Choosing between them
Same licence. Completely different life.
In California a six-bed house and a three-hundred-bed community hold exactly the same licence, which is why families confuse them and why the brochures are no help. What actually differs is who is awake at three in the morning and what kind of day your mother has.
In Anaheim specifically
The split is not what most families assume
Most of the homes are small. Most of the beds are not. Both facts matter when you start searching.
83
board and care homes
Six residents or fewer, in houses.
14
larger communities
Seven beds and up.
490
beds in small homes
Spread across the whole city.
1,751
beds in communities
Concentrated in a dozen buildings.
So the small homes are 86 per cent of the choices and about 22 per cent of the beds. If you search online you will find almost none of them, and if you rely on bed counts alone you will conclude the city is mostly large communities. Neither picture is right.
Side by side
What actually differs
| Board and care | Assisted living community | |
|---|---|---|
| Licence | RCFE, Dept of Social Services | RCFE, Dept of Social Services — identical |
| Residents | Six or fewer | Typically 50 to 300 |
| The building | An ordinary house on an ordinary street | Purpose built, lobby, dining room |
| Who is there at 3am | Usually one caregiver, sometimes asleep on site | Several staff on a night shift |
| Nurse on site | Rarely. Assume not unless shown in writing | Often during the day, rarely overnight |
| How the price is built | Usually one all-in monthly rate | Base rent plus assessed care levels |
| Activities | Television, conversation, the garden | A published calendar and an activities team |
| Suits somebody who | Needs hands-on help and quiet | Is sociable, mobile and wants company |
| Struggles when | The resident wants company and stimulation | The resident is frightened by scale and noise |
| Findable online | Almost never | Immediately |
How we would decide it
One question settles it more often than any other
Not how frail she is. Ask instead: what did she do with an ordinary Tuesday, back when she was well?
If the honest answer is that she read, watched the news, pottered in the garden and saw one or two people — she will be content in a house with five others and somebody always within earshot. A community calendar is wasted on her and the scale will tire her out.
If the answer is that she was out, had a circle, liked a room with people in it and got bored easily — a six-bed house will be the loneliest place she has ever lived, however good the care is. That is the mistake families make most often, usually because the small home felt cosier to them on the tour.
The medical needs then narrow the list within whichever answer you land on. They very rarely decide the category.
Common questions
The comparison, answered
- Is a board and care home the same as assisted living?
- In California they hold the same licence. Both are Residential Care Facilities for the Elderly, licensed by the Department of Social Services. The difference is size and therefore character: a board and care home has six residents or fewer in an ordinary house, while an assisted living community can have two hundred in a purpose-built building.
- Which one is cheaper?
- Usually the small home, though the comparison is not like for like and no published survey separates them — the national cost surveys count both in one category. The more useful difference is structure: small homes typically quote one all-in monthly rate, while larger communities quote a base rent and assess care levels on top.
- Which is better for dementia?
- It depends entirely on the person, not the diagnosis. A small house is less confusing and has a better ratio of attention. A larger community more often has a secured unit, an enclosed garden and staff on several shifts. Somebody who paces and exit-seeks may be safer in the second; somebody frightened by noise and corridors is usually happier in the first.
- Can either one refuse my mother?
- Yes, and both are bound by the same rules. California regulation lists health conditions an RCFE may not admit or retain at all, regardless of its size, including feeding tubes, tracheostomies and total dependence on others for every activity of daily living.
Longer on each: board and care homes in Anaheim and assisted living in Anaheim.
Last reviewed . Figures are re-checked against their sources whenever this page is revised.
Tell us what her Tuesdays used to look like
That, plus what she needs help with now, is genuinely enough for us to tell you which of the two she belongs in and which four homes to look at first.
Tell us who you are looking after
Four short questions. Nothing you answer is shared with a facility until you say so.
Prefer to talk now? (714) 975-9652, open every day until 6pm.