.J., Harrawood, L.K., & Koch, D.S. (2003). Substance abuse and the elderly: Unique issues and concerns. Journal of Rehabilitation, 69(2): 43-48.
  9. National Institute on Aging. (2021). Residential facilities, assisted living, and nursing homes.
  10. (2019). Treatment approaches for drug addiction drugFacts.
  11. (2020). Types of treatment programs.
  12. Blixen, C.E., McDougall, G.J., & Suen, L.J. (1997). Dual diagnosis in elders discharged from a psychiatric hospital. International Journal of Geriatric Psychiatry, 12(3): 307-313
  13. (2018). Comorbidity: substance use disorders and other mental illnesses drugfacts.
  14. Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 4, EARLY INTERVENTION, TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS.
  15. Greenfield, L., Burgdorf, K., Chen, X., Porowski, A., Roberts, T., & Herrell, J. (2004). Effectiveness of long-term residential substance abuse treatment for women: findings from three national studies. The American Journal of Drug and Alcohol Abuse, 30(3): 537-550.

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