"To keep the heart unwrinkled, to be hopeful, kindly, cheerful, reverent that is to triumph over old age." -- Amos Bronson Alcott

Board and Care vs. Assisted Living

If you are looking for long-term elder care that gives your loved one a sense of independence with round-the-clock supervision and non-custodial help, there are two choices to consider: Assisted living facilities and board and care homes. Both offer seniors similar kinds of support but in different types of environments. 

About Both Facilities 

Board and care homes and assisted living facilities are licensed and regulated by California's Community Care Division, a sub agency of the state's Department of Social Services. They both offer aging adults an alternative to in-home care or adult day care, especially if those types of support aren't available or feasible. Residential care is not the same as skilled nursing, where medical care, typically in the form of nurses, is available 24/7. 

Both residential care facilities provide assistance to senior citizens who need help with their daily living activities. Caregivers typically help with:
  • Dressing
  • Bathing
  • Meal preparation
  • Medication management
  • Incontinency care
  • Support services
  • Transportation
  • Recreational activities
  • Laundry
  • Housekeeping
  • Toileting
However, unless there is a licensed medical person such as a nurse on hand, seniors who need injections, their catheters maintained or colostomy care cannot live there.
The cost of both types of facilities is relatively the same and cheaper than skilled nursing care. Seniors can expect to pay as little as $1,000 or as much as $4,500 a month (or more) for care, depending on the level of assistance needed and where the facility is located. Medi-Cal and Social Security do not cover the costs of long-term residential care facilities, although some accept Supplemental Security Income (SSI).

How The Two Facilities Differ 

Overall, there really is only one major difference between California's board and care homes and assisted living facilities: The environment in which the care is given.
Assisted living facilities are generally larger group homes with a varied number of beds, some as high as 50-100. Residents have private or shared rooms and come together in common areas such as dining rooms or living/recreational rooms. There is a director and a large staff of administrators, caregivers and custodians to manage the facility.
Board and care homes are traditionally single family, private homes. They are operated by one or two individuals, many times retired registered nurses or similar professionals, who take care of all the residents' needs. Most board and cares house about six to eight residents, depending on their license. All of the rooms dedicated to the residents are shared among them. The owner lives in the house as well and is available 24 hours a day. 

How to Decide Which Is a Better Fit

Obviously cost and location play a major factor in determining what type of residential care facility your loved one needs. However, there are other features to consider.
If your loved one suffers from the beginning stages of Alzheimer's disease or dementia, a board and care home may be more accommodating. Since the staff-to-resident ratio is less than that of an assisted living, the older adult will receive more personal attention.
That's not to say that he or she wouldn't do well in an assisted living, which offers larger group activities and more chances to socialize with more than just a few people.

Do Your Homework

If possible, you and your loved one should tour several residential care facilities, both large and small and decide for yourselves the better fit. Remember the most important aspect is that your loved one feels safe, is comfortable in his or her new surroundings and is being care for and treated properly and with respect.

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