Board and Care Homes

The goal of board and care facilities is to provide housing and supportive services to individuals who are sufficiently impaired to require regular assistance with or supervision of daily tasks but are not in need of medical intervention (i.e., nursing care) on a regular basis. As with many older adults, needs at these midlevel facilities are for assistance with personal care, mobility, and supportive services, such as meals, laundry, medication management, and housekeeping.

The services provided in board and care homes, while variable across facilities, focus on helping with the daily tasks and personal care needs of residents, rather than with health care services. The range of services provided to residents is quite broad, responding both to their diverse needs (driven by both physical and cognitive impairments) and to variations among the facilities in terms of size, willingness to deal with more difficult or advanced care needs, and the fees paid for care (Morgan et al., 1995). Some homes offer a substantial range of services, while others provide a limited set at lower cost. In general, however, basic services to residents include meals, room, twenty-four-hour oversight, assistance in personal care (bathing, dressing, etc.), homemaking services, and assistance with mobility and with taking medications (Morgan et al., 1995). In addition, recreation, transportation, beautician/barber, and laundry services may be included. To the extent that homes attempt to keep residents from relocating to nursing homes, more advanced care may also be arranged, including assistance with feeding, toileting, mobility, and orientation, and even some nursing services. These services, enabling homes to keep residents and permit them to "age in place" as health declines, may be provided outside the home or by outside service providers delivering care within the board and care home.