Senior Living Versus Board and Care

Finding the right senior care community is difficult and emotional, especially when you have so many options to choose from. How do we find the “right” fit for our loved one? There are several things that need to be considered before making a choice. If you are like me, I like to analyze everything! First and foremost, it’s about listening to your loved one to see what’s important to them. Is it the dining experience, the activity program, the closet space, the outdoor living area? The list goes on. The key is to listen with your head and your heart to what your loved one finds important. While taking the needs of the family (the spouse, yourself, your siblings) into account is necessary, the primary focus should remain on what is best for the senior themselves. It is, however, good to consider having the family member who is most involved in care coordination be the one who lives closest in proximity to the senior loved one.

What are your loved one’s care needs? What specific kind of help with personal care do they need? What does each community have to offer? There is a wide array of community types, most of which are licensed the same by the state, under a RCFE (Residential Care for the Elderly) license. Residential Care for the Elderly includes assisted living communities, memory care specific assisted living and licensed personal care homes, often referred to as board and care. There is also a small segment of communities that are more retirement living focused, called independent living.

Independent Living communities typically provide supportive services such as meals, housekeeping, laundry services, scheduled transportation, activities and they include the utilities in the monthly rent. Research shows us that seniors who live an active and social life have a higher rate of satisfaction and are at a lower risk for isolation and depression. Restaurant style dining is a prime example of socialization and researchers show that we eat more calories when we eat with someone than when we eat alone.

Assisted Living communities offer a wide range of services, up to and including hospice care. Much like the independent living communities, they include all of the basic peripheral services, but assisted living places also have the added support of care staff that is hired by the community to be on site twenty-four hours a day. Three fresh shifts of caregiving staff. Caregivers can assist with activities of daily living such as dressing, bathing, grooming, medication management, special diets, etc. The goal here is to keep the resident as independent as possible for as long as possible, while helping them with those tasks they are no longer safe doing on their own. Assisted living communities encourage socialization through scheduled activities and shared spaces, ie; the dining room, the lobby, activity room, gardens, courtyards, patios, library/computer rooms, etc. A common misunderstanding about assisted living communities is that we are like a skilled nursing facility. We outsource home health services like physical and occupational therapies, and we do not have registered nurses nor physicians on site twenty-four hours a day. The advantage of living in an assisted living community is that is a much more social environment with a small medical component, versus a nursing home that it a more medical model with a small social component to it. Family members have peace of mind knowing someone can be readily available to your loved ones needs at any time of the day or night, but their loved one will still have their own private accommodation and privacy.

Memory care specific assisted living communities are equivalent to assisted living communities, but they often have a higher staff to resident ratio. They are usually on the smaller, more intimate size. Memory care communities are designed for those exhibiting a cognitive decline in memory and other functions. Most at this stage have a diagnosis of Alzheimer’s and or a related dementia. These communities have a safe and secured environment. They provide nutritious balanced meals along with monitoring for hydration. Memory care communities have a wellness team to keep and eye on any signs of an underlying health issue that may need attention. Importantly, they offer life engagement programs to stimulate each individual so that they can live a full life with their current disabilities.

Board and care or licensed personal care homes are homes in the neighborhood that have been licensed by the state to take just 5 or 6 residents at a time. They offer primarily private rooms, but some have shared rooms, too. Care homes provide the same basic amenities as assisted living communities, but just on a smaller scale. They usually cater to a more frail population, like those that need someone in closer proximity on a regular basis. The downside to a care home versus an assisted living is that they are NOT required to have an awake staff on the overnight shift. Their staff is usually sleeping at night so if your loved one needs regular interaction or redirection overnight; a care home might not be the best option.

At the end of the day, this is going to be your loved ones forever home, so it is most important that they LOVE it. As a family member, your goal should be to help make their next stage in life as comfortable, gratifying and safe as possible.