Adult Foster Care Homes

Adult Care Homes have been described using many terms. Other states use such terms as “Boarding Homes” or “Room and Board”, “Residential Care”. “Assisted Living”, “Personal Care Homes”, or “Adult Family Homes”. In Oregon, a pioneer for providing seniors with alternatives to nursing home care, the term most often used is Adult Foster Care, although more and more often you will simply see the term “Adult Care Home” or “Adult Family Care Home”.

By whatever name the system is called, there are a wide variety of services available for your loved one in a home-like setting. Adult Care homes are generally homes located in residential neighborhoods that have been upgraded to standards set by the State and County to meet the care needs, specifically, of the elderly. An Adult Care Home is a private residence, where residents are able to retain their dignity and privacy in a comfortable family-like setting, while receiving personalized, individual care until end of life.

Not all Adult Care homes are created equal. There are as many, if not more, specialized AFC homes as there are physicians. Each home is set up with distinctive variations. Some homes may care for women, or only men; others specialize in Alzheimer’s care, or will only accept those that are ambulatory (without wheelchairs) or some will only accept those that are private pay. Few welcome small pets, some offer a covered area for smokers.

Each home is Unique. Adult Care Homes have many faces.  You may drive by some homes in your neighborhood and not be able to tell that they are indeed an Adult Care Home. Although, they blend in with the rest of the neighboring homes, they have been modified with additional rooms, or baths, and appropriate safety features. Other homes have been specifically built as Adult Care Homes with private rooms including private baths or a half-bath, a living room, dining area, outside patios or decks.  The owners/caregivers live within the home in separate living quarters.  Most homes offer cable at no cost.

Each home has its own personality. Homes will take on the persona of the other residents as well as the personality of the caregivers or owners. Assessing that personality is generally almost more important for appropriate matching than location.

Adult Family Homes are required in Oregon to be licensed according to the level of care a provider is allowed to provide – either as a Level 1, 2 or 3. Oregon requires this community-based type of care to follow strict guidelines for operation. All caregivers and home providers must have a certain level of training and experience in the care of seniors – the licensing level of the home dictates the level of experience required.

Continuing Education of Caregivers and Providers is required.   Several hours of training classes are required annually to qualify for re-licensing. Visits to each Adult Care Homes are made by the licensing staff on a regular basis to assure these high standards are maintained. Complaint records are often available on local county levels and now on-line for the consumer to inspect.

The cost of care in an Adult Care Home should be care-based. Providing 24 hour, 7 day a week care for a senior is never easy work. In many cases the provider is required not only to provide quality care for the senior, but at the same time fill the home with a pleasant atmosphere, provide appetizing nutritious meals, keep the home sanitary and clean, motivate the seniors to keep as active as possible, and on top of all that make time for the seniors’ families along with their own; in other words, providing care is hard work.  Private pay residents on the average in the Multnomah, Clackamas or Washington Counties have a base rate of $4500 plus additional for heavier care needs. Costs vary from from city to city and even from one neighborhood to another. Adult Care Homes can also be found in rural areas on acreage.

The fee is negotiated by the client or their representative and the provider. In Oregon, the fee can be raised, if a 30 day written notice is given detailing the reason for the increased costs, such as increased care. In general, costs not covered by the monthly fee: private phone line, medications, transportation to doctors, church or social outings, and incontinence supplies.

Remember, Appropriate Matching is Extremely Important when choosing an Adult Care setting. Be sure to visit several homes and follow your gut feelings as well. Repeat visits can aid in accurate judgments regarding your final decision for placement. During your visit, you may want to observe the following:

  • Does the provider enjoy talking to and relating to the residents?
  • How do residents respond?
  • Does the provider encourage you to talk freely, ask questions, and speak to other residents?
  • Does the provider welcome suggestions from family members?
  • Are the other residents an appropriate match for your loved one?
  • Are the residents treated with dignity and respect?
  • Does the provider seem to be organized?