Faith and Religious Practice in Assisted Living and Board and Care

Assisted living communities and board and care homes, licensed in California as residential care facilities for the elderly (RCFEs), follow Title 22 of the California Code of Regulations and the Health and Safety Code. Several rules touch on faith directly:

• Every resident has the right to attend religious services or activities of their choice, in or outside the home, and to have visits from the spiritual advisor of their choice. Attendance must be completely voluntary (Title 22, section 87468.1).
• A home may not discriminate against a person seeking admission or a resident based on religion, national origin or ancestry, among other grounds (Health and Safety Code 1569.269).
• The home's planned activities should include cultural or religious activities, such as holiday celebrations and cultural traditions, and the home should arrange for community resources, which may include attending the place of worship of the resident's choice (section 87219).
• Meals must be planned with consideration for the cultural and religious background and food habits of residents (section 87555).
• The resident's record includes their religious preference, if any, and the name and address of their clergy or religious advisor, if any (section 87506).
• Residents have a right to reasonable accommodation of individual needs and preferences, except when health or safety would be endangered, and to a reasonable level of personal privacy in personal care (Health and Safety Code 1569.269).

None of these rules lists specific practices, such as prayer times or a room set aside for worship. They set the principle, and each home decides in practice what it can offer. That is why the questions further down matter.

Daily prayer is often the first practical question. Ask where your parent could pray in quiet: in their own room, a shared room with a curtain, or another space. In a six-bed board and care home, a private room may matter more for this than any common area. Ask whether staff can help your parent wash, dress or get into position for prayer at the times they need, and whether a reminder can go in the care plan.

For weekly worship, ask whether the home or family will handle the ride, and whether staff help your parent get ready on time. Residents have the right to visits from relatives and other people of their choosing during reasonable hours, privately and without prior notice, so a priest, rabbi, imam, pastor or other faith leader can visit as your parent wishes. Ask how the home handles a visit late in the evening if your parent is seriously ill.

Some homes hold services led by visiting groups. Under the rules, your parent can take part or decline, and no one may require attendance.

Ask how the home marks the holy days that matter to your parent, and whether family may bring food or hold a small gathering. Larger communities may have a calendar of celebrations. In a small home, the answer often depends on the owner and the other residents.

Fasting is a medical question as well as a religious one when a person takes medication or has diabetes or another condition. Ask your parent's doctor whether fasting is safe and whether medication times should change, and give the home the doctor's written instructions.

Religious food rules, such as halal, kosher or vegetarian meals, are covered in detail in our guide to special diets in assisted living. In short: ask whether the home can buy, store and cook food to your parent's rules, or whether family may supply it.

Many residents prefer that a caregiver of the same gender help them bathe, dress or use the toilet. We did not find a California rule that requires a home to provide this. It falls under the right to reasonable accommodation of preferences and to privacy in personal care, and whether a home can do it depends on who works each shift.

Ask directly, and ask about nights and weekends, when fewer staff are on duty. A home that says yes for the day shift only is telling you something useful. Ask whether the preference can be written into the care plan so that new or relief staff see it. Modest clothing, a covered head, privacy curtains and knocking before entering are smaller requests that most homes can agree to; ask anyway.

Bring these to each tour, along with your other questions. If the answers are vague, ask to see the activity calendar and the menu for a typical week:

1. 1

   Prayer and quiet

   Where can my parent pray, and can staff help with washing or getting ready at set times?

2. 2

   Worship and clergy

   Who drives to services, and how are visits from clergy handled, including late or urgent visits?

3. 3

   Holy days

   How are religious holidays marked, and may family bring food or visit for a celebration?

4. 4

   Food

   Can the kitchen follow my parent's food rules, or may family supply meals, and how is that stored?

5. 5

   Personal care

   Can a caregiver of the same gender help with bathing and dressing on every shift, and can that go in the care plan?

6. 6

   End of life

   How does the home support last rites, prayers or other practices if my parent becomes very ill?

Hamssa Benrekia helps families in the South Bay and Harbor area of Los Angeles County find licensed board and care homes and assisted living communities. She speaks English, Arabic and Spanish, and she can help you put these questions to each home and compare the answers. If language matters as much as faith, see finding a care home in your parent's language. To talk it through, contact Hamssa. More topics are in the California Assisted Living Placement Guide.