First, what is an RCFE and why would I ever want or need one? RCFE is short for Residential Care Facilities for the Elderly. These non-medical facilities are commonly referred to as Assisted Living Facilities and Board and Cares. In addition to housing, meals, support with activities of daily living (ADLs) and recreation, many RCFEs provide specialized care for residents with cognitive issues.
Most RCFEs do not have Doctors , RNs or LVNs on staff and do not perform any skilled medical procedures such as injections. There are more than 8000 residential care homes in CA. Approximately 90 percent of these are licensed for 6 or fewer residents and are largely located in homes in residential neighborhoods. These are frequently called board and cares or 6-beds.
Residential care facilities operate under Community Care Licensing, a Agency of the California Department of Social Services. This differs from skilled nursing facilities which operate under the California Department of Public Health (CDPH).
One of the most important factors to be considered is the cost of residential care facilities particularly compared to remaining in your own house with home care services. There is a large range of assisted living costs in California depending on the location, amenities and services of the home. They range from $33 to $300 daily. The monthly average is $3750 ranging from $987 to $9000. The mean annual cost is approximately $45,000 compared to the national mean of $42,000.
The above costs are the floor in large assisted facilities’ billing. Additional care such as medication management, incontinence care, help with showering and toileting and mobility assistance are added to your charges. A friend in a local assisted living adds about $2000 to her cost for these “extras” each month. These additional fees are generally much smaller in the small 6-bed as they are considered part of the regular care.
How about staying in your house with in-home care? A lot cheaper? You need to add the $26 average hourly rate for a caregiver in California to all of your other expenses such as mortgage or rent, property taxes, utilities, insurance, maintenance, lawn care, etc.
A growing issue has been providing care for seniors with Alzheimers or other forms of dementia. Caring for a spouse with dementia can be manageable in the beginning stages but become mentally and physically exhausting as it progresses. Sometimes it becomes necessary to find a suitable facility for the person suffering with dementia.
The small 6 bed RCFEs can be ideal because there is close supervision and fewer residents and staff members to deal with which lowers anxiety. The drawback however is that the large majority of these homes have no or limited activities which can be a negative for active or agitated residents.
Many large assisted facilities include a memory unit or occasionally several levels of memory units. These areas are generally restricted for access and egress. Their residents are exposed to a large group of others with dementia and to a larger staff which can add to their stress. They generally get to participate in the many activities and entertainment opportunities in the large facility.
When a senior and family members recognize that living alone is no longer a safe and healthy option, residential care facilities can be a relatively cost effective and successful solution. Seniors who still drive can usually keep their cars and continue their regular life routines. If not, the facility provides transportation generally on a pre-scheduled basis. Residents can come and go as they want with friends or family.
Quality of facilities and care varies greatly. It is very important that each home considered is thoroughly researched. The Long Term Care Ombudsman Program in your county is a wonderful resource and many do pre-placement counseling. In California you can call the State Long Term Care Ombudsman Program Office at 1-916-419-7510.
It is never possible to learn everything about a RCFE before moving in, but the research can make the difference between a happy resident and the need for a quick second move. Everyday Health magazine suggests the following strategies to ensure a good match and a smooth transition: Get to know the staff before deciding; see how management works with the residents (is there a regular resident council?); maintain family and friend relationships including frequent visits; take advantage of the many opportunities to socialize, make new friends and stay active, and do not be afraid to speak up when issues arise.
Leaving your home for any type of care facility is not an easy transition. It will be smoother however with advance planning and acceptance of the move by the resident.