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Everything You Need to Know About Residential Care Homes

Written by Merritt Whitley
9 minute readLast updated January 18, 2022

When your senior loved one begins to need regular help with their daily tasks and can no longer live alone safely, it may be time to consider senior living options. We know that this decision is a difficult one for families, but the safety of your loved one may depend on getting the proper care. Residential care homes are a great place to begin your search, especially if their needs require full-time supervision.

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Residential care homes are intended for seniors who would benefit from full-time assistance. Safety and health care needs of residents are met at these homes in a family-like environment. Homes are often tucked into neighborhoods and provide increased supervision and structure. This is a great option for seniors who enjoy a homelike atmosphere, value close relationships, and prefer a quieter lifestyle.

Just as every house on the block is different, no two residential care homes for the elderly are styled or managed the same way. Some offer vibrant activities, while others are more low-key. All residential care homes for seniors should provide high-quality housing, care services, meals, and companionship. Read on to learn more about what’s provided in elderly care homes, including the services, staffing, costs, and more.

What services are included in residential care homes?

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 include assistance with activities of daily living, which can cover all day-to-day and long-term needs of residents.

The following services can also be found at residential care homes:

  • Home-cooked meals
  • Laundry and housekeeping
  • Transportation
  • Medication administration and management
  • Planned activities, events, and outings

When you’re considering care homes — sometimes referred to as adult family homes — it’s important to note their distinct differences from other types of senior living care options.

“Adult family homes can have a higher level of care than assisted living,” says Cindy Nelson, a Senior Living Advisor at A Place for Mom. “It’s usually the next step when someone requires more supervision and attention.”

What are some other names for residential care homes?

There are many other terms used to talk about residential care homes. Depending on where you live, these homes might be called the following:

  • Elder care home
  • Purpose-built home
  • Adult family home
  • Foster care home
  • Private care home
  • Personal care home
  • Private assisted living
  • Board and care home
  • Home for the aged
  • Adult care home
  • Group home

What’s the atmosphere like in residential care homes?

“Residential care homes for the elderly are usually quieter than assisted living facilities and offer a smaller, homelike family setting for seniors,” says Nelson.

It’s important to note the differences between care homes and assisted living communities. Care home residencies are typically located in traditional neighborhood homes and are equipped to care for a small number of residents, usually between two and 10. These homes are also a good option for seniors with memory-loss-related conditions who may become overwhelmed in high-energy, larger spaces.

Each senior living option is specially designed to meet the unique needs of their residents and can vary greatly between care. Make sure to have a conversation about what your loved one is looking for and what kind of lifestyle they’d feel most comfortable in.

Is this type of care best for my senior 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 like each senior has a unique set of requirements, each home has a different environment, 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:

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1. Consider their activity levels

For someone who is very social and active, an elderly care home may not offer enough stimulation for their hobbies and interests.

“We have arts, crafts, and music in our adult home. On the weekends, we have a salon that comes in, and families can visit on the weekends, too,” says Maria Macariola, an adult care home owner and trauma nurse in Washington state.

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 social activities, including games, events, field trips, and more.

2. Consider the care needed

“Individuals in residential care homes usually have high care needs,” Nelson explains. “We usually refer families to them when someone has a high risk of falling, or if they’re getting closer to their final years of life.”

Of course, your loved one doesn’t have to be in their final years of life to benefit from a care home, but if they are, some families prefer a residential care home to specialized hospice care.

Since residential care homes vary greatly, it’s essential to assess the needs of the potential resident. If they require 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.

“Many residential care homes also cater to people with dementia,” Nelson says.

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 and less stressful experience for the resident.

3. Consider licensing and safety

Researching adult care homes can be complicated because there are no federal standards for these communities. Instead, the standards vary between states — some states have regulations and licensing rules, while others don’t have any. That’s why it’s important to do your own research before committing to any community.

For example, Missouri’s licensing for residential care facilities is provided by the Department of Health and Human Services, and a directory of licensed facilitiescan be viewed online.

In states that license residential care homes, surveys on each elder care home are available at local licensing offices. Care homes are required to provide their most recent survey if it’s requested.

“You can ask the [care home] homeowner for their recent survey results to find out if there are any citations,” Nelson says.

To learn more about care home and assisted living licensing in your state, check out our comprehensive guide to assisted living regulations.

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How much should I set aside for care home costs?

The cost of a residential care home is often half the cost of a nursing home but can vary greatly depending on the location and services offered. In some states, it’s even more affordable than an assisted living community. Although prices vary considerably across regions, residential care homes usually cost around $3,500 to $4,500 per month.

Care homes that specialize in dementia care typically range from $5,000 to $6,000 per month, as caregivers in these homes usually receive advanced training specifically for memory care. While these numbers may be daunting, various financial options may be available to many seniors and their families through insurance or veterans benefits.

How can I pay for a residential care home for my senior loved one?

Personal care homes typically require some private payment. However, some long-term care insurance policies pay for residential care home costs. Veterans may also receive some financial assistance through the U.S. Department of Veterans Affairs’ Community Residential Care (CRC) program. It’s essential to know the financial requirements of each care home you are considering before deciding which one to go with.

Macariola 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.

Medicaid health insurance is the largest public payer of long-term health care services and can help pay for long-term care for low-income people who qualify. However, some care homes don’t accept Medicaid, and Medicare doesn’t typically pay for care home fees.

Be sure to research what you qualify for, and don’t be afraid to ask care home administrators any questions you may have — they should be well-versed in the many payment and insurance options. Find out all the facts about payment options to make your loved one’s transition into a care home as stress-free as possible.

What is staffing like in residential care homes?

A care home’s family-like atmosphere is fostered by a high staff-to-resident ratio, which means there are more staff available to residents at any given time than other senior care types. The staff-to-resident ratio is typically higher in residential care homes than in nursing homes or assisted living communities. The staff-to-resident ratio varies in care homes but can range from 1-to-3 to 1-to-6. This ratio enables residents to get more quality attention from caregivers.

There are basic educational requirements for caregivers at these homes, according to Macariola. They must be a certified nursing assistant and health care aid. The National Council of State Boards of Nursing (NCSBN) provides a state-based directory of nurse aid registries.

You can check within your state to ensure that the caregivers’ certifications at the home you are considering are complete and valid. Keep in mind that each state is different, and some states require more training to become certified.

Explore senior living options near you

There are many different types of senior living communities and care types available depending on your loved one’s needs. Contact one of our Senior Living Advisors to schedule tours, ask questions, and find more senior living resources in your area.


Meet the Author
Merritt Whitley

Merritt Whitley is a creative copywriter at A Place for Mom. She has written for senior audiences for about six years and specializes in health, finance, and lifestyle content. Merritt has managed multiple print publications, social media channels, and blogs. She earned a bachelor’s degree from Eastern Illinois University, where she focused on journalism, advertising, and public relations.

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