Cost, quality of care, and location are the primary factors people usually consider when choosing a facility, but there are many other features to take into account. The Assisted Living Federation of America provides an excellent detailed checklist to follow when evaluating potential residences, but here are general areas to investigate:
1. Geographic location—Most people want to live close to at least some family members and close friends so that they can visit regularly. Depending on your level of activity, you may also wish to be close to shopping centers, cultural opportunities, houses of worship, or recreational areas. If you have ongoing medical issues that require regular treatment, is an appropriate hospital or clinic nearby?
2. Staffing—Ask about the different kinds of staff who work at the facility (nurses, aides, financial counselors, security, etc.), whether they go through a screening process, and what sort of skills or training they have. Some states require special training and certification for staff at assisted living residences—find out what the standards are in the state in question. Spend some time at the facility to observe how staff treats the residents. Talk to residents about whether they are satisfied with the way staff treats them. What are the procedures for handling complaints?
3. Level of care—Are the current residents comparable in health to the family member in question? Can spouses requiring different levels of services be accommodated? What medical services does the facility provide (such as medication management and emergency response), and are they adequate for your family member’s medical needs? States generally regulate what services are mandatory in assisted living facilities. Ask how many minutes in a 24-hour day a resident receives hands-on assistance and whether staff is available around the clock to help with unexpected needs. If your family member has Alzheimer’s disease or other forms of dementia, make sure that the facility is physically secure and has monitoring practices in place, such as periodic check-ins throughout the day, to keep residents safe.
4. Ongoing assessment—Find out the process by which residents’ needs are evaluated and monitored so that the level of services they receive can be adjusted. Standard procedures should be in place so that reassessment occurs on a regular basis, before problems occur. Does the facility provide continuing care as a resident’s health deteriorates and the need for services increases, or must the person go elsewhere?
5. Emergency procedures—You’ll want to know that your family member can get help quickly in an emergency. How are residents monitored? Do the rooms or apartments have emergency call buttons or chains in case of falls or medical emergencies? Are hospitals nearby?
6. Cost—Obtain a written copy of the facility’s financial policies. Consider not only the current costs, but how they increase over time and whether you can afford such increases. What forms of payment are accepted? What are the policies for payment and lapses in payment? Some facilities have staff available to assist residents with their finances or help families put together payment plans.
7. Physical environment—Some facilities are beautifully landscaped, with outdoor garden areas for residents’ use. Others are high rises with minimal views of nature. You must consider what’s important to you or your family member. Is the facility attractive and comfortable inside? Is it clean and free of unpleasant odors? Are community areas available for social gatherings and family visits? Do doorways and hallways easily accommodate wheelchairs and walkers? Find out the different sizes and types of living units that are available. What types of handicapped access, security, and emergency response features do they have? Do they accommodate individual telephone and cable service? Do they include refrigeration and cooking facilities?
8. Food—How many meals are served a day, and in what setting (community dining room, individual service if needed, etc.)? Talk to residents and find out whether the food is varied and tasty. Many facilities have regular snacks available in lounges or bistros. You may have special dietary needs—is a dietician or nutritionist on staff or available for consultation, and can special diets be accommodated? Do individual units have refrigeration and cooking equipment?
9. Social environment and activities— Consider the sorts of leisure interests you (or your family member) have. Does the facility provide exercise classes, social events, and other forms of entertainment such as periodic concerts or speakers? Is there a piano, a library, a TV room, an arts and crafts area? Most prospective residents want to know that staff is pleasant and friendly, but they may fail to consider the sociability of other residents. Some facilities are plagued by social cliques who exclude new residents from dining tables or card games. How does the staff encourage social interaction and address problems?
10. Transportation—Find out whether the facility provides transportation to and from medical appointments and whether they can provide transportation at short notice. Are there regularly scheduled trips to shopping areas or community events? Are grooming services (such as a barber/beauty shop) available on site, or can transportation to appointments be provided? Are residents allowed to keep their own cars, or do they have to give them up upon entering the facility?
Once you find a facility that seems to be what you’re looking for, check its inspection records with the agency that regulates long-term care facilities in your state. Talk not only to staff, but to current residents and their family members. Find out not only about their level of satisfaction with their choice, but what the most important factors in their decision were and whether they would make the same choice again.
Our directory of Assisted Living Facilities is a great place to start your search. And when you still have questions, you can contact the facilities directly from their listing here. Start your search for Assisted Living Facilities.