Linda Keilman is a practicing gerontological nurse since 1989 and a member of the Michigan State University College of Nursing faculty since 1992.
Linda J. Keilman, DNP, MSN, GNP-BC, FAANP Gerontology Updated: Oct 19, 2023, 5:19am Have a question we may not have answered?Ask our editors here
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While many of us envision living out our golden years with total independence and minimal health concerns, the truth is that care needs often increase with age–and can drastically change overnight. Thankfully, there are plenty of housing options with various levels of care older adults can consider, one of which is referred to as a residential care home. Read on to learn more about residential care homes, including how they function, what amenities they offer and who might benefit from living in such an environment.
A residential care home is a small cluster of homes intended for older adults who need a little help with day-to-day living, according to Kathy Quinn, a certified senior advisor and board-certified patient advocate in New York. Some residential care homes cater specifically to people with intellectual disorders or mental health issues, she adds.
“They are just like regular homes that people would live in, [but they’re] for people who are starting to have trouble living independently,” says Quinn. “You have to be mobile to live in a residential care home, but you might have trouble cooking, bathing or dressing.” While there typically isn’t 24/7 care available or a health care team onsite in a residential care home, trained aides are typically available to help residents with activities of daily living (ADLs).
Margaret Gillett, a certified senior living expert and the author of The ABCs of Aging, explains that the level of care provided at a residential care home typically exceeds that of an independent living community and is less than that of a nursing home. It’s the middle option, she says.
There are also various types of residential care homes—and other similar senior living options—which are described below.
A skilled care residential care home offers health care services that non-skilled care residential homes don’t offer, such as physical therapy, IV medicine administration and catheter care, explains Quinn.
Non-skilled care homes don’t offer onsite health care services. However, trained aides can help with tasks like dressing, oral medication administration, bathing, meal preparation and light cleaning, says Quinn. This type of living community can also be referred to as custodial care.
Independent living communities are a type of senior living option that people may come across when researching residential care homes, says Katie Krupka, a gerontologist, certified senior advisor and the director of placement and aging services at Assisted Living Locators, a nationwide network of certified senior advisors. At independent living facilities, residents must be able to care for themselves without assistance and not require help with ADLs. Often these communities host organized events for residents to enjoy on a regular basis.
Assisted living communities are designed for older adults who need help with day-to-day living but don’t need round-the-clock care, says Krupka. The living environment size is the main difference between an assisted living community and a residential care home, as assisted living communities tend to be much bigger, she notes. Often, assisted living communities have all meals prepared and available for residents and offer many organized events to keep residents socially and physically engaged.
Memory care is a type of assisted living designed to offer care for people experiencing cognitive impairment or dementia. Memory care facilities are required to have staff specifically trained in aiding people with dementia, explains Krupka.
The people who can benefit most from residential care homes are those who don’t need constant monitoring but do need help with certain daily tasks, according to experts. Residential care homes are also a good option for end-of-life care as long as a person doesn’t need constant monitoring or have health care needs like IV medicine administration, says Gillet.
In addition to knowing who might benefit from a residential care home, it’s equally important to know who wouldn’t be a good candidate. People with chronic medical conditions or functional decline often require a level of care greater than what a residential care home can offer and may not be the best fit, says Quinn. “Also, people with dementia are typically not the best fit for residential care homes,” she adds.
If you decide a residential care home is right for you or your loved one, the next step is finding a place that feels like home. Working with a certified senior advisor or placement agency may be helpful. Krupka explains that local certified senior advisors are likely familiar with the options in your area and know which ones would best suit your needs and preferences. “They can help walk the client through the process, set up tours, help with paperwork and even coordinate the moving process,” says Krupka.
Whether you’re looking into various residential care homes on your own or working with a senior advisor, there are several factors to consider.
Krupka says the first question to ask when considering a residential care home is, “Can this place meet my [or my loved one’s] level of need?” When talking to the staff, do they seem educated on how to best help? What training does the staff have?
Residential care home staff must meet certain requirements set by each state’s department of health services, explains Gillet. “These regulations typically ensure that aides are knowledgeable about medication management and can help with day-to-day activities, such as bathing or dressing. [Residential care homes] also require an evacuation plan in case of emergency,” says Gillett.
Research shows a strong tie between social connection and longevity, so activities planned by a residential care home can be a crucial consideration for the well-being of those who live there. Gillett says that residential care homes vary in terms of how many activities they offer to residents. Some popular examples of activities residential care homes offer might include game nights, craft events, music classes or exercise classes.
Is the community you’re considering close to loved ones? Are you able to get to the grocery store, your place of worship or other locales that are important to you? Do you feel most at home in an urban environment or a more natural landscape? Ask yourself these important questions when deciding where to live, experts suggest.
If the residential care home you’re considering provides meals, try a meal during a visit or official tour to see if you like it. You might also ask for a weekly or monthly meal schedule. “Food is one of the biggest things to consider, because if you don’t like the food, you probably won’t be happy there,” says Krupka.
It’s vital to consider how your or your loved one’s care needs may change in the future. Most people looking into residential care homes want this move to be their last, says Krupka. So, if you’re starting to experience memory or mobility problems, consider the type of memory care services or hands-on assistance the home offers, she advises.
Consider not only what you can afford now, but also whether the cost of the residential care home you like will be affordable in the long term, says Krupka. Quinn reiterates the importance of thinking about future needs, too. “If the residential care home can’t meet your needs and you then have to pay a nurse aid to help you, that [would be] a significant expense,” she says.
Residential care home costs can vary significantly, with options in urban areas costing more on average than those in rural areas. In general, experts agree that residential care homes are typically less expensive than assisted living communities and nursing home facilities.
Residential care homes typically cost between $3,000 and $4,000 a month, says Krupka. Again, the exact price varies depending on where you live or look. When considering a residential care home, experts agree that it’s important to ask about any hidden fees, such as one-time community fees. Typically, Quinn says that one-time community fees aren’t required at residential care homes unlike at assisted living communities where they are more common.
Some insurance plans may help cover some of the costs associated with residential care home living, specifically long-term care insurance and the Veterans Aid and Attendance benefit, which supports both veterans and their spouses.
