When I met Jim, he was in his mid-80s and living in an independent retirement community. However, after two hospitalizations with pneumonia and his worsening chronic lung disease, it became clear to his son that his father needed more help than what he could receive from his current living environment. Jim was not happy when his son informed him that he was searching for a new home for his father. “Why can’t I just go back to where I live now?” he growled. So much for the ‘sweet man with a great sense of humor,’ I thought to myself, recalling how Jim’s daughter-in-law had described him.
Jim was weak from his recent bout of pneumonia, and given that he was using oxygen regularly, his son wanted a smaller place without the long hallways.
When I met Jim, what struck me most was his hearing loss. In a large assisted living facility, where 70-80 people gather for every meal in a big dining hall, I knew he would have a hard time hearing and making conversation. If there was a friendly person under the surface, making new friends there would be challenging. Therefore, I thought that an Adult Foster Home would be a better fit for Jim.
The history of adult foster homes
The AFH program started in Oregon in the 80s. It was one of the first in the country. Those days we didn’t have assisted living facilities or memory care, and the only option for any aging adult who needed care was a nursing home. To this day, I have clients tell me, “I promised my mom that I would never put her in a “home.” By “home,” they mean a nursing home, which as most of us know, would be quite a depressing place to spend your last days.
The AFH program was built on the concept of family taking care of their aging parents. It was also an opportunity for families, where the mother did not work outside the home, to have an additional income by taking aging adults into their home and provide them with the care they needed. There were many AFH where a family with young children lived together with the seniors who felt that they are part of the family.
Through the years, the flavor of AFH changed, and nowadays, most of them do not have a family living with the seniors, but they still have the feel of a family-like care community.
Life in an adult foster home
The AFH is a house in the community that can accommodate up to five residents who live together like roommates. Each has a private room (very few have shared rooms), shared bathroom (very few offer private bathroom), and shared common area. While meals are served at a set schedule, the residents can set their own daily schedules. They can get up at 7:00 am and have breakfast with everyone or, they can get up at 10:00 am and have breakfast by themself or just a snack before lunch. They can have a say in what will be on the weekly menu as the meals are home-cooked, they can have visitors whenever they want and decorate their room however they like.
The caregiver sleeps in the house at night and stays for three or four days at a time. Because of the size of the AFH, residents and their families tend to feel like one big family. When I owned an AFH, we used to have a big gathering on holidays, and our Christmas party was always fun with a secret Santa gift exchanged.
The benefits of living in adult foster home
- Smaller home allows better accommodations for the residents’ wants and better attention to their care needs.
- Unlike shift to shift caregivers in other care communities, the caregiver in AFH stays in the house for three or four days at a time. This schedule allows the caregiver to create more significant relationships with the residents and provide more personal care.
- For the person who is hard of hearing, it is easier to connect and have a conversation in a smaller and quieter dining or living room.
- The person whose mobility is limited, can still walk by themselves the short distances around the house, without needing to give up their independence. In a larger senior community, they will more likely need the help of a caregiver to push them in a wheelchair down the long hallway. It helps the residents keep a sense of independence and worth.
- For the person with dementia without behavior or wandering issues, the small quiet home with the personal hands-on attention can feel safe and comforting.
- Falls are common with older adults and are not always easy to prevent. But the smaller the community is, the easier it is to keep an eye on the person who keeps falling and attend to them as soon as they want to get up to help decrease the fall risk.
- If you are on a special diet, such as vegetarian or diabetic, it is easier to accommodate in an AFH.
- A small, homey environment allows the residents and their family to go through the end of life journey in an intimate, loving and caring way.
Adult foster home is not for everyone
- AFH does not provide social activities, and for the person who is a social butterfly or looking to engage in varieties of social activity, an assisted living would be a better choice.
- While there is a caregiver around the clock in the home, at night, the caregiver is asleep and is not able to provide night-time care on an ongoing basis.
- The person living with dementia can benefit from the social activities that memory care has to offer, especially the music program.
- For those who are very private and having a private bathroom is essential to them, an assisted living, where you have your apartment, may be a better option.
- If you have a dog or a cat you can’t part with, it will be harder to find AFH that would allow you to bring them with you.
- The person with a progressive disease that would result in a higher level of care than what can be provided in AFH may want to look for a senior care community that can provide all levels of care that may be needed in the future.
How would you know if adult foster home is the right choice for your loved one?
Senior care communities are not a one size fits all. When we combine our knowledge of all of the senior care communities in Lane County along with a thorough assessment of a client, we can recommend the appropriate type of senior care community.