What’s a Group Home for Aging Adults? How Does It Work?


Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

A group home can go by different names, depending on what state you reside in. The most common labels are residential care homes, board and care, adult foster, and boarding homes. Group homes have been in existence for a long time and historically have served people with mental, intellectual, and physical disabilities. 

Jump ahead to these sections:

Group homes still exist for people with developmental disabilities, mental health problems, or substance abuse issues. Homes for these populations offer a degree of independence while providing for their unique needs. 

Some older adults are starting to look at other alternatives to assisted living that offer lower cost, built-in community, and flexibility. That’s where group homes come in. They present something different for older adults. Below we will share the pros and cons of such a choice and guide you through the process of choosing the best one. 

What’s a Group Home for Aging Adults?

According to the census bureau, over 54 million adults in the U.S. were over the age of 65 in 2019. Those numbers remind us that people need a place to live, and many require care as they get older.

Even though most older adults say they want to age in place in their homes, this may not be possible for large numbers of people. The traditional model of assisted living, memory care, and nursing home care is suitable for people who like those models and can afford them. 

A group home for aging adults may have similar characteristics, but there are differences as well. Each state and locality regulate group homes and, therefore, dictates what is required.  Here are the general features of group homes across the country.

Group homes are residential in nature, serving anywhere from two to 20 people in a home-like atmosphere. The larger group homes may have a more institutional feel but still fall under the name group home. In many states, group homes are governed by the same regulations that guide assisted living communities. In other states or localities, rules might be much looser.

These types of homes usually provide residents with a private bedroom, but bathrooms may be shared, and communal meals are common. There may or may not be some group rooms for use by the residents. Group homes are generally owned by private individuals who may live on the premises and may also own other homes. Also because of their setup, group homes may be in a residential area and have a “home-like” feel instead of an assisted living community that might seem more institutional.

Some states allow residential care homes to operate without a license legally. It’s worth being wary of these situations due to the potential for abuse or exploitation. Group homes do have the potential to operate “under the radar.” VA medical foster homes are specialized group homes for veterans who meet specific criteria.

In these homes, residents often need a high level of care, but the Veterans Administration provides medical care on-site. 

» MORE: Grief can be lonely. Create space for your community to share memories and tributes with a free online memorial from Cake.

What Type of Care Do You Get at a Group Home?

The type of care you receive in a group home will vary depending on where you live and in some cases, what the community is called. Each state dictates what kind and type of senior care are permitted. In general, group homes do not provide the level of care you could expect in assisted living and certainly not in a nursing home.

General characteristics of a group home are:

  • 24-hour supervision, as someone is on the premises 24-hours a day.
  • All meals and activities
  • Housekeeping and laundry
  • Transportation to medical appointments
  • Some help with personal care might be provided, but some places will offer none at all meaning you will have to arrange that yourself.
  • Medication reminders. In some communities, medications are dispensed, but that is rarer. In those cases, you will need to manage medications yourself or get a family member’s help. 
  • Some communities might offer “house call” services where a physician or nurse practitioner visits the location to attend to medical needs. Unlike assisted living, there won’t be a nurse on staff to coordinate care.
  • If you require consistent medical care or help with transfers and toileting, the group home may deny you admission or ask you to move to a higher level of care if you already live there. 

Who Typically Lives in a Group Home?

Older adults are attracted to group homes for a variety of reasons. Due to the more independent nature of group homes, you will unlikely find people with complicated physical impairments.

Group homes try to have people of similar needs in the same location, making it easier to manage and monitor residents. These are some of the reasons people seek out group homes instead of assisted living.

People with some cognitive impairment or other neurological conditions benefit from supervision but don’t need confinement to a locked unit. Examples of this can include independent seniors who are looking to downsize and have the companionship of peers their age.

It can also include seniors who are not ready for assisted living but want the convenience of meal preparation and relinquishing of household responsibilities. However, if you have some medical or mobility issues, you may want to reconsider a move to a group home if your condition is unlikely to improve. 

» MORE: Online obituary that is 100% free. Honor a loved one beyond a newspaper.

How Do You Pay for a Group Home?

One appeal of a group home is the cost. The monthly price is generally lower than for assisted living or memory care. This is because the level and intensity of care are not as high in a group home. Assisted living communities can offer nursing and full aide service for their residents, along with an array of other amenities. 

Paying for a group home is the responsibility of the resident. Medicare does not pay for senior living except short term skilled rehab. However, if you have a long-term care insurance policy, it might cover some of a group home’s expenses depending upon the state licensure. A long-term term care policy could also pay for in-home caregivers to fill in care gaps at a group home.

When it comes to senior living, finances should be part of long-term care planning. As part of that planning, you have to assume that there is a possibility you may need more care at some point than a group home can provide. If you do need more care, it will likely be more expensive than what you are paying in a group home. Having a back-up plan and a way to pay for it will give you peace of mind.

Questions to Ask a Group Home

Before diving into the idea of a group home, do your homework. The patchwork of licensing and oversight across the country can leave older adults in a vulnerable situation. Ask these questions before making a decision.

Find out about the licensing requirements in your state for group homes

Once you have that information, make sure that the group home under consideration is licensed correctly. Don’t assume that just because the home is operating that it is licensed.

Ask about the makeup of the residents

You may not want to choose a place whose residents have dementia if you don’t. If you prefer a more independent group of residents, ask whether you can expect that at the group home you are looking at. 

Who is the owner?

Try to get as much information as you can about ownership. Are they new to the business, and do they have experience running group homes?

What is the cost per month?

You’ll want to have it detailed as much as possible. Will there be any add-on fees for amenities like cable and internet or additional care?

What is the level of staffing?

You will want to know what the staff to resident ratio is and if that is consistent with industry standards. It also helps to look up what the industry standard is, and if your state has any other regulations regarding staffing at group homes.

What are the qualifications of the staff?

Specifically, ask what is required staff training and how many have healthcare certifications. 

Ask about what, if any, assistance is available. You don’t want to move in only to find out that there is no help available for bathing, dressing, or grooming if you have that need. Is there an activity schedule? If so, ask to see it.

What preferred methods of care does the group home have?

Does the group home have preferred home health or home care providers in case you have that need? Will they help coordinate that care?

Can you visit beforehand?

When you visit, pay attention to cleanliness and their safety and accessibility features. Are there handrails, stairs, and an emergency response system?

In addition to these questions, ask yourself if you can imagine living with a group of people in a small space. If privacy is important to you, consider the fact that your bedroom might be the only place you can truly be alone.

» MORE: An online memorial is a perfect ending to honor and celebrate someone's life. Create one for free.

Group Homes for Older Adults

Group homes are a viable and attractive option for many older adults. As housing options continue to grow for older adults, the choices become more varied and more complicated. 

The key to making the best decision for you or your loved one is to choose carefully and plan wisely.


Icons sourced from FlatIcon.