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Adult Family Homes

When the time comes to think about senior care living options for yourself or a family member, you may consider the typical choices, either an independent living community, an assisted living community, memory care community or a skilled nursing center. You may not realize other choices are available. One such choice is an adult family home, also referred to as an adult care home, personal care home or an adult foster home, depending upon their locations across the country.

What is an Adult Family Home?

An adult family home is usually a traditionally-built home located in a residential neighborhood that has been retrofitted to provide for the needs and safety of seniors. Although some states allow homes with fewer residents to be unlicensed, most are licensed and regulated. Depending upon location and state licensing standards, an adult family home can house between two and up to 9 non-related residents.

The homes provide some essential services including room, board, assistance with activities of daily living (ADLs), personal care, laundry, social services and any supervision needed to make sure everyone is safe and well cared for.

The level of care each home provides will vary. Some are operated by nurses. Others hire nurses or licensed care staff to provide more advanced care. Still others specialize in memory care. Some provide only basic care. All residents are required to have a current client assessment and plan of care which reflects their needs and their preferences of how they prefer those needs to be met.

As previously stated, most are regulated by the state. Those that are, are inspected at least every 15 months to ensure compliance with state-mandated care standards. Adult family homeowners and staff receive training prior to contact with clients followed by mandated training to be completed annually.

Due to their smaller size, adult family homes provide a much more intimate setting than can be found in the typical senior living community which can be similar to a large apartment complex.

Some adult family homes are operated by a single person, a married couple or a family who also live in the home with the residents. Others are managed by business partners who hire employees to provide care to the residents.

Individuals as young as 18 years of age may reside in and receive care in the home; however, the age of the typical resident falls somewhere between 40 and 80 years of age. Since women live longer than men, it’s not surprising that there are more women than men residing in them as well.

Key benefits of living in an adult family home:

  • Small intimate setting with a family-oriented environment, even more so if the owners live in the home themselves.
  • Home-cooked meals served in a family-oriented setting.
  • Being in a residential neighborhood, residents have the opportunity to interact with a wider range of age groups than in a traditional senior living community. For example, a young couple with a new-born, someone with young children or a group of college students may live next door, just like in a typical residential neighborhood.
  • Costs can be lower than the traditional senior living community.
  • They are often able to cater to the needs of their clients more easily.
  • Higher levels of care are available in some homes
  • High staff to resident ratios allows for more one-on-one care.

Some adult family homes specialize in providing care to individuals with very specific needs such as dementia, mental illness or developmental disabilities. If one or more of the staff members living in the home is a licensed nurse, care requiring more extensive medical needs may be available.

Cost of Adult Family Home Care

The cost of care in an adult family home can be quite affordable, in fact, even a bit lower than the costs associated with the typical senior living community. Fees are often based on the level of care required and the type of room desired

Be sure to ask what is covered in the base monthly rate and what additional charges may be incurred. The base rate generally covers the basic services in most care homes including room and board, meals, housekeeping and laundry. Be sure to get the cost of all services in writing.

Specific care needs may have additional costs. Although each home is different, examples of these may include:

  • Transfer and mobility assistance
  • Eating assistance
  • Bathing and toileting assistance
  • Dressing assistance
  • Grooming and hygiene assistance
  • Cognitive assistance or behavior monitoring
  • Hospice care

Monthly costs range between $3,000 to $6,500 with costs varying between homes and location.

How to Pay for Adult Family Home Care

Since an adult family home is a long-term care facility, most payment methods associated with long-term care can be used. Currently, Medicare does not cover care in an adult family home; but, you have several other payment options available to you.

  • Self-pay which can eat up savings quickly.
  • As long as you meet the specified requirements and guidelines of their policies, long-term care insurance will pay for care in an adult family home. See our Long-Term Care page for a more detailed discussion concerning long-term care insurance.
  • If the home carries a Medicaid contract, Medicaid may cover long-term care in an adult family home for seniors who meet specified income eligibility requirements.
  • If you’re a homeowner who is at least 62-years-old, you may qualify for a Reverse Mortgage if you own the home outright and have a low mortgage balance. The value of your home and your age are used to determine how much you qualify for.
  • Some Life Insurance policies cover specified long-term care services and locations.
  • Some life insurance policies have Accelerated Death Benefits that can be used in the event of a terminal illness diagnosis.
  • Long-term care annuity contracts can be used.
  • Life Settlement, which is the sale of a life insurance policy to a third party, can be used to pay for the costs of long-term care. The party purchasing your life insurance policy will pay a value that exceeds the policy’s cash surrender value, but less than its face value or death benefit.
  • Eligible military veterans and their spouses may use Veterans Benefits to pay for long-term care in an adult family home.

The stipulations that are attached to these options vary. Some have age requirements/restrictions. Some require you to be healthy while others can only be used after illness has already ensued.

If you plan to pay using Medicaid, Veteran’s Benefits, long-term insurance or any other method besides private pay, be sure the home you choose accepts that method of payment.

How to Find an Adult Family Home

There are thousands of adult family homes across the United States. You can use the following options to locate an adult family home:

  • Use ElderCare Locator to find long-term care options including adult family homes. Their phone number is: 800-677- 1116
  • The Long-Term Care Ombudsman Program representative in your area may be able to help.
  • Depending upon locations across the United States, adult family homes may be referred to by other names including adult care homes, personal care homes or adult foster homes. You can do a Google search using these names to locate one near you.

Once you have narrowed your scope down to a couple homes, do your due diligence by:

  • Asking them for references from former residents and their family members. Call the references!
  • Contact the Department of Social and Health Services (DSHS) Field Manager in your geographic area to find out if any complaints have been lodged against the home.
  • Contact the Long-Term Care Ombudsman Program representative in your area and ask about the homes you are considering. Since they work to resolve problems for residents in long-term care, they are an excellent source of information.

How to Determine the Right Adult Family Home for You

Due to their small intimate nature, each home provides a unique experience. It’s important you consider your current and potential future needs as you evaluate each home.

Once you have compiled a list of possible homes, visit each one several times at varying times of the day. Visit during a mealtime to determine if the food looks appealing and to see how it is served. This can be time-consuming, but it’s very important to ensure the best decision possible.

Tour each prospective home considering not only your physical care needs but your spiritual, social and cultural needs as well. Get answers to all your questions. Some questions you might want to ask include:

  • Are they licensed and how long have they been operating?
  • How many staff are generally on shift, both during the day and during the night? Are staff members awake during the night?
  • How are family visits handled?
  • Are planned and structured activities offered during the day? What kinds of activities?
  • How is medication management handled?
  • Do steps have to be navigated to get into the home, or to access parts of the home?
  • How are dietary needs provided for? Can favorite foods/recipes be requested?
  • Is some level of nursing care provided, and how often is it available?
  • Are transportation services provided?
  • Are provisions made for your food choices and do you have pantry and/or refrigerator space to store your personal food items?
  • Are bedrooms private or shared?
  • Do they allow pets?
  • What is the policy for rate increases?
  • What amenities are within close walking distance – library, shopping, movie theater, etc?
  • Is there an area to enjoy outdoor activities such as walking/hiking, sitting or gardening?

These are just a sampling of things you may want to ask. Be sure to have your list of questions written down so you don’t forget what you want to ask, and to ensure that you ask the same questions at all the homes you are considering.

Once you move into the home, understand that you’ll have a period of adjustment. The first few weeks can be difficult until you get established and become familiar with the routines and your surroundings. Discuss any concerns you have with the administrator of the home. Sometimes what you want or need is never more than a question away; therefore, don’t be afraid to ask. Then, sit back, relax and enjoy your new home.

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