Small Board-and-care Homes

Small board-and-care homes have existed informally for many years as alternative settings for long-term care. Typical residents have been discharged from another facility with some physical or mental impairment. Most are women over the age of 75 with minimal financial or social resources. While these homes are often viewed negatively as warehouses for the ill and under privileged-they are now growing in numbers and receiving increased attention for their ability to provide a loving environment and customised care at a modest cost. Small Board-and-Care Homes is the first book to examine these settings from the perspectives of their operators and residents. Based on ten years of research in Baltimore and Cleveland, it addresses key concerns about this option for residential care: who lives in the homes, who operates them, what services are delivered, the economics of their operation, how residents and operators perceive these environments. Since the operators are predominantly women, the authors also exam, Operators, of gender and employment. no benefits they note, receive little pay and for providing a vital service in their own homes, outside the formal systems for health care and human service delivery. The final chapter looks at policy implications: should these homes follow the institutional, medical model of nursing homes and strict regulation, or are they more analogous to the less-regulated, personalised child care or home care? With their potential for cost savings, given the growing population of dependent adult, needing non-medical assistance, and the need to provide appropriate regulations for operating them, small board-and-care homes will become an increasingly important topic for gerontologists and health policy professionals interested in the delivery of care to elderly people. Combining surveys and in-depth interviews, this book provides a wealth of information about people working in these homes and those in their care.