EPISODE 10 - Adult Foster Homes: The Unsung Heroes of Long-Term Care in Oregon

When most people think of long-term care, they picture nursing homes or assisted living—but adult foster homes are one of the most compassionate and personalized care options available.

In this episode, Jamie Callahan explains what adult foster homes are, how they work, and why they’re often the best fit for seniors with higher care needs.

She covers:

• How adult foster homes differ from assisted living and memory care
• The unique 1:5 caregiver-to-resident ratio
• Licensing, safety, and what to look for in a quality foster home
• Why these homes can accept residents with complex medical needs
• The biggest challenge: limited availability across Oregon

Whether you’re navigating discharge from a hospital or exploring care for a loved one, this episode gives you the knowledge to make a more informed choice.

📞 Questions? Call Team Senior at (541) 295-8230.

Transcript

Hi, this is Jamie Callahan with the Team Senior Podcast. Our goal is to simplify aging. Society grooms us to plan for retirement—but what about life beyond retirement, where the rubber meets the road? Maybe you've had a stroke, been diagnosed with cancer, or perhaps you're beginning to forget things and now have dementia.

That’s our area of expertise. We’re here to share our insights. Welcome to the Team Senior Podcast.

Today, we’re going to talk about adult foster homes—a deeply under-recognized and underutilized form of long-term care that exists in many variations across the country. Specifically, we’re going to focus on how they function in Oregon.

An adult foster home is always in a residential setting—usually someone's personal home. That can look different depending on the owner. Some foster home owners have two residences—one they share with residents part-time and another where they can take breaks from the 24/7 nature of care work. But more often than not, they live in the home full-time with the residents.

One of the best things about adult foster homes is that they are limited to no more than five residents, which ensures a maximum 1:5 caregiver-to-resident ratio. This makes them one of the most intimate care settings available.

In contrast to larger assisted living facilities—which often require residents to be relatively high-functioning—foster homes are willing and equipped to care for people with higher acuity needs, such as:

• Two-person transfers
• Wound care
• Bariatric care
• Tube feeding
• Brittle diabetes

Many assisted living facilities either can’t or won’t take residents who require this level of care, due to staffing limits, liability, or licensing restrictions. Foster homes, however, routinely care for these individuals—making them a critical resource.

The one major limitation for foster homes is evacuation ability. In the event of a fire, they must prove they can evacuate all five residents in under three minutes. This means they can’t take too many bedbound residents, even if they’re otherwise capable caregivers.

Now, let’s talk about licensing. There’s a common misconception that foster homes aren’t as strictly regulated as assisted living facilities—but that couldn’t be further from the truth.

Licensing has two parts:

1. The person running the home must pass background checks, complete training, and prove competency in care and administration.
2. The home itself must meet detailed safety and accessibility standards (hallway width, window size, ramps, etc.).

Licensers conduct random, unannounced inspections multiple times per year, reviewing everything from medication records to incident reports and care plans.

And the care? It’s often superior. In a foster home, when a resident needs help, the call time (how fast a caregiver responds) is usually much faster than in larger facilities. With only five residents and often the owner themselves providing care, the attention is more personal.

Foster homes often feel like family. Residents stay for months or even years. Caregivers know the residents’ preferences—what time they like lunch, how they take their hot chocolate, and more. That level of customization is rarely possible in institutional settings.

Vacancy is the problem. In Southern Oregon, there are about 150 licensed foster homes. But with 12,000 to 14,000 people turning 65 every day nationwide, demand is skyrocketing—driven by the aging Baby Boomer population.

When someone is in the hospital and needs high-acuity long-term care, it’s often a foster home that can meet their needs. But too often, there’s no space, and those patients end up living in the hospital for months—an expensive and unsustainable solution for both the healthcare system and families.

We need more foster homes, and through our nonprofit, New Age Oregon, we hope to support more of them opening.

Before I close, let me share a concept we use often:
 “The chandelier doesn’t provide the care.”
Don’t be fooled by appearances. Some of the best care homes aren’t the prettiest on the outside—but inside, they provide exemplary care. That’s where Team Senior comes in—we know who provides high-quality care, and we’ll only recommend those we trust.

Whether it’s a humble home run by a retired nurse or a large, luxurious residence in a fancy neighborhood—what matters is quality of care, not décor.

And lastly, aging in place is encouraged. If someone moves into a Level 1 foster home (lower care needs) and later becomes a Level 3 resident (higher care needs), the state will often grant a variance so the person doesn’t have to move. That stability is essential for wellbeing.

But don’t wait too long. If someone becomes too high-need, their chances of placement shrink. Providers will always prefer a lower-acuity resident over a high-acuity one—especially when reimbursement is the same.

So if you’re considering long-term care, reach out early. We can help assess options and timing.

Thank you so much for listening. I hope this episode helps shine a light on the powerful and compassionate role that adult foster homes play in long-term care.

We’re here every week with relevant information. Give us a call if you have questions—Team Senior can be reached at 541-295-8230. Until next time, this is Jamie Callahan.