Can Someone Under 60 Live in Assisted Living in California?

Yes, as an exception to the general design. Assisted living communities and board and care homes are licensed in California as residential care facilities for the elderly (RCFEs). Health and Safety Code section 1569.2 defines an RCFE as a housing arrangement chosen voluntarily by persons 60 years of age or over, or their authorized representative. The same definition says that persons under 60 with compatible needs may be allowed to be admitted or retained.

Title 22, section 87455, puts it in the list of people a home may accept or keep: persons who are under 60 years of age whose needs are compatible with other residents in care, if they require the same amount of care and supervision as do the other residents in the facility.

Note the word may. Nothing obliges a home to admit a younger adult, so ask on the first call.

Health and Safety Code section 1569.316 says that in determining a person's compatibility, the home shall consider criteria that include both of the following:

• The extent to which the person's personal and health care needs can be adequately met in the home.
• The existence of a past history of violence or mental illness that would create a risk for the person or other residents of the home.

The Title 22 wording adds a comparison: the same amount of care and supervision as the other residents. A 55-year-old recovering from a stroke who needs help with bathing, dressing and medicines may match that description in a home whose residents need the same help. A 45-year-old who wants to work, drive and come and go late may not, even if a home would take him.

Everything else in the rule book applies regardless of age: the physician's report, the pre-admission appraisal, and the limits in section 87455 on who may be accepted, such as the bar on people who need 24-hour skilled nursing care. Our overview of senior care levels in California explains where an RCFE sits among the other kinds of care.

Think about fit as well as rules. The other residents will be 60 or older, often much older, and the day is planned around them. Some younger adults find that restful, and some find it isolating. Visit at an active time of day and let your relative judge.

California has homes licensed specifically for adults under 60, and other kinds of care for particular needs. The main ones, as the responsible state departments describe them:

The Department of Social Services also keeps a public facility search with information about licensed homes throughout California, including adult residential facilities.

The right door depends on why your relative needs care. A common order is:

1. 1

   The doctor or the hospital discharge planner

   Ask what level of care is needed: help and supervision, or nursing care around the clock. That answer narrows the list more than age does.

2. 2

   The regional center, for a developmental disability

   The Department of Developmental Services works through 21 regional centers that assess people, determine eligibility, provide case management and coordinate the services in each person's plan.

3. 3

   The county, for help at home

   For In-Home Supportive Services, a county social worker interviews the person at home and decides which services and how many hours to authorize.

4. 4

   Homes themselves

   Call adult residential facilities and, if the needs match, RCFEs. Ask each RCFE whether it accepts residents under 60 before you tour.

The reason for needing care shapes the questions. Our guides on ALS and multiple sclerosis and on mental illness go into two of the common ones. For any home, ask:

• Do you accept residents under 60, and have you had one recently?
• How old are the residents living here now, and what help do most of them need?
• How would you decide whether my brother's needs are compatible with theirs?
• What would he do during the day? May he come and go, have visitors his own age, and keep his own schedule?
• Is the home cleared for residents who use a wheelchair, if he does?
• If his condition is expected to progress, at what point would you say you can no longer meet his needs?

Programs that help pay for care have eligibility rules of their own. Our guide on how to pay for assisted living lists them. Ask each program directly whether your relative's age matters.

Hamssa Benrekia is a senior living placement specialist in Torrance. Her work is with licensed RCFEs in the South Bay and Harbor area: assisted living communities, board and care homes, memory care and independent living. She does not place people in adult residential facilities, skilled nursing facilities or regional center homes, and she does not arrange home care. For an adult under 60, she can tell a family candidly whether an RCFE in her area is likely to be a fit, and suggest who to call if it is not. To talk it through, contact Hamssa. The California Assisted Living Placement Guide covers the rest of the decision.