Assisted Living vs. Board and Care Homes for Seniors: What’s the Difference?

Robert Shipman • July 1, 2019

When an aging loved one transitions from living independently to long-term care, it’s often a choice between an assisted living community or a board and care home.


While there’s no clear, nationwide definition for board and care homes like there is for assisted living communities, the main difference between the two is size. Assisted living communities typically have more residents, while board and care homes for seniors have fewer residents. Both living options provide similar services, but your loved one may be better suited to one option over the other. Like assisted living, board and care homes are licensed by individual states.


Let’s take a closer look at each of these types of senior living.


What is assisted living?


Assisted living provides long-term housing and care for seniors. It is ideal for seniors who need help with some activities of daily living (ADLs) but are interested in leading a social, active lifestyle. Keep in mind that both assisted living and board and care homes offer less care than nursing homes.

More like inclusive hotels for retirees, assisted living communities may offer the following:


  • Suites with mini-kitchens, or larger apartments that allow couples to age together
  • Help with laundry, housekeeping, and activities of daily living— such as bathing and grooming — that seniors may have difficulty with
  • Restaurant-style dining, happy hours, and activities based on resident interest
  • Outings and transportation to local stores, theaters, and museums


It’s important to remember that assisted living communities often have health standards for admitting new residents. This means that for a resident to join, they’d perhaps have to be able to feed themselves independently or move from a bed to a wheelchair without assistance.


When is assisted living the right fit for a loved one?


Assisted living may be the right choice for seniors who:


  • Need minor help from nursing staff or assistance taking medications but don’t require full-time medical care
  • Are looking for new friends or social activities
  • Want more amenities, activities, and recreational opportunities than what a board and care home would offer
  • Are currently in good health but know they’ll need more help soon
  • Need help with daily living activities, such as dressing and bathing
  • Want a maintenance-free lifestyle without lawn care or home repairs
  • Would prefer an active life but don’t have access to transportation

What are board and care homes?


Board and care homes are houses in residential neighborhoods that are equipped, adapted, and staffed to care for a small number of residents, usually between two and 10.


These homes provide comparable care to what’s offered at assisted living communities, but still usually less than what a nursing home provides. This means board and care homes can help with daily routines, but typically don’t provide 24-hour skilled nursing assistance.


Caregivers at board and care homes prepare two or three home-cooked meals a day for residents and typically help with activities such as:


  • Mobility
  • Health condition monitoring
  • Grooming and hygiene
  • Medication management
  • Toileting


Group home and other names for board and care homes


Board and care homes may be referred to as:


  • Residential care home
  • Adult family care home
  • Group home
  • Senior group home
  • Adult foster care home
  • Personal care home


In some regions, one term is more popular than the others. In California, “board and care home” is a common term, while in North Carolina, you may hear “group home.” But don’t let all these names confuse you — they’re essentially the same concept.


When is a board and care home the right fit for a loved one?


Board and care homes for seniors may be a better fit for loved ones who:


  • Prefer a cozy, intimate, and homelike environment
  • Need some help with everyday tasks, such as dressing and bathing, but don’t need 24-hour skilled care
  • Want a home with fewer residents, which allows for more interaction and attention from staff
  • Would enjoy a relaxed, unstructured environment
  • Want the privacy of a bedroom without all the responsibilities of an entire apartment, such as housekeeping


How do I learn more about senior living options?


Senior living choices have expanded as the needs and expectations of older adults have changed over the past several decades. Figuring out the best option for your loved one’s needs is crucial for keeping them healthy, active, and safe.

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