Board and care facilities also are called adult homes, residential care facilities, domiciliaries, rest homes and retirement homes. Since these different names can be confusing if you are trying to obtain information about living options for seniors, it is preferable to focus on the type of facility you are seeking and the services offered rather than on the name.
Board and care facilities are based on the residential model of care not the medical model, meaning that they are home-like rather than hospital-like. The emphasis at these facilities is on providing for the basic needs of residents in a “no frills” atmosphere. This arrangement is called a “congregate environment” since it consists of a group of unrelated adults living together in a shared home. Residents in board and care facilities are provided with the following:
- Room and bath (usually shared)
- Three meals daily and sometimes snacks
- Basic housekeeping services
- Some personal care
Adult foster care homes (also known as a family type homes for adults) provide similar services to board and care facilities, but in family settings housing fewer residents who, like those at a board and cares, are unrelated to the host family.
One of the major advantages of both types of facilities is that they are relatively low cost, especially when compared to nursing homes. Often these are the only affordable alternatives for seniors on limited incomes who require some assistance but who do not require skilled nursing services.
In a board and care facility, sharing and cooperation are emphasized rather than privacy with residents generally sharing rooms and bathrooms. A common arrangement is two residents of the same sex sharing one room with one shared bathroom for every two rooms (four residents of the same sex). Meals and snacks are provided by the facility in a communal dining room and residents are responsible for getting there themselves at mealtimes. Other common rooms used by all the residents are sun porches and lounges for watching television, playing cards or participating in other activities.
Board and care facilities and adult foster homes are not health-related facilities. They do not provide nursing or medical services as part of their regular care. To be eligible for this type of housing, an applicant should be ambulatory and able to move from bed to chair and back without assistance (transferring). He/she must also be continent and able to use the toilet independently. He/she must also be able to get to the dining room for meals, which may require negotiating stairs. There are some exceptions to these requirements in special circumstances. For instance, in the case of a temporary illness, a resident may have meals delivered to his/her room on a tray. However, there usually are limits on how long these exceptions last. Most of these facilities are not organized or sufficiently staffed to provide a great deal of personal attention. A major exception making it possible to receive nursing services in a board and care facility is an assisted living program that provides a higher level of care without relocating the resident. This program will be discussed further.