What is a board & care home?

When a loved one can no longer live independently, there are many options for residential care programs. One option is a board and care home that offers non-medical custodial care in a private residential home.

There is no one size-fits-all residential care program and the choices can be confusing and overwhelming. Long Beach-based Premiere Cottages Owner Jose Umana and Administrator Elsa Roman say that families must weigh both the residents’ needs and interests against the different options to find the best residential home care for them. There are some specific features that set board and care homes, like the five run by Premiere Cottage in Long Beach, apart from other residential care facilities, they say.

“Our board and care homes are not medical facilities — they are houses in residential neighborhoods that serve as home to no more than six residents at a time,” Umana says. “Like larger residential care communities, Premiere Cottages and other board and care homes usually offer activities for residents, but that’s where the similarities end.”

Three Ways Board & Care Homes are Different

Umana and Roman say board and care homes are different from other retirement or assisted living facilities in three main ways:

1. An Intimate Approach to Care

With a three-to-one ratio of caregivers to residents at Premiere Cottages’ homes, the caregivers and residents form close relationships. “Each home becomes its own family unit with the caregivers and residents each getting to know each other well,” Roman says. “They’ll use nicknames with each other and create meaningful bonds.”

As the residents often rely on the caregivers for assistance with everything from showering to getting dressed, building trust with their caregivers makes accepting help easier for most residents, Umana observes. Many of Premiere Cottages’ residents were referred from larger facilities because it was clear the resident needs that intimate level of attention and care, he says.

An intimate approach to care is even more important for residents with a dementia diagnosis, as those who suffer from the disease have a harder time establishing trust and thrive with consistency and environments that don’t overstimulate them. Premiere Cottages staffs its homes with same caregivers on a weekly basis to help build those trusted relationships.

2. Tailored Activities

Residents have a lot of say in the activities — and even the meals — that they participate in because there are so few of them. Premiere Cottages plans activities, outings and entertainment, but residents’ requests are often included in the planning. “We have pizza making, gardening and arts and crafts,” Roman says, adding: “Many of the residents enjoy cooking and baking and we ask for their input on the shopping list so they can have what they prefer.”

Not all board and care facilities offer activities from outside vendors, but it is a perk that Premiere Cottages provides to residents. Enriching activities, outings and entertainment, Umana and Roman say, keep with Premiere Cottage’s mission statement “To create a home that fosters wellness, independence, dignity, and quality of life for each resident”

3. The Right Home for Each Resident

Premiere Cottages residents are on a wide spectrum of acuity levels and medical needs, Roman says. When evaluating which home to place a new resident, Umana and Roman work closely with the families so that the resident is with housemates and caregivers who will help them thrive. “We want to know if the incoming resident is social, mobile or has issues related to speech or memory so we can be sure their new home is the right fit,” he adds.

“We do whatever we can to ensure the new resident fits in with their housemates, and it’s really lovely to see their friendships form,” Roman says. She recalls when one house was filled entirely with men who previously served in law enforcement, fire departments and the military. They shared stories over meals and understood and supported each other, Roman adds.

Moving from independent living to any kind of residential care setting is a big adjustment, and Roman cautions that it can take several weeks until a new resident feels settled. Working with the families and drafting extensive care plans helps set everyone’s expectations realistically. While it can be a hard decision to move a parent or grandparent to a board and care home, families find that the peace of mind that comes with their loved one receiving trusted care relieves everyone’s stress and tension, Roman says. Families can then spend quality time with elderly family members minus the feelings of frustration or burden that can come with caring for them.

When searching for a care facility, it’s important to ensure that the facilities being considered are licensed and are in good standing. Residential Care Facilities are licensed by the California Department of Social Services, Community Care Licensing Division.

Premiere Cottages began in 2014 and continues to grow. Umana and Roman, who were both raised by their respective grandparents, work hard to make the houses “homes.” One way Premiere Cottages accomplishes that goal is through a unique model where the caregivers don’t live in the house. This has the double advantage of employees returning to their own homes at the end of a shift to recharge and for the homes to be staffed with caregivers who remain awake overnight. Umana and Roman are proud of the low staff turnover and high level of care and enjoy providing welcoming, safe and comfortable environments to Long Beach residents.

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