Tips for Finding the Right
Residential Board and Care
for Your Loved One.

All residential board and care homes for the elderly were created equal. By that, I mean, title 22 of the California manual of policies and procedures, which recognizes, and spells out the minimal requirements for licensing. After that, it is up to the individual to make the right choice for their parent who needs assistance with the activities of daily living. 

Tip #1 Eliminating the bad apples.

As with most industries, there are some places that cannot or will not measure up to the minimum requirements of the state. Look for the latest state inspection report issued by the department of social services, which must be posted in a conspicuous place within the home. If for any reason you can't look at it and you are still interested in the house, call department of social services community care licensing division to see if there are any major deficiencies against the home.

Tip #2 Finding the good apples.

Each county has a group of dedicated volunteers who regularly make unannounced visits to all licensed residential board and care homes. They check the cleanliness of the residents, freshness of the food supply, and talk to the residents to see if there are any problems. Long-term care ombudsmen are listed in the white pages under Ombudsman, Long Term Care. They will furnish you with a list of places in your area, which meet or exceed their expectations. Ombudsman champions the rights of the residents. They are unbiased in their choices of homes for your loved one. It is the best place to start, and the list is free.

Tips #3 At first, don't look.

When visiting a new place, resist being over or under-whelmed by the physical size and layout of the house. After all, it is the quality of care that is most important. The first impression of a house should come from your sense of smell.  A clean house with clean residents should smell clean. A perfumed or Lysol odor could be a red flag.

Tip #4 How's the grub

For elders whose physical prowesses are slowing, and their world shrinking around them, meals become one of the most important activities of the day. While your sense of smell can separate a good house from a poor house, Breakfast, lunch, dinner and snacks are the measure of a good house versus a great one. Generic brands of fruit juices and cereals may be equally nutritious, but it speaks volumes about how the owner feels about his or her residents. Canned or frozen fruits and vegetables are less labor intensive to prepare, and easily substituted for fresh. If you find fresh fruits and vegetables on the table, you are in a home that cares about quality of life issues.

Tip  #5  Who's taking care of Mom and Dad?

The care-givers that's who. These are the folks that are with Mom or Dad when they wake up, bathe, prepare/serve meals, assist with medications, clean house, do laundry, make beds, run activities, monitor physical/emotional changes and get your parent ready for bed everyday. Your first question for the owner or administrator is how many full time care-givers are there for how many residents. There is no minimum number of care-givers required in an elderly board and care home. In low-end homes, you might find an owner doubling as a care-giver along with one other person. If this is the case, you aren't using the list provided by your ombudsman. In mid range homes, expect two care-givers at all times plus an active owner who does the shopping and carts residents to doctors and dentists. A house with just two care-givers will usually lack activities, have ready made types of meals, less time for personal hygiene, and little if any personal interaction between your parent and a caregiver. It will probably be safe and secure, but run with a "warehousing " type attitude. Higher end houses maintain a one caregiver for every two residents plus an active owner. This begets a lot of one on one time, activities morning and afternoon, excursions out of house, and better preparation of meals. If you are able to afford a higher end home and your parent isn't happy there, then you are not getting what you paid for. Move to another place!

Tip  #6  Looking around.

The neighborhood, is it safe? Would you feel comfortable walking there. If not, move on. Your peace of mind is equally as important as your parent's well being. Is the house big enough to accommodate six residents plus two or three care-givers? Will his or her bedroom be large enough to bring some personal belongings and that favorite piece of furniture along? Check out the bathrooms. Residential board and care homes are only required to have one bathroom. If you are in a home without two or three bathrooms then you are in the wrong house. At least one of those bathrooms needs a walk in shower. Mom or dad might not need it now but eventually they will. Is there room outside the house to walk around in such as a wood or cement patio?  A grass backyard with stepping-stones is an accident waiting to happen. 

Tip  #7  Taking Mom or Dad to meet the folks.

With most of the legwork done, you hopefully found at least two places, which meet your expectations. Take mom or dad only to the places which you have pre-approved. Do not make an appointment this time. We know that this may make you uncomfortable, but you will be entrusting your loved one to people you have just recently met.  Does the place look and smell the same as you remembered it?  Is everyone appropriately dressed? While there, introduce your parent and engage the residents in conversation. Let mom or dad just observe unless he or she wants to join in. Ask the residents what their interests are, and what they usually do with their day. Do they ever get out of the house and how do they like living there. After visiting each one on your list, discuss each place with Mom or Dad right after leaving. 

Giving your loved one input as to his or her ideas is empowering and will make the transition so much easier for both of you. Finding the right place for your loved one can be an onerous task with many pitfalls. We hope that these tips will help to lessen the burden. A safe, comfortable, and fun place for a loved one will bring you peace of mind for the rest of their days.