How to Evaluate a Board and Care Home

When you or your loved one is looking for a residential community that provides a homey atmosphere, and you don't need round-the-clock medical care, a board and care home might be the ideal solution. Sometimes also known as residential personal care homes or adult foster care homes, these communities typically provide living arrangements and meals to small groups of elderly adults, often within a single-family home. Residents with dementia or Alzheimer's disease can also often be cared for well in a board and care home.

If you're intrigued, take a look at what you can expect at a board and care home and what steps you should take to investigate specific residential options further.

What to expect from a board and care home

Board and care homes typically look just like the other single-family homes in their neighborhoods. When you visit the choices available to you, you may not even recognize them as the special facilities that they are.

In these residential personal care homes, the staff-to-resident ratio is typically very high, with about one staff person for every four residents. You're unlikely to find any personnel on site with medical licenses, though the personnel are often trained to help residents with the activities of daily living, including bathing, grooming, dressing, and medication management.

Because board and care homes don't have a large medical staff or a facility with lots of amenities, they typically are more affordable than assisted living facilities or other large senior living communities. That means you can expect lower costs. More residents are likely to receive assistance from Medicaid than are those in assisted living or nursing homes.

In a residential personal care home like this, you can expect to have a room rather than an apartment. In some cases, residents share their room with a roommate. All housekeeping services are provided. Residents of a board and care home typically dine together in a communal dining room.

Questions to ask before you visit

You can learn a lot about the board and care homes you're interested in before you ever visit the facilities. Start by checking out any inspection reports available through your state's licensing divisions. While personal care homes are typically required to keep that information on site, you should also be able to get it through the government offices.

If your state licenses board and care homes, make sure the facility's operating license is up to date. Your state may also require that the administrator have a license, and you can check that license as well. If you're eligible for Medicaid, make sure the facility is certified for Medicaid. You can also ask what training the staff members have and whether they've been background-checked.

You can ask a lot of other questions ahead of time as well, if only to narrow down the communities you also want to visit. Ask about the staff-to-resident ratio (and don't forget to ask what it is at night as well). If you or your loved one is dealing with any specific medical conditions, ask if the community will accept residents with those conditions.

It can be easier to ask financial questions up front as well. How much does the board and care home cost? Do you have to pay an entrance fee, and is it refunded if you or your loved one needs to make other arrangements? Understanding financial obligations may also help you narrow down your options.

During your visit

Your first impression will tell you a lot when you check out board and care homes for yourself or your loved one. Even from the time the front door opens, you can tell whether the home is clean and whether it smells fresh or unpleasant.

Take a good look at the room where you might be living. Is it large enough for you or your loved one to live in comfortably? And does it have enough room for your stuff? If you'll be taking on a roommate, do you like them and think you can live together peacefully? Ask as well whether you can bring in your own furniture or add personal touches to the room.

As you look at the common rooms, see whether they seem comfortable and welcoming. Are the current residents using the common areas? And is the facility in good shape? (Look at the lighting, flooring and general maintenance.) Check as well for handrails and guard rails in bathrooms and along steps.

What to ask when visiting a board and care home

When you visit the board and care homes that you're considering, you'll want to ask a lot of questions. Start by talking with the staff member who gives you a tour — they're likely to be able to answer a lot of questions. If you can talk to residents as well and find out how they feel about the home, you'll learn a lot. It's easier to make sure you get all the answers you need if you take a list with you. Start with these questions to help you recognize the moment when you've found the right residential care home:

• What is a typical day like for the residents? (And does that typical day sound like one that would help you or your loved one to thrive?)
• How do the staff help residents who have problems with incontinence? Are incontinence supplies provided under the residence fees or not?
• What safety precautions are in place for any residents with memory problems or a tendency to wander?
• Does the board and care home provide transportation to medical appointments? What about transportation for shopping or entertainment?
• What opportunities are available for exercise? How do the staff encourage residents to maintain a healthy, active lifestyle?
• Do the staff help with health monitoring activities such as blood pressure checks?
• How are weekly menus prepared? If you or your loved one have special dietary needs, how are they handled?
• Are snacks available between meals? Can residents eat in their rooms if they prefer?
• May friends and relatives visit, and what kind of privacy do they have when they do?
• What emergency procedures are in place?

Starting with these questions is a great way to begin your evaluation of a board and care home. When you're ready to start your search, Seniorly is ready to help you.