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Adult Foster Care Defined: Benefits and Costs

April 13, 2023
In this article...
  • Foster homes offer a safe, supervised living environment to adults with special needs. Learn what adult foster care is and who may benefit from these services.

Foster care isn’t just for children. For adults with special needs, foster homes offer a safe, supervised living environment that promotes independence while providing essential care services. This article provides an overview of adult foster care, including the potential benefits for residents, and explores what types of individuals may benefit from this type of residence.

What Is Adult Foster Care?

An adult foster care home is a small residential care facility that satisfies the service requirements of adults with special needs who are unable to live on their own. Designed to reflect a homelike atmosphere, these adult foster homes provide support and services that promote the personal safety and well-being of their residents.

For a residence to be approved as an adult foster care home, it must be overseen by a supervisor, who's licensed to work with this population. Depending on the region of operation, this license may be granted by local or state regulatory agencies, such as the Office of Housing and Adult Services or the Department of Family Services. Adult foster care homes are typically limited to six residents, but may be even smaller.

Adult foster care may also be referred to as:

  • Adult residential care
  • Domiciliary care
  • Elderly foster care
  • Adult family care
  • Small-group assisted living

How Does Adult Foster Care Work?

Individuals aged 18 and older may reside in adult foster homes if they are unable to live independently due to special needs related to:

  • Mental health issues
  • Disorders associated with aging
  • Dementia and other memory impairments
  • Evolving medical conditions such as diabetes 
  • Physical, developmental or intellectual disabilities

Prior to move in, residents may be assessed for the purpose of care planning. Many states also require residents or authorized family members to sign resident agreements before moving in to an adult foster care home. These contracts usually define customary costs for services, resident rights and responsibilities, and termination policies. Residents are expected to abide by these agreements.

Adult foster care homes typically have private or semiprivate living quarters where residents have easy access to the care and support needed to meet their daily needs. These services may range from minor assistance with specific tasks to comprehensive, around-the-clock care.  Housekeeping, laundry services and meals are usually provided.

In most adult foster care settings, day-to-day supervision is provided by a live-in house manager or house parents, and these roles are often filled by social workers, counselors, legal aids or other trained professionals. The residences are typically staffed around the clock so help is always available, but staff may not remain awake 24 hours a day.

The Benefits of Adult Foster Care

Adult foster care can provide a safe, supportive environment for individuals who wouldn’t otherwise be able to live independently, and foster homes may be ideal for individuals whose family members are not available to provide the care they need. Because foster homes usually have fewer residents than assisted living communities, they may feel less institutional, and residents may receive more personalized care. These residences may also be more cost-effective than assisted living or skilled nursing facilities for individuals who need less-complex care.

The following benefits may be available through adult foster care:

  • Mobility and transfer assistance
  • Medication management
  • Housekeeping and laundry services
  • Opportunities for socialization and personal enrichment
  • Freedom to come and go
  • Group social outings
  • Prevention of self-harm behaviors
  • Secure areas for wanderers
  • Transportation for medical appointments, shopping and other errands
  • Help with personal hygiene and other activities of daily living

Can an Individual Receive Adult Foster Care at Home?

Although most adult foster care is provided in a residential environment, adult foster care services currently may be provided at home if you live in one of the following states:

  • Connecticut
  • Indiana
  • Louisiana
  • Massachusetts
  • Ohio
  • Oregon
  • Rhode Island
  • Texas
  • Washington

When foster care is provided at home, relatives or friends typically serve as the primary caregiver, and not all services may be permitted. Families who choose this option must adhere to strict state and local regulations, and caregivers receive compensation from the government for services provided.

Adult Foster Care: Cost Comparisons

The cost of adult foster care depends largely on your state of residence, what services you require and the individual facility's amenities. In general, however, individuals who require more complex services incur higher costs for care. 

According to Genworth’s Cost of Care study, the cost of assisted living in the United States averaged $4,300 per month in 2020, and a private room in a skilled nursing facility was $8,821. Because services rendered in adult foster care tend to be less complex, you can expect the cost to be considerably lower. 

Additional Resources

If you have Medicare or Medicaid, these programs may cover some or all of the costs of care associated with an adult foster home. Some states may also offer financial assistance for residential care through non-Medicaid programs. A caseworker or geriatric care specialist who's familiar with state laws can help you navigate the options available where you live, or you can contact your local Area Agency for Aging to learn more about long-term care support services in your area.