Board & care homes (B&C) offer the same types of services as the larger communities, but service is provided in a small residential setting. The intimate setting afforded by board and care homes allows for closer oversight of residents and is accompanied by a higher staff-to-resident ratio. They share the same Residential Care Facilities for the Elderly (RCFE) license as the bigger buildings. Both are regulated and monitored by the Minnesota Department of Health.
In Minnesota, board and care homes operate in residential neighborhoods and generally have a limit of six residents. Some operators convert existing houses into B&C homes. Others are purpose-built. Driving down the street, you probably would not know that a house is operating as a board and care provider. From the outside, the home looks just like any other on the street, except of course, for the ADA-compliant entrances and walkways.
Board and care homes range from three to six bedrooms, offering both private and shared rooms. Not all houses have private bathrooms. Rooms with private baths can be more expensive and often depend on whether the house was purpose-built or a retrofit of an existing structure.
The benefit of a B&C is the small size and higher staff ratio. In Minneapolis, the good homes have at least two caregivers for every six residents. A more fragile resident or one needing close 24-hour supervision benefits from this type of environment since it provides the closest thing to having a private caregiver without the cost.
Houses have different arrangements for staffing. There seems to be an equal split of B&C homes with on-site live-in caregivers and those that have caregivers working in shifts. In a few instances, the owners of the home live on the premises and have designated certain rooms for the care of residents, perhaps using the downstairs for the residents and maintaining their own quarters on the second floor.
Many seniors, as they age and have increasing needs, require help with what is known as Activities of Daily Life (ADLs). ADLs include:
Personal hygiene – bathing/showering, and grooming
Dressing – choosing clothes and physically dressing and undressing oneself
Eating – the ability to eat independently
Maintaining continence – being able to mentally and physically use the toilet. This includes the ability to get on and off and clean oneself
Transferring – being able to stand from a sitting position, as well as get in and out of bed
Mobility – the ability to walk independently from one location to another
Medication Management – ordering, managing, and ingesting medications on a schedule independently
Assistance with ADLs can be performed by caregivers or CNAs. It does not require a skilled professional such as a nurse or doctor. Seniors who need this type of custodial care for their ADLs usually do best in a home-like assisted living environment rather than in a medical-style nursing facility. Those whose needs may require round-the-clock, 24-hour supervision often find that a board and care style of assisted living in Minneapolis may be most suited to their needs.
