New Orleans Senior AdvisorBy New Orleans Senior Advisor Care Team · September 19, 2026
Jefferson Parish has the most licensed assisted living, Orleans the most nursing homes and hospitals, and St. Tammany the oldest population and the newest buildings. Choose the parish by where family can visit, then compare providers there; a daily drive across the Causeway rarely lasts.
Start with the drive, not the brochure
The most reliable predictor of how well a parent settles is how often family visits, and the most reliable predictor of visits is the drive. In the New Orleans area, that question often comes down to which side of Lake Pontchartrain, or which side of the river, the family lives on. The Causeway and the Twin Span make the Northshore feel close on a map, but a daily round trip in traffic wears thin within months.
The three big parishes side by side
| Parish | Residents 65+ | Share 65+ | Median age | ARCPs | Level 3 or 4 | Nursing homes | Home health & hospice offices |
|---|---|---|---|---|---|---|---|
| Jefferson | 88,462 | 20.5% | 40.5 | 37 | 6 | 12 | 30 |
| Orleans | 65,389 | 18.1% | 39.2 | 8 | 6 | 13 | 5 |
| St. Tammany | 58,209 | 20.9% | 41.8 | 17 | 12 | 9 | 19 |
Population figures are Census Bureau estimates for July 1, 2025; licenses are from LDH's October 2026 roster.
Jefferson Parish: the most choice
Jefferson has more licensed adult residential care providers than any other parish in the region, concentrated in Metairie, with Kenner, Harahan and River Ridge adding more. The mix runs from eight-bed personal care homes to large Level 3 buildings, so a family can compare many options within a few miles. Ochsner Medical Center's main campus and East Jefferson General Hospital anchor the East Bank; West Jefferson Medical Center serves the West Bank.
Orleans Parish: hospitals and long-established homes
New Orleans itself has fewer ARCPs but more nursing homes, including nonprofit and faith-based homes that have served the same neighborhoods for generations, and most of the region's major hospitals. For a parent whose life revolves around a church, a neighborhood or a doctor in the city, staying in Orleans can be worth a shorter list. PACE Greater New Orleans serves the parish's ZIP codes, which is a real advantage for a parent who could otherwise need a nursing home.
St. Tammany: newer buildings, older residents
The Northshore has the oldest population of the six parishes and has added large assisted living buildings around Covington, Mandeville and Slidell in recent years. Newer buildings can mean modern apartments and amenities, but also shorter state records, so read the license dates on each facility page. St. Tammany is outside PACE Greater New Orleans' listed ZIP codes, so the Community Choices Waiver and LT-PCS are the main Medicaid routes for care at home there.
Making the decision
Pick the parish first by where the most involved family member lives and works. Then shortlist three providers there, check each one's level, capacity and posted statement of deficiencies, and compare their storm plans; the Northshore's higher ground does not make every location safe, and areas near rivers and the lake have flooded in past storms.
The hospital question
Hospital access is part of the choice. On the South Shore, Ochsner Medical Center on Jefferson Highway, University Medical Center and Touro in the city, and East and West Jefferson serve most addresses. On the Northshore, St. Tammany Parish Hospital in Covington and Slidell Memorial Hospital are the main acute-care hospitals on LDH's roster, with rehabilitation and specialty hospitals nearby. Each facility page on this site lists the closest acute-care hospitals by straight-line distance, which is a useful first filter for a parent with frequent appointments.
The smaller parishes
Families in St. Bernard, Plaquemines and St. Charles face a different version of the question, because licensed care inside those parishes is limited. LDH's roster shows no ARCP or nursing home in St. Bernard Parish, a single nursing home in Plaquemines, and a few providers in St. Charles. Most families there compare options in New Orleans, the West Bank of Jefferson, Kenner or Slidell, and the right answer usually follows the commute of whoever will visit most.
Moving a parent across the lake
If the move means leaving a lifelong neighborhood, plan for the losses as well as the gains. A parish church, a pharmacist who knows your parent, friends who drop by: these matter, and they are hard to replace. Some families keep one weekly anchor, such as a standing lunch or Mass at the old parish, for the first months after a move.
A checklist before you decide
Before committing to a side of the lake, write down who will visit and how often, which doctors your parent will keep, which hospital your parent prefers, and how the storm plan would work from each location. Then tour at least one provider on each side. Families who compare in person usually find the answer obvious within a day.
Frequently asked questions
Is assisted living cheaper on the Northshore?
No published figure says so. CareScout reports Louisiana statewide medians only; ask providers on both sides for written quotes.
Does PACE serve St. Tammany Parish?
Not according to LDH's ZIP code list for PACE Greater New Orleans, which covers Orleans, much of Jefferson, St. Bernard and Belle Chasse.
Which parish has the most nursing homes?
Orleans Parish, on LDH's current roster.
Which parish has the oldest population?
St. Tammany, with a median age of 41.8 in the Census Bureau's 2025 estimates.
