Long gone are the days when a nursing home was the only choice for an elderly parent no longer able to live at home. These days there is an array of senior living options on hand, including one alternative to nursing care that we take a closer look at: the residential care facility.  

What is a Residential Care Facility?

Residential care facilities are small private facilities, usually with 20 or fewer residents (some places might house as few as three or four people) that are staffed around the clock, delivering non-institutional home-based services to seniors who do not need 24- hour nursing care. In addition to providing meals, these facilities offer personal care assistance with such activities as grooming and toileting.

Keep in mind that the name for a residential care facility can vary depending on the state -- the term “board and care home” is often used in California, for example. Other names include: residential care for the elderly (RCFE), personal care home, sheltered housing, homes for adults, domiciliary care, adult foster care or senior group home. (Although some states broadly define residential care to include assisted living and there isn't always a noticeable regulatory difference between the two types of housing, we consider an assisted living community to be a distinct form of senior living.)

Many residential care facilities were once single-family residences located in suburban neighborhoods that were converted into multi-unit dwellings and equipped and adapted for seniors. Rooms may be private or shared, and bathrooms are usually shared as are living and dining rooms. By contrast, assisted living communities tend to be larger than residential care facilities, and residents are often housed in apartments decorated with their own furniture and often featuring kitchenettes. Bathrooms are private, of course. Assisted living communities also have plenty of shared space, such as homey living rooms as well as libraries, cafes, and computer or business rooms.

For a more detailed explanation on what assisted living is, read our What is Assisted Living guide.

No Nursing Staff

As far as medical care goes, residential care facilities may offer residents medication management as well as help scheduling and keeping medical appointments, but they do not typically keep nurses or certified nursing assistants on staff. On the contrary, assisted living residences hire licensed nurses who oversee resident care and complete comprehensive, tailored assessments for each resident. Nurses and certified nursing assistants are onsite or accessible 24 hours a day and some communities deliver on-site physical, occupational and speech therapy. As well, health care professionals, such as podiatrists or geriatricians, often visit these communities and transportation services can be provided for off-site appointments. In addition, some assisted living communities provide a memory care wing for those with dementia or other cognitive problems while others dedicate the entire community to providing memory care.

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Limited Recreational Activities

When you look at recreation and leisure, at best residential care facilities provide limited activities like bingo games or movie nights, or use community resources such as adult day care programs for their residents. Assisted living communities, however, truly shine in this area (think musical shows, happy hours, arts and crafts classes, and planned day trips to local museums and galleries!). In addition to strong recreational programs, these communities typically offer exercise and wellness programs and some deliver walking trails, fitness centers and even swimming pools. Assisted living residents may have on-site access to such amenities as hair salons or concierge services and most offer housekeeping and laundry services.  

If you are cash-strapped, price might be the most important factor when it comes to senior living. If that is the case, recognize that a residential care facility is likely to be a less expensive alternative than an assisted living community (which in turn is often less costly than a nursing home). On the other hand, bear in mind that senior living is one of the most important choices you can make -- sometimes the extra cost is worth it for a comfortable stress-free lifestyle that would allow your loved one to stay healthy and active well into their senior years.

Are you looking for assisted living options due to concerns about Alzheimer's disease or another form of dementia? Download our free guide to understanding dementia and Alzheimer's and get answers to your questions today.

Frequently Asked Questions

What is residential care?

Depending on the state you live in, residential care can be an alternative to assisted living. Residential care homes are often much smaller than assisted living communities, serving 4-10 residents in an intimate, homelike setting.

What's the difference between nursing care and residential care?

Skilled nursing care is provided by qualified and licensed medical professionals, such as nurses or therapists. Skilled nursing communities have these professionals serving residents around the clock. In contrast, residential care provides caregiver support but does not provide skilled care services, such as wound management or IV management.

What should I look for in residential care?

When searching for residential care, look for a community that has the type of room that would serve you best. Not all rooms are private, for example. You should also look for a community that meets your budget and that offers the type of caregiver support you need to be safe, comfortable, and healthy.

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