A beginner's guide: Residential Assisted Living

When families are searching for assisted living for their loved one with dementia, they’re likely to consider several options among the large assisted living facilities. But there’s another option worth considering: high-end family care homes, also referred to as residential assisted living.

Family cares homes come in many shapes and sizes – but they’re not all the same. While family care homes have traditionally been “mom and pop” establishments, a recent trend has emerged in states like Arizona and California – and now, Charlotte – with the introduction of boutique-style assisted living communities found in a residential setting. These high-end family care homes offer the best of both worlds – they combine best-in-class, highly personalized care with a home-like setting, and families across the country are taking notice.  

From the outside, you'd never know this is a memory care facility (and that's the point).

(1) What Sets Residential Assisted Living Apart from Large Facilities for Memory Care?

What truly sets family cares home apart is the high level of individual attention that residents receive.  Because they can only have up to 6 residents (in North Carolina), the community provides a minimum ratio of 1:6 caregivers to residents and awake-at-night staff. Higher-end homes often have a ratio of 2:6 and are thus an ideal – and cost-effective – solution for seniors with greater care needs such as those with dementia, Alzheimer’s, Parkinson’s, and diabetes.

Research has shown that residents who remain in home-like settings experience greater levels of personal dignity and lower rates of depression and anxiety. While still offering many of the benefits and amenities of a large facility (such as chef-prepared meals and hair salons), high-end family care home offer an easier transition from one’s own home to assisted living as residents don’t get lost in the shuffle in a large, hotel-like facility. There are no long hallways or communal dining rooms to navigate.

(2) How Can A Home Offer The Same Services as a Large Facility?

Although residential assisted living communities can't offer amenities like swimming pools and restaurant-style dining, these amenities are often geared toward those who can function relatively independently and/or towards the family member(s) making the decisions for their loved one. In reality, those with memory care issues often need something completely different that large facilities CAN'T provide: lots of meaningful one-on-one interaction, redirection, guidance, familiarity, and structure. Family care homes are thus ideal for those who require a greater level of assistance with activities of daily living. Large facilities may have glamorous amenities but even the most beautiful and well-amenitized facilities will have no more than 1 caregiver for every 12 residents. Those who have tried them will tell you that's simply not enough.

(3) Are All Family Care Homes Basically The Same? It's A Home, How Different Can They Be?

In short: VERY different. Services among residential assisted living facilities are often the same as those offered in a large facilities and include 24/7 care, lodging, housekeeping and laundry service, three daily home-cooked meals and snacks, social programs and activities, transportation to doctor’s appointments, and medication management. But they're not all the same. Higher end residences might even offer amenities such as hair salons, beautifully appointed bedrooms, nurse and physician services, personalized activity plans, and chef-prepared meals.

Although a beautiful atmosphere is certainly a nice selling point (and a sign of ownership's financial commitment to the home), what truly distinguishes the higher-end residences from the rest is how hands-on and involved the ownership is. When you meet the owners, you'll know who's in it for the right reasons and who will be there when you need them most. Ownership that cares and is present will manifest in many ways: they'll be there for the tour and want to personally learn about your needs, they hire higher quality staff and hold them to a higher standard, they experience lower staff turnover ratios because staff has direction and is treated with respect, and the home is kept clean and well-maintained (just the way you'd take care of your own home).

(4) Is Residential Assisted Living Regulated?

Very much so. Like any large facility here in North Carolina, family care homes are strictly monitored by the Department of Health and Human Services (DHHS) and the Division of Health Service Regulation (DHSR). These two regulatory bodies ensure compliance with local, state, and federal regulations and regularly inspect all aspects of the care home.  The rules governing large assisted living facilities and family care homes are nearly identical.

If you're considering assisted living for your loved one with dementia or are in a facility and unsatisfied with the attention your loved one is getting, consider the benefits of a residential setting. Take a tour, meet with the owner, and ask lots of questions. You'll likely be pleasantly surprised with what you find.

Visit us at to learn more about the benefits of residential assisted living and to schedule a tour. Let us show you how our dedicated team can bring your family peace of mind knowing your loved one is well cared for every day.


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6741 Ciscayne Place,

6001 Bismark Place, 6021 Glenridge Road

Charlotte, NC 28211

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