Consider this common scenario that adult children find themselves in: an aging parent faces increasing health issues that force the family to realize their beloved mother or father can no longer live by themselves. Families then face a sudden problem: they cannot move the person in with them, but institutional care is not necessary. Traditional assisted living can be overly expensive and impersonal. But there is another, often overlooked option.
They are often called board and care homes, residential homes, group or adult foster homes. Regardless of the name, these adult foster homes can be an ideal solution. By providing a family-like environment, these homes blend seamlessly into local communities, and are a feasible option for the elderly who need help with daily tasks, but not the clinical care of traditional nursing homes.
A Homely Environment
Adult foster homes tend to share the common philosophy of providing a home-like environment for a small number of clients. They provide residents with round the clock supervision, food, personalized assistance, autonomy and social interaction while helping with personal care tasks like getting dressed, bathing, medication management and transportation.
The main goal is to allow residents to age in the community while avoiding costly institutional care. Residents maintain independence, often attending workshops or programs created specifically for the residents. “They can be one of the best options for some people because it’s a home-like setting. It’s like a family, there’s much more one-on-one,” said Amy Goyer, AARP family and caregiving expert and author of Juggling Work, Life, and Caregiving.
Quality and Standards
Be aware that there are no federal guidelines for adult foster homes. Licensing and certification vary by state, as do services, training and supervision.
In New York, a “family type home” serves up to four residents and is certified by the Office of Children and Family Services. However, operators caring for five or more residents must be licensed as an adult home. In Michigan, the Department of Health and Human Services licenses and regulates adult family homes, which are inspected every two years to ensure they meet basic care standards. In California, the Department of Social Services licenses adult family homes for up to six residents.
In Florida
Adult family care homes (AFCHs) are private residences that are licensed to provide housing, meals, and personal care services to older individuals and disabled adults who are unable to live independently. Unlike assisted living facilities, AFCHs are owned and operated by licensed AFCH “providers” who live with the residents they serve. AFCHs are limited to a maximum of five residents. AFCHs are intended to serve as a less costly alternative to more restrictive, institutional settings for individuals who do not need 24-hour nursing supervision.
While AFCHs are generally less expensive than other residential care facilities, the cost of an AFCH can vary based on the location, amenities, and services provided by the AFCH. Although many residents living in AFCHs pay privately, there are programs designed to assist with AFCH residency for persons who qualify. All licensed AFCHs are required to designate at least one bed for a resident receiving Optional State Supplementation.
Taking Precautions
Some adult foster homes may not be as well regulated by state agencies as larger facilities. Professionalism can vary from home to home, and staffing is sometimes an issue, specifically when residents require assistance beyond what an owner provides.
Additionally, neglect or abuse may be more difficult to spot, so it is important to speak with other residents and to check with the state ombudsman, who is the public official that investigates individuals’ complaints against maladministration, to see whether a specific home has any violations. It is advised that family members drop by unannounced from time to time, to ensure that their loved one’s needs are being met.
Looking Ahead
As the elderly population continues to increase, the need for affordable and supportive, community-based housing will also increase. That makes finding the appropriate environment for each individual so important to successful aging. “If a person doesn’t have appropriate housing, everything else is that much harder,” said Janet Hunko, director, of the Housing Bureau for Seniors at Michigan Medicine, the academic medical center of the University of Michigan. However, with the right support in place, we can reduce our reliance on institutional care.
Contact OC Estate and Elder Law at (954) 251-0332 or info@ocestatelawyers.com to find out more about elder law issues and how estate and Medicaid planning can help you maximize your life savings, while you search for a new home.
