If your loved one has received a diagnosis of dementia, or if they are not thriving while living at home on their own, a senior living community can provide the assistance they need in order to maintain their health and independence. However, not all senior living communities are the same. Each offers different types of assistance, support, and amenities. To make matters even more confusing, there are different names that go along with each type of care option.

If you find yourself searching for nursing home alternatives, you might run across common senior living options like assisted living, memory care, or residential care. Here is a quick primer in telling the difference between them so that you can determine what type might suit your situation best.

What is a Residential Care Facility?

Residential care facilities or senior care facilities are small private facilities, usually with 20 or fewer residents (some might house as few as three or four people) that are staffed round 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 activities such 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), senior care facility, personal care home, sheltered housing, homes for adults, domiciliary care, adult foster care, and 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 multiunit dwellings and equipped and adapted for seniors. Rooms may be private or shared, and bathrooms are usually shared as are living and dining rooms.

What Are Assisted Living Communities?

Assisted living communities offer caregiver assistance with activities of daily living, such as grooming, bathing, mobility, and medication management. Caregivers are available round the clock, and nurses oversee resident care plans and physician communication. Communities are busy and vibrant places with plenty of shared spaces for residents to connect with one another, monthly event calendars full of opportunities, and meals served in a social dining room setting.

Assisted living communities are regulated by the state and are expected to meet certain requirements and recommendations.

What Are Memory Care Communities?

For someone living with Alzheimer’s disease or another type of dementia, a memory care community can provide specialized care in a tailored environment designed to increase quality of life in the face of cognitive decline. While memory care communities can be found in skilled nursing facilities, most are located in designated areas of assisted living communities.

Memory care provides around-the-clock care from caregivers who have taken additional educational courses about dementia, along with a secured environment that ensures safety without compromising independence. Residents enjoy meals together and participate in a variety of events and activities throughout the day.

Differences Between a Residential Care Facility and an Assisted Living Community

There are some similarities between residential care facilities and assisted living communities. For example, they both offer round-the-clock caregiver assistance and three meals served daily. However, there are some significant differences that can help you make your decision as well. Here are some of the biggest differentiators between residential care facilities and assisted living communities.

Community Size

Assisted living communities tend to be larger than residential care facilities. Residents in a residential care facility often live in a furnished room either privately or semi-privately and might share a bathroom with at least one person. In contrast, residents in an assisted living community live in their own homes and choose from floor plans that often include studio, one-bedroom, and two-bedroom options. Assisted living communities also have plenty of shared space, such as homey living rooms as well as libraries, cafes, and computer or business rooms, which are not always available in smaller, cozier residential care facilities.

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

Nursing Staff and Care

As far as medical care goes, residential care facilities and assisted living communities offer caregiver support with activities of daily living. Though a senior care facility may offer medication management services as well, 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 caregivers are on-site or accessible 24 hours a day in assisted living communities. Some assisted living communities deliver on-site physical, occupational, and speech therapy as well. In addition, some assisted living communities provide a memory care neighborhood for those with dementia; this specialized area is not typically offered in a residential care setting.

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Events and Activities

When you look at recreation and leisure, residential care facilities at best provide limited activities such as 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 financially conscious, 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.

Picking the right senior care facility depends on understanding your options and then choosing a community that will provide a solution for your current situation. If dementia is part of your specific situation, choosing an assisted living memory care community will ensure your loved one is safe, comfortable, and engaged in a highly specialized environment.

Picking the right community begins with knowing the type of community that will serve your loved one best. In cases of dementia, memory care communities are the safest and most sustainable option. Learn more about memory care by downloading our free guide, Comparing Dementia Care Living Options.

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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This post was updated in November 2022.

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