For seniors (older people), and people with disabilities looking for supportive housing that provides a range of care and services (such as meal preparation, housekeeping, personal care and/or medical services), there are a number of options available.
Adult Care Homes
Adult care homes are licensed, single family residences that offer assistance for up to five adults in a homelike setting. These homes offer a private or shared bedroom, private or shared bathroom, meals and snacks, care and services. Each home has one operator who may employ additional caregivers. All staff have experience providing care and receive ongoing training. Some homes are operated by registered nurses or other medical professionals. Care provided typically includes assistance with bathing, dressing, grooming, eating, walking, getting into or out of bed, toileting, medication management, and memory or behavior support. Nursing tasks are monitored by an RN, and some homes specialize in serving residents with dementia or other diagnoses such as traumatic brain injury. Many operators accept Medicaid payment or long term care insurance, and most accept private payment.
All homes are licensed annually and monitored quarterly by the Multnomah County Adult Care Home Program (ACHP) via unannounced home visits. The Adult Care Home Program requires that all adult care home operators and caregivers
- pass a criminal record check;
- complete a basic training course and pass an exam;
- have hands-on professional care giving experience;
- are physically and mentally able to provide care;
- provide care in a home that meets structural and safety requirements.
The Adult Care Home Program offers a free search tool called Adult Care Options that allows consumers to locate adult care homes based on a wide range of criteria such as vacancies, location, accessibility, bedroom/bathroom preferences, specialized skills and experience, pets and smoking policies. Many operators have posted pictures of their homes along with a full description of their services.
Assisted Living Facilities
Assisted living facilities provide apartment-like housing settings and support services for six or more people. Residents of assisted living facilities live in private studio, one-bedroom, and two-bedroom apartments. Each apartment has a kitchenette and a private bathroom with a wheelchair-accessible shower. Assisted living facilities are best suited for individuals who want to remain as independent as possible and are able to direct their own care.
Assisted living facilities are licensed and regulated by the Department of Human Services, Aging and People with Disabilities. They are not required to have licensed registered nurses on staff 24 hours a day. The duties and qualifications of direct caregivers will vary among facilities. The staff-to-resident ratio will typically be lower than what is required for nursing homes. Caregivers are not required to be certified, although training prior to providing services to residents is mandatory.
Residential Care Facilities
Residential care facilities provide housing and support services for six or more people who do not need 24-hour nursing care. Residential care facilities offer shared and private rooms. They are not required to provide private bathrooms or kitchenettes. Many residential care facilities specialize in caring for individuals with Alzheimer's or dementia.
When considering any long-term care setting, request and closely read copies of the residents' rights, the admission contract, and the price list. These facilities are licensed and regulated by the Department of Human Services. Residential care facilities are not required to have licensed nurses on staff for a specific number of hours per week, and the nurse typically does not provide hands-on personal nursing care. The duties and qualifications of direct caregivers will vary among facilities. The staff-to-resident ratio will typically be lower than what is required for nursing homes. Caregivers are not required to be certified, although training prior to providing services to residents is mandatory.
Nursing facilities are most appropriate for people who need 24-hour medical oversight and a protective or structured setting. Residents may have medical or behavioral needs that cannot be met in other care settings. Most residents must share their room. Space is limited, but residents are allowed to bring personal items to encourage a more home-like atmosphere.
Nursing facilities are licensed by the Department of Human Services, Aging and People with Disabilities and are required to meet both federal and state regulations. Services offered in nursing facilities include:
- 24-hour nursing care
- on-site physical rehabilitation
- recuperation after hospitalization for serious illness or surgery
- restorative services
- end-of-life care
Continuing Care Retirement Communities
Continuing Care Retirement Communities are generally made up of independent living residences and assisted living, residential care and nursing facilities. These communities require an entrance fee along with monthly and/or other periodic charges. They are required to register with the state and disclose information about their finances and the services they provide. Only a nursing, residential care or assisted living facility located in the community must be licensed by the State. Otherwise, Continuing Care Retirement Communities are not regulated.
Retirement Homes / Complexes / Communities
Retirement communities are for people who desire, and are able, to live independently, but do not want to maintain a home. Many people prefer to live in a community of people who are the same age as them, and who share their interests.
The Department of Human Services, Aging and People with Disabilities does not regulate or license retirement communities.