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Fortunately, there is an option that can serve as a compromise between the two, and this is in the form of board and care homes. Over one-third of all board and care residents self-report poor or fair health. As shown in Exhibit 6-6, the most prevalent health problem was arthritis/rheumatism, reported by 42 percent of residents. High blood pressure , diabetes , and asthma, emphysema, or chronic bronchitis were other frequently mentioned health conditions. Overall, residents reported an average of one and one-half health conditions.
Some of this increase in the average age of residents appears to be attributable to the aging-in-place of persons with psychiatric disorders. Although nearly a third of the residents reported having a mental, emotional, or nervous condition, and 11 percent had a diagnosis of mental retardation/developmental disabilities, only 22 percent of the residents were age 18 to 64. More than half of the direct care operators reported working around the clock with an additional 9 percent working more than 60 hours per week (Exhibit 5-7).
Deciding On What Board And Care Home Is Right For You
Sixteen percent of the residents used antidepressants, while slightly fewer, 14 percent, used anxiolytics, sedatives, or hypnotics. Half of the residents who used psychotropic drugs did not use mental health services in the previous year; one-fourth of these users had no psychiatric history. Although 28 percent of the operators of small facilities reported earning less than $15,000 annually, only 7 percent of operators of large facilities reported this salary (Exhibit 5-13). However, more operators of small facilities than large facilities reported incomes greater than $75,000 annually (12 vs. 2 percent). About one-fourth of direct care operators were also licensed nurses.
Only half of the staff members in board and care homes who gave shots were LVNs or LPNs, and another one-fifth were RNs. Over one-fourth of the staff members in board and care homes who gave shots were not licensed nurses . More than two-thirds of the direct care operators of large board and care homes received their training from a school or State agency only as opposed to 36 percent of the operators of small board and care homes.
2 Training and Experience
Just like each house in a certain neighborhood is different, senior board and care homes are very different from each other, too. Some homes are simple and offer the most basic amenities, while others are more luxurious. Originally, board and care homes were run by individuals or families who also lived on the premises, and were closely involved with the day to day care of the residents living in the house. Over the years, however, there has been a shift in the kind of ownership as there are now many corporate run facilities that employ caregivers 24/7. Consistent with this finding is the fact that licensed home residents were more likely to have Medicaid coverage and to be SSI recipients than were those in unlicensed homes, regardless of size.
Also, with a smaller home, you will still have a smaller staff to resident ratio. Having fewer people to keep track of and monitor can be a benefit. Staff can notice changes or problems and act on them, whereas in assisted living, someone can get lost in the crowd. It may be a potentially less traumatic move since your loved one is moving from one home to another, so the adjustment may not be as intense. In most cases, board and care will be less expensive than assisted living.
How To Find Board And Care Homes
Although the occupancy rates were similar, we found that the average monthly revenue per resident in licensed extensively regulated homes was over $300 higher than in licensed homes in States with limited regulations. In particular, licensed small and medium homes had significantly higher average per-resident monthly revenue than did comparably sized unlicensed homes (Exhibit 3-4). We developed an operational definition for an eligible unlicensed board and care home that we used across the States.
Further, 45 percent of the residents received assistance from another person with bathing. Approximately 20 percent received assistance with dressing, with over one-third of these receiving extensive help or being totally dependent on others do dress them. Nearly 20 percent of the residents received help from another person with two or more activities of daily living .
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In addition, if the board and care is in a residential neighborhood, it can feel more like home and provide a sense of belonging. All of these additional services in assisted living come with a cost. A base price is a monthly fee for renting the apartment and includes amenities such as meals, activities, cleaning, and transportation. Some places have tiers of care, depending on how many hours of help you need each month. RCFEs operate as a bridge for those who require some level of assistance that prevents them from living on their own but who do not require 24-hour medical care, service, or supervision.
Moreover, while there is “overlap” between board and care homes and these two other modalities at either end of the continuum, it is apparent that board and care homes provide a distinct service. To determine staff knowledge about basic care and medications monitoring, we presented four scenarios describing changes in a resident’s condition or a resident’s reaction to medication. We also asked staff about monitoring residents on specific medications and what side-effects to watch for.
Large facilities employed more white staff members than small facilities (72 vs. 53 percent), while small facilities employed more Asians or Pacific Islanders than large facilities (18 vs. 3 percent). However, African Americans and Asian Americans made up a significant percentage of the operators, 21 and 14 percent, respectively (Exhibit 4-1). The demographic profiles of operators in licensed and unlicensed facilities were virtually the same. It seems clear that board and care homes do, in fact, fit in the “niche” between residential settings with few services and nursing homes.
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