Board & Care Homes

Prospective residents request and fill out an application form for their desired board and care home facility. Once the application is submitted, the prospective resident will also need to undergo an interview and the board and care home will perform a needs assessment to determine if the facility is the right fit for the individual.

For prospective residents and family members who need assistance with the interview and needs assessment process, the board and care home administration staff can also talk to current social workers, medical staff, or other geriatric healthcare providers who could provide more information.

This is especially helpful for prospective residents who struggle with communicating their needs, their current living situation, and why they would benefit from residing in a specific board and care home.

In most cases, board and care homes are very affordable for seniors looking for alternative residential housing as compared to other long-term care options. Prices vary per state, but the average monthly cost ranges between $2,000-5,000.

If a resident requires additional personal or medical support services, such as seen in residents with dementia, the monthly fee tends to be a little higher. Seniors have the option of having a shared or private room, but private rooms come with a higher price tag.

Another reason that board and care homes are generally cheaper than assisted living or skilled nursing care is that it doesn’t have the same level of medical care available on site.

Residents are typically expected to pay for board and care home costs themselves since most medical insurance policies, including Medicare, do not cover the monthly fees. Some seniors may think that using their long-term care insurance policy will work, but some policies will not include coverage for residential home living like board and care.

Oftentimes, seniors will liquidate assets by selling their current home or by converting or cashing in on their life insurance or retirement funds. In some states, Medicaid offers partial assistance for board and care home fees and waiver plans.

There are a lot of similarities in care services provided between board and care homes and assisted living facilities. There are a few key differences though:

• Staff to resident ratio: Assisted living accommodates for up to 100 residents at a time, so there are more residents per staff member. Board and care homes have a much smaller staff to resident ratio, meaning staff members can spend more time with each resident to meet their individual needs.
• Meal services: Assisted living meals feed more folks, so there’s less wiggle room for home-cooked customized meals. Since up to 6-20 people live in a board and care home, each resident can have customized food options.
• Medical care: Medical care is generally less complex in a board and care home as compared to assisted living.
• Transportation and community outings: It’s generally easier to arrange transportation and community outings for board and care homes since the numbers are so much smaller.

Many board and care homes offer structured days filled with activities available for seniors to participate in. This could include community outings as well as in-home activities such as arts and crafts, table-top activities, and board games.

Availability of amenities depends on the home as well as the location and proximity to other community activities. Although board and care homes offer active structure for social participation and recreation, residents are also allowed to spend the day as they please.

Typically, staff who work at board and care homes are trained to assist with ADLs as well as functional transfers and mobility. There are also staff available for housekeeping, maintenance, and transportation. Staff members and/or the site manager generally live at the board and care home with the residents.

Although staff members are not required to be awake 24/7, residents have immediate access to help if needed. Staff members on site are not medically trained, so certified nurses must be contracted or called in to come assist residents with their medical needs.

Since board and care is considered a home, residents are allowed to bring in some of their personal belongings. This includes clothing, some furniture, and other personal, meaningful items.

However, many board and care homes have limitations on the type of belongings that can be brought in so that staff members and residents are kept safe. Prospective residents should consult with staff members about what the requirements are and what items are allowed in.

If you or a loved one are increasingly struggling with completing your daily activities such as personal hygiene, bathing, self-feeding, toileting, medication management, and dressing, then it might be time to consider transitioning into a board and care home.

But…how do you choose between board and care and another facility setting like assistive living. Let’s take a look at the following scenario:

Deborah is a 67 year old female who resides at home with her older sister. Deborah has schizoaffective disorder and, for many years, has been able to manage her own self-care tasks and work full-time as a seamstress. As Deborah has gotten older, and arthritis has become a growing problem, she has trouble with managing her self-care tasks and relies on her aging sister for help. As a result, her sister’s self-care tasks are being compromised and there’s no room in their schedules or strength in their hands to conduct daily housework. Deborah is not much of a people person and doesn’t require complex medical care at this time. She and her sister start considering a transition to board and care.

Board and care homes have increased in popularity over the years so there are many to choose from. However, since residential homes are kept small there are generally waiting lists to consider.

When selecting a board and care home, consider the following questions:

• If waitlisted, how long does it usually take to get accepted into a board and care home?
• What is the staff to resident ratio?
• How many residents are there?
• What medical conditions or disorders do the residents have?
• Are any of the residents aggressive?
• Are the staff pleasant and easy to work with?
• What is the visitation policy?
• What are the monthly fees like and are they expected to increase over time?
• What is transportation like? Are the staff safe and capable drivers?
• Is the option available to have a private room?
• How do board and care home contracts get terminated?
• What are community outings like?
• Is the board and care premise safe and secure?
• Is there an emergency protocol in place and are the staff familiar with it?
• What ADL tasks will staff assist with?
• Are the staff trained to handle oxygen tanks, incontinence supplies, or other common medical equipment devices?

Board and care homes have grown to become suitable, affordable options for seniors who want to retain as much independence to their day as possible while still having support in place when needed. Talk to your friends and family who have experiences with board and care homes.

Compare and contrast to pros and cons of residing in board and care. Talk to your primary physician if you are concerned about being healthy enough to live in board and care. Consult with a financial advisor to negotiate your best moves to pay for the monthly fees.

Tour and research multiple facilities before committing to one. Be proactive in your selection and take your time with the process so you can enjoy your selection and have a higher quality of life.