Adult Foster Care a Solution in Oregon

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Nursing homes are usually at the bottom of people’s list of places for their parents. A workable and little-known alternative is available in many states: adult foster care.

This PBS video about Oregon’s program features a suburban Portland woman, Carmel Durano, who provides 24-hour care in her home for five elderly people, including her mother. Durano has been a good solution for Steve Larrence’s 99-year-old mother. He feels comfortable with Durano and lives in the same neighborhood, so he can walk over anytime to talk to his mother.

“You don’t feel like you’re in an institution. You feel like you’re living with a family,” Larrence said in the video.

Durano is part of a network of more than 1,500 adult foster care programs in Oregon. Many of them care for more than one senior. Durano, a Filipina immigrant, got involved 30 years ago, because she had three young boys at the time and wanted to stay home for them.

Foster care is much cheaper than nursing homes. And, like nursing homes, state Medicaid programs often pay for the at-home caregivers. But though adult foster care is not immune to cases of abuse, Paula Carder, an expert on aging and dementia at Portland State University, said the Oregon program generally delivers “a high level of care.”

State regulations require caregivers to be certified annually, pass background screenings, and submit to surprise home safety checks and interviews with the adults in their care.

This may be at least a partial solution to the growing problem of an aging population.

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2 comments
Edward Hoffer MD

A very interesting idea with which I was not familiar. For appropriately chosen elders, this would be much more attractive than the usual nursing home, as well as less expensive. As the US population ages, we need to be creative in how we deal with our elders in ways that are both humane and cost effective or we will drown in medical care costs.

Susan Picerno

The idea is interesting but in this specific example, how can one person take care of five elders? The one in the picture appears to be profoundly disabled.

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