Residential Care Home: An Alternative to Assisted Living

Seniors get personal care in a home-like setting

Assisted living communities aren’t the only housing option for an older adult who needs care. 

Another option is a residential care home, also known as a board and care home or personal care home.

These places provide care to small groups of adults over age 60. In California, 90% of these homes have 6 or fewer residents.

Residential care homes are typically located in the middle of regular residential neighborhoods because they’re usually private homes that were converted and staffed for small group living. 

We explain the type of care that a residential care home provides, how much they cost each month, and who might enjoy living in these types of senior housing.

What kind of care do residential care homes provide?

A residential care home provides a higher level of care than assisted living, but a lower level than a nursing home (aka a skilled nursing facility).

The biggest difference is that there’s more personalized care and staff attention because each home has few residents.

Each home may also offer different services. Some provide a high level of care while others focus on the basics. 

It’s important to find out from each place exactly what services they will and won’t provide.

Residential care homes typically offer:

• A single or double room (not an apartment)
• Shared bathroom
• Meals
• Housekeeping
• Personal care

Generally, most provide supervision and help with activities of daily living like:

• Bathing
• Dressing and grooming
• Moving around
• Storing and distributing medication (but not administering)
• Toileting and incontinence care

Some residential care homes may also provide:

• Some level of medical services, like giving medication
• Transportation

What’s typically not provided:

• Certain types of medical-level care, like tube feeding or treatment of open bedsores
• The level of amenities and recreational activities you'd normally find in an assisted living community

How much does it cost?

According to Genworth, residential care homes typically cost about the same as assisted living, $4,500/month on average.

However, costs will vary depending on the level of care needed, the quality of the home, and most importantly, its location.

One key difference is that a residential care home usually doesn’t accept Medicare or Medicaid.

They do accept private payment, money from VA Aid & Attendance, and long-term care insurance.

Who would enjoy living in a residential care home?

1. Seniors who dislike the larger, institutional-type living situation found in most assisted living communities
In a residential care home, your older adult can live as normal a life as they’re able. 

They can go shopping, have friends and family visit whenever they want, go for walks, dine out, etc. 

It’s a great option for those who can’t live independently, but hate the idea of being in a large institutional setting.

2. Seniors with Alzheimer’s disease or dementia
For people with Alzheimer’s disease or dementia, living in a smaller place with fewer people can reduce anxiety and stress. 

They’ll also be able to get care from a few staff members who can get to know them and their specific needs.

Related Articles:

• 7 Senior Housing Options: Which One Works Best?
• How a Senior Living Advisor Helps Find Housing
• How to Pay for Assisted Living: 6 Options

Image: AM/PM Homecare
Sources: CANHR, California Registry

About the Author

Connie Chow

Connie was a hands-on caregiver for her grandmother for 20 years. (Grandma made it to 101 years old!) She knows how challenging, overwhelming, and all-consuming caring for an older adult can be. She also knows how important support is — especially in the form of practical solutions, valuable resources, and self-care tips.