As we grow older, our needs change and it becomes harder to perform daily activities without assistance. For many elderly individuals, this means they require a level of care beyond what their family or friends can provide. In such cases, there are various options for elderly care including home care, ARF, RCFE, ICF, and Board & care, each with its own unique features and benefits. In this blog, we will discuss the differences between these care options.

Homecare vs. Assisted Living vs. Residential Care Home

These are the three main categories of different services/facilities that assist people with physical disabilities, mental disabilities, chronic disorders, and old age. Home care doesn’t require you to live in a facility, instead, you will stay at home and the nurse, physicians, and other workers will come to you. Assisted living facilities on the other hand consist of Adult Residential Facility (ARF), Residential Care Facility (RCFE), and Intermediate Care Facility (ICF). These facilities are 24-hour care where you stay with other patients in need. These are usually big and can accommodate more people. Lastly, Residential Care Home, also known as Board and Care offers the same as Assisted Living but is just smaller in size and can accommodate fewer people. 

Homecare

Homecare is a service in which the caregiver comes to the client's home to assist them. This type of care is appropriate for people who need only minor assistance with activities of daily living (ADLs) like bathing, dressing, grooming, and medication management. Homecare allows the elderly or disabled to stay in their own homes while receiving necessary assistance. 3 out of 4 Americans over the age of 50 prefer to stay at their current homes as long as possible, according to the American Association of Retired Persons (AARP). Caregivers for home care services are typically licensed and trained to provide basic healthcare services and may work part-time or full-time.

There are different types of Home care services and workers, these are:

1. Non-medical

   These are home care workers who help the patient with household chores, cooking food, buying groceries, etc.. They can also help the patient with their needs that they cannot do on their own like grooming,  bathing, getting dressed, and eating. They are also referred to as the “homemakers”

2. Nursing care

   this homecare worker is a qualified nurse who provides medical support and care at home for their patients. They can do medical tasks such as: monitoring vital signs, medication management, treating wounds, and other tasks that include maintaining the overall health of the patient. 

3. At-Home Physicians

   these physicians go to the patient’s home as needed or as called to regularly check the patient’s medical condition. They can also diagnose or treat any illness or injury.

4. Physical, occupational or any other type of therapy

   different therapy treatments are done to patients at home. If a patient is having trouble with their speaking abilities, a speech therapist may go to their home and help them with it. And a  physical therapist can design a treatment plan to help a patient regain or strengthen muscle and joint function.

5. Social Service -  A social services case worker may be assigned to look after a patient's wellbeing in some instances. Social service workers can give counseling and look for more community resources that the patient can use for their recovery. They basically serve as a manager who coordinates and manages the patient’s care by coordinating with other resources. 

ARF (Adult Residential Facility)

An Adult Residential Facility (ARF) is a facility that offers 24-hour care to adults who do not require medical attention. ARFs typically offer a home-like environment in which residents can live while receiving personal care services such as assistance with bathing, grooming, dressing, eating, and medication administration. In addition, they may provide housekeeping, laundry, transportation, and recreational activities.

ARFs are intended to serve adults AGES 18-59 with a wide range of needs, including those with developmental disabilities, physical disabilities, or mental health conditions. ARFs are state-licensed facilities staffed by trained caregivers who can provide basic medical care.

RCFE (Residential Care Facility for the Elderly)

A Residential Care Facility for the Elderly (RCFE) is a non-medical facility that provides services for elderly individuals who do not require medical attention, but are unable to live independently.  People aged 60 and up are served by Residential Care Facilities for the Elderly (RCFE). 

They provide room and board, as well as housekeeping, supervision, and personal care assistance with activities such as personal hygiene, dressing, eating, and walking. Medication is typically stored and distributed centrally for residents to self-administer. They also provide social activities where seniors can enjoy the company of each other. RCFEs are intended to promote independence and self-direction as much as possible in a residential setting. They provide many planned social and recreational activities for the elderly to enjoy. RCFEs follow many guidelines and regulations to ensure the safety and the betterment of service they provide. There are over 20,000 assisted living communities and 3,588 in California alone, according to assistedliving.org  

All residential care facilities are privately owned operating businesses. The cost of living in a RCFE on average is about $3,000. But it can range from $1000 for residents with  Supplemental Security Income (SSI) to $5,000 a month. The cost would be higher for people who have chronic illnesses that require special services according to their needs, or people who are on Private Pay. Sometimes there could also be pre-admission fees that cover the medical assessment of the patient, this fee can be refundable. 

ICF (Intermediate Care Facility)

An Intermediate Care Facility (ICF) is a facility that provides 24-hour care and medical services for individuals who require skilled nursing care or rehabilitation services. ICFs are intended to provide custodial care for those who are unable to care for themselves due to mental illness or deteriorating health. ICFs are typically smaller facilities that house eight to fifteen residents on average. Because ICFs are more of a rehabilitative facility they cater more to those who are mentally disabled that need daily assistance. 

You also need to pay for this service,  the cost for an ICF varies depending on insurance and needs. An ICF may be covered under Medicaid for people with intellectual disabilities who qualify. On the other hand, Medicare insurance only covers medically necessary programs, whereas an ICF focuses on custodial care. An ICF, on the other hand, will be less expensive than a nursing home and thus more affordable for many people.

Board and Care 

Board and Care homes are also known as residential facilities or “group homes”. This is a type of care option where the elderly individual lives in a private home with a caregiver who provides room, board, and personal care services. This type of care is suitable for individuals who require assistance in daily activities but do not need a skilled nurse all the time, and for those who prefer a home-like environment. Board and Care facilities are usually smaller and accommodate less than 20 people. This is good for a senior who prefers to live in a smaller setting. 

The cost of living in a Board and Care facility does not differ much from an assisted living facility, it can range between $1,500 a month to $4,500. A private room would cost more than a shared room. The cost can vary depending on some factors such as the location of the facility (it cost higher in big cities), services offered, and the needs of the patient. 

Final Thoughts

Each of these care options has its own distinct features and benefits. The individual's needs, level of care required, and personal preferences all influence the care option chosen. It is critical to thoroughly research each care option and select the one that best meets the needs of the individual.

The cost of living in these facilities can also affect the decision that will be made. There are a lot of resources and programs made available for seniors and people with disabilities. You just have to research what they are and know which one you are eligible for. We made a blog about the Different Resources Seniors Can Go to For Support, you should check that one out! 

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