Board and care homes are smaller facilities, accommodating between 3 and 40 residences. They are called by various names, including care homes, residential care homes, and personal care homes. But they all provide a very basic and needed service: care for seniors in a home-like setting.
Most Board And Care Facilities Are In Residential Neighborhoods
Most board and care homes are located in residential neighborhoods and are converted single-family homes. The conversion involves retrofitting and remodeling to create multi-unit facilities. Some of these may only have the ability to care for three or four residents, whereas others can care for 20-30. Some facilities are more like hotels or apartment buildings and can accommodate 30+ residents. But overall, board and care facilities are smaller, more residential like and house fewer residents than ALRs. It is uncommon for a care home to offer services for more than 10 seniors, which helps create a more personal, home-style living environment.
Regulatory requirements differ by state. For example, in some states, residential care facilities may be regulated like assisted living facilities. In other states, they may be unregulated. Regardless, you should always get a facility’s state license and contact your state’s licensing authority for clarification on the license type, level of care, and the services provided by the facility you are investigating.
What Makes Board And Care Homes Popular
Board and care facilities are small, usually under ten residents. The small size allows them to target niche groups or provide a special level of care for one or two of the home’s residents. For example, residents who don’t meet the criteria for nursing home placement and lack funds for assisted living may find they can afford a board and care home. It can also be a good choice for residents who have mental health disorders. Assisted living facilities often reject residents with mental health issues because they consider them dangerous to the rest of the community. A board and care home may better be able to address this concern.
How To Find Board And Care Homes
Board and care homes are small. Some only house four or five residents. They don’t make a lot of money and often don’t have advertising budgets. Yet the best ones are always full. They operate by word of mouth and waiting lists. If this type of living arrangement interests you, the best way to identify these homes is to find one and seek advice.
Carmen and I also recommend you create two profiles or two people with different needs. This will allow you to see how the board and care address’s your inquiry. I like to describe two seniors, so I get a thorough idea of how the owner deals with residents of very different abilities. For example, I might describe a sixty-eight senior who likes socializing with roommates and needs help with cleaning, laundry, and meals. And a second senior that’s eighty that has some dementia and needs help with cleaning, laundry, meals, showers, medication reminders, and wander monitoring. This was the description we used for a parent. The two differing capabilities reflected the current state and what we believed might be the state fifteen years down the road.
From a care perspective, these are very different seniors. A board and care facility is not likely to cater to both. But an experienced owner whose been in the neighborhood for a long time will know other facilities that address care levels they don’t.
How To Evaluate Board And Care Homes
The small size and number of housed residents in a board and care facility mean the residents often shape the care scope and feel of the house. The only way to discover a facility’s current feel and capabilities is to visit. If you have a little money, another technique is to hire a small (one or two-person), local (to the area you’re considering) that’s been in business for five or more years, senior assessment and placement firm. These small, local firms know the area, often deal with board and care facilities, and know their track record and current owners.
Pay Attention To Resident Composition
Many seniors are attracted to board and care facilities because they offer similar services to larger assisted living facilities at lower prices. However, because they are largely unregulated, what they promise to deliver and what they actually deliver can be very different. They don’t face derogatory ratings from government regulators. They also tend to align their residents with their services. That means they may provide great services to a group of residents that share similar care needs but would have trouble addressing the need of a different class of residents. The best ones have the same staff year after year. The worst ones often have high staff turnover. If your facility is small and uses only a few caregivers, losing one key employee can immediately affect the quality and continuity of service.
In general, 24/7 caregiver support is not provided. It is usually too expensive. Instead, some board and care facilities maintain a person on premises 24/7, but whether that person can sufficiently attend to all the residents’ needs can only be assessed on a case by case basis.
States, faith-based organizations, and private donors are becoming increasingly aware of these facilities and occasionally provide grants and financial support.
Common Services And Amenities
Services generally include:
Care homes offer food services and assistance with daily living but do not typically have a medical professional on-site. It’s not a primary focus of this type of community.
Deciding On What Board And Care Home Is Right For You
Do the following once you’ve identified a few board and care facilities that meet your general criteria (location, services, price).
Visit The Facility
Visit the facility a couple of times (i.e., weekday, weekend, day, night). This allows you to see the facility staffed by different people. We don’t recommend spending a few nights at the facility unless the owners encourage you to do so. When a senior moves, it can be very traumatic. Most seniors that move, especially from a location where they’ve lived for a few years, will not like the new facility. So a two or three-day trial period usually results in a disaster. The better alternative is to build a two or three-month out clause into the lease. This is when you put a clause into a lease allowing the new resident to leave with minimal penalties after a few months. Seniors can adjust to a new home, but it usually takes a couple of months.
Get And Review The Rental or Lease Agreement
Get a copy of the rental agreement and read it closely. Pay close attention to the following paragraphs (issues).
Build A Pro/Con Comparative Worksheet
It’s important to build a comparison chart for deciding among alternatives. You can get ours here. Making a serious mistake in selecting a board and care facility can result in a loss of thousands of dollars, bad move experiences, and unnecessary disagreements with home owners and managers.