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What is an RCFE? Board and Care

We finally get to the last (but not least, except maybe in size) option under the banner, RCFE. A Board and Care is a residential home that has been licensed by the California Department of Social Services to house and provide non-medical care for six elderly residents. These homes are one of the best values in the long-term care world.

Besides being small, are there other features that distinguish the care of a Board and Care home? Well for starters, it’s a little bit like the cousin it sounds like, “Room and Board.” A boarding house conjures up images of a sweet widow in her sixties renting out a few of her spare rooms to some local college students, with breakfast included.

A Board and Care is often a home that is occupied by a nice family or caregivers who live in the home. In addition to providing room and board, these homes also provide assistance for elderly who are losing their independence and require care.

A huge benefit to the Board and Care model is that it is usually family based. That means that they very often are “contract” employees and usually are paid by the day. This kind of arrangement is significantly less expensive to the family that owns the home, and there is a very real savings to the residence of the home. Another plus is the home environment. Residents of a Board and Care are literally living in a home (often with a family). There are many people who enjoy the experience that kind of arrangement would foster.

The big downsides to the Board and Care model are tied to its upsides. Because the staff is live-in or on 24 hour shifts, it makes consistent service very challenging. The caregiver is on shift for 16 hours and is legally supposed to be sleeping eight hours at night. During the night time, they are available for only true emergencies (e.g. fire), and that makes the night time a large risk factor for the residence of a Board and Care.

Serving six needy elderly residents is difficult for eight hours. It’s hard to imagine the state of someone who needs to do it over and over for 16 or more hours every day. The burn-out factor creates huge grey areas of care and service in the Board and Care model.

Board and Care is a great option for people who have a limited budget. You can’t even get a good hotel for $100 a night. But a Board and Care, which provides a room, food and personal care will often be as low or sometimes lower than $100 a day. Board and Care is also a great option for people who have limited care needs. Anyone who needs attention at night, or more than a “one person assist” will usually need to look beyond the Board and Care option. For a Board and Care to stay affordable and manageable for the families who run them, they cannot offer extensive care for very needy residents.

With the masses of elderly needing care, and even more on the way, Board and Care homes provide a very real and tangible service to our society. There are so many people that would be without options, if not for the wonderful option that Board and Care homes provide.

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