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Your Complete Guide to Residential Care Home

Find residential care home options

What is a residential care home?

Residential care homes are private houses — usually with no more than 10 residents — for seniors who need help with activities of daily living (ADLs). These settings are ideal for people who prefer a quiet, homelike atmosphere over the more bustling, apartment-like environment of an assisted living community. Just as every house on the block is different, no two residential care homes are styled or managed the same way. Some offer vibrant activities, while others are more low-key, but all should provide high-quality housing as well as personalized care services, meals, and companionship.

Residential care home definition

There are a variety of terms used to talk about residential care homes. These terms may or may not reflect official state licenses, levels of care, and the services provided. We recommend that when considering these communities, you request to see their official state license or contact your state’s licensing authority for clarification on their license type and the services they’re authorized to provide.

Depending on your location, these homes might be called the following:

  • Elder care home
  • Purpose-built home
  • Adult family home
  • Adult foster care
  • Private care home
  • Personal care home
  • Private assisted living
  • Board and care home
  • Residential assisted living
  • Home for the aged
  • Adult care home
  • Group home
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What are the benefits and services offered in residential care?

Relaxation, companionship, and a quieter lifestyle are all hallmarks of the residential care home experience. Generally, care homes offer a private or shared room and personalized services, like assistance with activities of daily living (ADLs), which can cover all day-to-day and long-term needs of residents.

Care home residences are typically located in traditional homes and neighborhoods and provide care for fewer residents than larger assisted living communities. It’s uncommon for a care home to offer services for more than 10 seniors, which helps create a more personal, family style living environment.

Benefits of living in a residential care home

Seniors living in a care home have a unique opportunity to form close bonds with their housemates. This may be especially beneficial for seniors looking for new friendships and close connections. And, with a smaller staff to care for the residents, seniors and their families may also form closer bonds with their caregivers.

“The biggest benefit I see to care homes is the close relationships they foster between the residents and the caregivers. Any red flags regarding health might be noticed much more quickly due to the smaller amount of staff caring for the residents,” says Amy McLoughlin, a senior living expert at A Place for Mom who’s helped families navigate assisted living, memory care, home care, and more over her 17 years in the senior living industry.

As with most family homes, seniors can expect the following traditional amenities at a residential care home:

  • A living room or family room for playing games, watching TV, or enjoying activities
  • A dining room or eat-in kitchen to make meal times more social
  • A kitchen with residents’ favorite foods on hand for easy snacking
  • Outdoor spaces, such as a yard, deck, or patio
  • Some may also have pools, computer rooms, and other features

Services offered in residential care homes

Residential care homes typically offer supervised care, meals, activities, and health management. Seniors in a care home can take advantage of many of the same services that are offered in an assisted living community.

Here are some of the basic services offered in care homes:

  • Planned activities, events, and outings
  • Home-cooked meals and snacks
  • Housekeeping and laundry service
  • Medication management
  • Transportation to doctor’s appointments, errands, and activities

In addition to the basics, residents will also receive services tailored to their individual preferences and needs. Caregivers often cater to each resident’s tastes, which allows for a more personalized experience than what you’d find in an assisted living community. For many residents, this is one of the biggest advantages of living in a care home.

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What types of care can residential care homes provide?

When you’re considering care homes, it’s important to understand what they can offer as compared to other types of senior living options, like larger community settings.

“Every type of senior care community, including care homes, can differ in the level of care and services offered. This applies to both larger assisted living communities and care homes, as their level of care depends on state regulations, ownership preferences, and even the needs of the current residents,” McLoughlin says.

Some care homes may only provide basic assisted living services with general caregivers, while others may offer advanced memory care with specialized caregivers for seniors with Alzheimer’s or another form of dementia. Some care homes might even provide skilled nursing services. It’s best to ask each community about the specific types of care they’re equipped to provide, in case a resident’s needs go beyond what the care home can offer.

Care homes and independent living

Independent living can be provided in a smaller home or larger community. It caters to independent seniors who want a social atmosphere with lots of amenities. Seniors in these homes or communities are self-sufficient but take advantage of services like housekeeping or transportation. When available, independent living services are designed to make life easier for residents.

Care homes and assisted living

Care homes are similar to their larger assisted living community counterparts only in the services they provide.

Assisted living facilities are typically much larger, usually housing 25 to over 100 residents within a community. Because of more facility space, larger assisted living communities are able to provide more resort-style amenities. More space and residents means they might also have a lower staff-to-resident ratio. This may not be ideal for residents who prefer more personalized attention from staff or for less outgoing residents who like to see familiar faces.

However, assisted living communities can offer seniors a bit more privacy with private apartments. And they typically provide residents with a wide variety of on-site amenities and activities — like fitness centers, movie theaters, courtyards, and more — to promote engagement and socialization. Often the activity schedule is much more robust than what you’ll find in most residential care homes.

Depending on your loved one’s personality and lifestyle, they may have distinct preferences. Make time for a conversation on the differences between residential care homes and larger assisted living communities.

“You can think of the experience as choosing between a full-service hotel and a bed-and-breakfast for your vacation. Both can offer all the services and amenities you need but provide those services in very different ways. It’s a matter of understanding not what would make you most comfortable, but what would make your loved one most comfortable,” says McLoughlin.

Read more: Assisted Living vs. Board and Care Homes

H3: Care homes and memory care

Memory care communities provide specialized support for seniors experiencing memory loss due to Alzheimer’s or another type of dementia. Facilities can range from larger, apartment-style communities to smaller residential care homes. Caregivers and staff at these communities receive specialized memory care training to help them care for seniors with memory loss. Memory care communities are intentionally designed to prevent confusion and wandering.

Residential care homes licensed in memory care usually have caregivers trained in memory care practices. These care homes replicate comforting, homelike environments to help residents with dementia continue living in a familial environment. However, care homes typically don’t offer the same advanced security features that larger facilities have.

If you’re considering a care home for your loved one, know that — depending on the home — they may live alongside seniors who aren’t experiencing cognitive decline. This will create a different experience compared to a memory care community that exclusively caters to seniors with a dementia diagnosis. Larger memory care communities also house more residents than residential care homes. Big or small, licensed memory care homes or facilities often have a high staff-to-resident ratio to promote comfort between caregivers and residents.

Care homes and nursing services

Nursing homes offer 24-hour nursing care services for seniors who need a more advanced level of care. Typically, seniors in a nursing home need significant assistance with transferring and mobility. Their medical needs take priority, so nursing homes have a mixture of licensed nurses and caregivers on hand at all times.

Common medical services found in nursing homes include:

  • Medication administration
  • Care planning with medical oversight
  • Rehabilitation therapies
  • Hospice or palliative care
  • Mobility assistance
  • Personal care services

Nursing homes also reduce the need to leave for medical appointments, as most medical services are provided by on-site or visiting medical professionals. Some care homes can provide an array of nursing services via on-site nursing professionals or visiting doctors to oversee common medical conditions. But residents must be relatively stable since residential care homes don’t usually provide the 24-hour medical oversight found in nursing homes.

Home care and care homes

If your loved one owns their own home, they may hire an in-home caregiver in order to age in place as long as possible. Depending on your loved one’s needs, they may hire a caregiver to help with any of the following:

  • Household chores
  • Laundry
  • Preparing meals
  • Running errands
  • Transportation
  • Companionship
  • ADL support

Caregivers typically work for a set number of hours each week, and may work independently or through a home care agency.

Caregivers in a care home will provide the same services that an in-home caregiver would, including ADL assistance. In a care home, however, a caregiver is always on-site to oversee residents. This means they can get help for residents in an emergency, even if it happens overnight.

Residential care homes vs. continuing care retirement communities (CCRCs)

Continuing care retirement communities offer several levels of care, as well as resort-style amenities and services, all on one large campus. Care options include independent living, assisted living, skilled nursing, and sometimes memory care. Those variations in services and care settings, along with campus size and number of residents, make CCRCs vastly different — and larger — than residential care homes.

With so many options covering a range of needs, CCRCs enable seniors to safely age in place. They also enable aging couples with different care needs to live together in the same community. Within a CCRC, residents can easily move to a different care setting as their needs change. And they can still interact with community members in shared spaces and during community activities.

CCRCs may seem like the best option due to the multiple levels of care, but keep in mind that these communities often come with a hefty price tag and unique financial contracts. CCRC contracts typically follow two payment structures for care services: buy-in or monthly payment.

  • The buy-in option requires a large, initial entrance or community fee to cover all future care services. If care services are never used, this fee may be refundable.
  • The monthly payment option rolls care fees into a resident’s monthly rent, meaning their rent may be substantially more if they have more care needs.
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How much does a care home cost?

Living in a residential care home is often less expensive than the cost of nursing home care. In some states, it’s even more affordable than assisted living communities. However, several factors can affect the cost of living in a care home:

  • The location of the care home
  • The size of your loved one’s room
  • Whether your loved one has a private or semi-private room
  • Whether your loved one has a private or shared bathroom
  • The community’s pricing structure
  • Your loved one’s level of care

Across A Place for Mom’s partnered care homes, the national median monthly cost of a private room in a residential care home is $4,500. Semi-private rooms are less expensive with a national median monthly cost of $3,500. Care homes that offer dementia care will likely cost more, since they employ caregivers who’ve received specialized training.

Depending on the care home, your loved one may have other fees as well. Some homes that offer medication administration or assistance may charge a monthly medication fee. Across our partnered homes, the national median medication fee is $200 per month. Some homes also charge a one-time entrance fee, which is paid up front. Much like a deposit on an apartment, this typically goes towards preparing the room for a new resident and updating amenities. Across A Place for Mom’s partnered homes, the national median entrance fee or deposit is $1,500.

Care homes overall may be a good option for seniors on a budget.

“Care homes may offer a bit more flexibility when it comes to tight budgets, so they are a great option to explore for those seniors who have too much income to qualify for Medicaid but too little to afford a fancy big community,” says McLoughlin. “A privately owned care home may also have more flexibility as it’s not as likely there is a big corporation dictating those financial decisions.”

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How can my loved one pay for a care home?

Most families pay for personal care homes using private funds, which may include retirement savings, converted life insurance policies, or home equity. Additionally, some long-term care insurance policies can help cover residential care home costs. Veterans may also receive some financial assistance through the U.S. Department of Veterans Affairs’ Community Residential Care (CRC) program or other benefit programs for disabled veterans or spouses. It’s essential to know the financial requirements of each care home you’re considering before deciding which one to go with.

Maria Macariola, an adult care homeowner and trauma nurse in Washington state, explains that many residents with long-term care policies are fully reimbursed for their care home services. “People often forget they have this coverage,” she says.

Be sure to research what your loved one qualifies for, and don’t be afraid to ask care home administrators any questions you may have — they should be well-versed in the many forms of payment and insurance options.

For more information on payment options, visit our Complete Guide to Paying for Long-Term Care.

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Is a care home right for my loved one?

Finding the right care involves matching your loved one’s unique needs and preferences with an atmosphere and a staff that’s best equipped to assist them. Just as each senior has a unique set of requirements, each personal care home has a different environment with different offerings, so don’t get discouraged if you have to tour more than one.

Here are some things to keep in mind when searching for a residential care home.

1. Consider your parent’s personality and activity levels

McLoughlin notes that care homes may be ideal for introverted seniors, even helping them avoid feelings of isolation that they might still experience in a large community.

“Isolation and loneliness can lead to depression or even exacerbate memory issues. Where a more traditional assisted living setting could trigger anxiety, the smaller, homelike setting of a care home could be an easier transition to settle into since there are fewer people to meet and more familiar faces day after day,” says McLoughlin.

Care homes should provide activities that cater to the interests of their residents. The environment also tends to be smaller and more familial. Many activities are supported and scheduled in the home, though outings to favored places might be a popular activity as well. It often depends on the interests and comfort level of the residents.

“We have arts, crafts, and music in our adult home,” says Macariola. “On the weekends, we have a salon that comes in, and families can visit on the weekends, too.”

On the other hand, for someone who is very social and active, an elderly care home may not offer enough stimulation.

It’s usually best to ask the care home what kinds of activities and events they offer, as each elderly care home is different. Often, larger communities organize a wider range of activities for seniors, including games, events, field trips, and more.

2. Consider care needs

Since residential care homes vary greatly, it’s essential to assess the needs of the potential resident. If a person requires around-the-clock care, for example, it’s important to visit several homes to find the best combination of staffing and resources for your aging family member.

Especially for seniors who want to build close relationships with caregivers, it’s important to ask about future care needs when choosing a community.

“You don’t want to choose a community that looks like a perfect fit for who your loved one is now but doesn’t have the correct licensure to offer the appropriate amount of care as things progress,” McLoughlin says. “People are surprised to learn that something like needing more than one person to help you in and out of a wheelchair could place you outside of a community’s licensure.”

Memory care is another important care need to consider. Seniors with dementia can greatly benefit from a care home, since the caregivers have more time to connect and build relationships with the resident. This can make for a more personalized, peaceful, and overall less stressful experience for your loved one with dementia.

3. Consider licensing and safety

Researching adult care homes can be complicated, because there are no federal standards for these communities. Instead, they’re licensed at the state level and standards can vary greatly. Some states have residential care home requirements, regulations, and licensing rules, while others don’t have any. In some states, care homes and assisted living communities are licensed the same way. That’s why it’s important to do your own research before committing to any particular community.

For example, Missouri’s Department of Health and Human Services licenses residential care facilities and provides an online directory of licensed facilities for consumers. In states like these that license residential care homes, surveys of each elder care home are available at local licensing offices. Care homes in Missouri are required to provide their most recent survey upon request. However, few states have this level of oversight on care homes.

To learn more about care homes with assisted living licensure in your state, check out our Comprehensive Guide to State Regulations for Assisted Living.

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How can I find the right care home for my loved one?

Touring any type of senior care home is the best way to get an understanding of what it would be like for your loved one to live there. McLoughlin explains that while larger communities often have some amount of marketing involved, care homes are different.

“Oftentimes, the person meeting with you is the same person with a hand in the resident’s care, preparing meals and cleaning as they go,” she says.

This actually gives you an excellent window into what the caregivers in the community are like, and McLoughlin notes that many care homes go out of their way to make residents happy.

“What you can expect, however, is that they will be honored to prepare your loved one’s favorite dish, exactly according to the family recipe card that’s been handed down over generations for your loved one’s birthday, or maybe even for just next Tuesday,” she says. “You can expect this not only because of the smaller setting but because the people you find in that care home are in that setting because they have a true heart for the work they do in serving the seniors you love.”

As you consider which home is right for your loved one, you may benefit from a little extra assistance. There are many care homes across the country, though many are not on public listings and work on a referral-only basis. A Place for Mom’s local Senior Living Advisors can help you find the care homes in your area that will meet your loved one’s lifestyle preferences and budget. They’ll get to know what’s most important to you and your loved one, and take care in helping you set up tours to find a community that’s just the right fit. And, most importantly, all of this comes at no cost to you.

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Care Homes

Residential care homes are shared neighborhood homes for seniors who need a live-in caregiver to assist with activities of daily living, like dressing and bathing.

Top states for Residential Care Home

0.0
Alabama (AL)
75 facilities
6.7
Alaska (AK)
74 facilities
7.6
Arizona (AZ)
1496 facilities
0.0
Arkansas (AR)
21 facilities
7.7
California (CA)
5355 facilities
7.5
Colorado (CO)
343 facilities
0.0
Connecticut (CT)
34 facilities
0.0
Delaware (DE)
14 facilities
7.5
Florida (FL)
1733 facilities
7.3
Georgia (GA)
1177 facilities
1.0
Hawaii (HI)
63 facilities
7.6
Idaho (ID)
150 facilities
7.0
Illinois (IL)
80 facilities
0.0
Indiana (IN)
34 facilities
3.0
Iowa (IA)
28 facilities
8.5
Kansas (KS)
131 facilities
0.0
Kentucky (KY)
31 facilities
0.0
Louisiana (LA)
81 facilities
8.5
Maine (ME)
62 facilities
7.8
Maryland (MD)
449 facilities
1.0
Massachusetts (MA)
83 facilities
8.0
Michigan (MI)
943 facilities
7.1
Minnesota (MN)
215 facilities
0.0
Mississippi (MS)
55 facilities
4.8
Missouri (MO)
177 facilities
5.0
Montana (MT)
59 facilities
0.0
Nebraska (NE)
14 facilities
5.0
Nevada (NV)
107 facilities
0.0
New Hampshire (NH)
47 facilities
8.5
New Jersey (NJ)
66 facilities
6.7
New Mexico (NM)
133 facilities
7.6
New York (NY)
190 facilities
7.8
North Carolina (NC)
379 facilities
0.0
North Dakota (ND)
4 facilities
8.1
Ohio (OH)
412 facilities
6.9
Oklahoma (OK)
51 facilities
7.7
Oregon (OR)
721 facilities
8.2
Pennsylvania (PA)
241 facilities
0.0
Rhode Island (RI)
10 facilities
0.0
South Carolina (SC)
96 facilities
0.0
South Dakota (SD)
18 facilities
8.5
Tennessee (TN)
108 facilities
8.0
Texas (TX)
1021 facilities
7.1
Utah (UT)
56 facilities
8.5
Vermont (VT)
23 facilities
8.3
Virginia (VA)
209 facilities
8.0
Washington (WA)
1830 facilities
0.0
West Virginia (WV)
27 facilities
6.8
Wisconsin (WI)
413 facilities
0.0
Wyoming (WY)
6 facilities

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