Assisted Living vs. Board and Care Homes: What’s the Difference?

When an aging loved one transitions from living independently to long-term care, it’s often a choice between an assisted living community or a board and care home.

There’s no accepted, nationwide definition for board and care homes, but the basic difference is size. Assisted living communities have more residents, and board and care homes have fewer residents. Both living options provide similar services, but your loved one may be better suited to one option over the other.

Let’s take a closer look at each of these types of senior living.

What is assisted living?

Assisted living is ideal for seniors who need help with some activities of daily living (ADLs) but are interested in leading a social, active lifestyle.

More like inclusive hotels for retirees, assisted living communities may offer:

• Suites with mini-kitchens, or larger apartments that allow couples to age together
• Help with laundry, housekeeping, and activities of daily living — like medication management, bathing, and grooming — that seniors may have difficulty with
• Restaurant-style dining, happy hours, and activities based on resident interest
• Outings and transportation to local stores, theaters, and museums

It’s important to remember that assisted living communities often have health standards for admitting new residents. This means that for a resident to join, they’d perhaps have to be able to feed themselves independently or move from a bed to a wheelchair without assistance.

When is assisted living the right fit for a loved one?

Assisted living may be the right choice for seniors who:

• Need minor nursing assistance or medication but don’t require full-time medical care
• Are looking for new friends or social activities
• Want more amenities, activities, and recreational opportunities than what a board and care home would offer
• Are currently in good health but know they’ll need more help soon
• Need help with daily activities like dressing and bathing
• Want a maintenance-free lifestyle without lawn care or home repairs
• Would prefer an active life but don’t have access to transportation

How much does assisted living cost?

The median cost of assisted living was $4,051 a month in the United States in 2019.

Assisted living costs depend on a number of factors:

• Type of residence
• Size of apartment (studio or a one- or two-bedroom apartment)
• Types of services needed
• Amenities offered (More expensive communities might include beauty salons, massage therapy, or private dining.)
• Which state the community is in (States in the Northeast usually are more expensive than those in the Midwest and Southeast.)

Assisted living communities often charge a flat rate that covers many basic services, with additional fees for special services.

What are board and care homes?

Board and care homes are houses in residential neighborhoods that are equipped, adapted, and staffed to care for a small number of residents, usually between two and 10.

These homes provide comparable care to what’s offered at assisted living communities but usually less than what a nursing home provides. This means board and care homes can help with daily routines but typically don’t provide 24-hour skilled nursing assistance.

Caregivers at board and care homes prepare two or three home-cooked meals a day for residents and typically help with activities such as:

• Mobility
• Health condition monitoring
• Grooming and hygiene
• Medication management
• Toileting

Like assisted living, board and care homes are licensed by individual states.

Group home and other names for board and care homes

People use several other terms to refer to the board and care concept, including:

• Residential care home
• Adult family care home
• Group home
• Senior group home
• Adult foster care home
• Personal care home

In some regions, one of these terms is more popular than the others. In California, “board and care home” is a common term, while in North Carolina you may hear “group home.” But don’t let all these names confuse you — they’re essentially the same concept.

When is a board and care home the right fit for a loved one?

Board and care homes may be a better fit for elderly loved ones who:

• Prefer a cozy, intimate, and homelike environment
• Need some help with everyday tasks like dressing and bathing but don’t need 24-hour skilled care
• Want a home with fewer residents, which allows for more interaction and attention from staff
• Would enjoy a relaxed, unstructured environment
• Want the privacy of a bedroom without all the responsibilities of an entire apartment, like housekeeping

How much does a board and care home cost?

The cost of living in a board and care home depends largely on location. Because the homes are private residences, cost is tied to real estate value.

Prices vary vastly, so a board and care home could cost anywhere from $1,500 to $4,500 a month. In a more expensive state like California, the monthly cost might be as much as $10,000.

Cost also depends on:

• Room privacy (A shared room costs less than a private room.)
• The type of services offered (Some charge $5,000 to $6,000 a month, but these are typically homes that specialize in dementia care.)

How do I learn more about senior living options?

Senior living choices have expanded as the needs and expectations of older adults have changed over the past several decades. Figuring out the best option for your loved one’s needs is crucial for keeping them healthy, active, and safe. At no cost, our Senior Living Advisors can guide you through all the senior living options and help you find the right fit for your family.