Spend time researching and visiting communities to ensure a proper fit and appropriate level of care before you or a loved one makes the move.
Taking a tour is a good starting point for learning about an assisted living community, but that alone won't give you enough information to feel truly confident about moving your loved one there.
"Families need to lead the evaluation process for the assisted living community. They need to know the right questions to ask," says Kathy Smith, author of "Assisted Living Comparison Checklist."
But what are the right questions? Here are six common questions people have when selecting a facility and how to find satisfactory answers.
- Can We Afford It?
Assisted living is not cheap, so it's important to be realistic about the costs and what you can afford. "Creating a budget, noting all sources of income and benefits, and comparing that with the cost of living at the community will help paint a realistic financial picture and hopefully, reduce stress," counsels Marcy Baskin, author of "Assisted Living: Questions I Wish I Had Asked."
If you plan to rely on insurance, know that Medicare does not pay for assisted living. Learn about the difference between Medicare and Medicaid. And while some centers reserve a select number of placements for Medicaid recipients (increasing the chances that you could stay there if your funds dry up), others don't accept Medicaid. If it's possible your money won't last, go into assisted living with a plan for what you'll do next.
- Is the Community Safe?
Safety is a top concern about assisted living. Grab bars and shower rails should be standard throughout the community, residents must have a way to call for a staff member when they have a need and all employees should be trained on the community’s emergency plan. A community also must be secure. For example, the doors should be locked to visitors at a certain time each night, and there should be security cameras in use.
Call police or sheriff's department in the jurisdiction of the community to ask if they've been called there and why, suggests Smith. She also recommends researching whether any sex offenders live nearby.
Check with your state's board of health or local ombudsman to see if the community has had any abuse allegations, health deficiencies or other complaints.
- Will My Loved One Be Well-Cared For?
The staff can make or break a facility. Ask questions to learn more about them, including:
- Are background checks and drug tests conducted on all employees? They should be! Are they just for new employees or regular ones for current employees as well?
- What is staff turnover like? A high turnover is a bad sign.
- Can I speak to the director? If the director doesn't make time to speak with you, that's another negative.
- What training does the staff receive?
- How is the staff supervised?
- What is factored into each resident’s care plan?
- How can I stay involved in that plan?
To get a real sense of staffing quality, drop in unannounced at various times to see what's going on when they aren't expecting you. Do staff members seem interested and engaged with residents, or are they constantly checking phones and acting put-upon. If you see family members visiting a loved one ask to speak with them and pose some questions. What is their perspective of the community?
Medical care is important, too. For starters, a community should have a nurse on-site daily and an on-call nurse available twenty four hours a day. "Keeping in mind that assisted living is a non-medical model, communities with a concierge physician (independent doctor who has office hours at the facility) can be desirable," recommends Baskin.
Additionally, understand that assisted living isn't sufficient for all situations. Some people need the greater care offered by a skilled nursing facility. Be sure to ask the nursing director and executive director if there are any health conditions or behaviors they are unable to provide care for. Consult a physician for recommendations on what arrangement is best.
- Can Residents Maintain a Sense of Their Old Life?
Privacy and independence are important to people entering an assisted living community. When you go on a tour, note whether the rooms are private and who has access to living quarters. Are there certain wake times and are residents required to dine at a set schedule?
Some residents actually discover a new sense of independence when they move to an assisted living facility. Home upkeep chores, such as lawn mowing, are no longer a resident's responsibility, leaving the individual more time to pursue personal interests. Some facilities even take care of housekeeping and laundry.
- Will We Know What's Going On?
A center should notify family members about changes in the care plan, and the family should have regular meetings with the staff. Some facilities even put out a newsletter to keep families informed about facility happenings. How can a family member make inquiries about a loved one, or express concerns?
"It's important that not only is the assisted living facility there to care for the residents, but they need to be focused on the family caregiver as well," advises Smith. A support group for family members is an excellent resource some communities offer.
- Will My Loved One Be Happy?
Find out as much as you can about whether current residents are happy with the facility. Each resident should complete a satisfaction survey every year, so ask for a copy of it, says Smith.
Next, learn as much as you can about what the facility offers. Ask to see a dining calendar and eat a meal there. Look at past event calendars to find out whether the center offers activities that appeal to your loved one. Choose an event that may interest your mom or dad and attend this. And although a nice building doesn't guarantee quality care, it's good to ensure that the property is clean and well-maintained, because that does have an effect on resident satisfaction.
Baskin admits that the move to assisted living can be a difficult transition for some people. Facilities should have a plan on how they will help your loved one adjust.
And while you hope the fit will be perfect, take note of the contract's termination terms -- just in case.
But for the real scoop on an assisted living community, talk to people who have first-hand experience with it. Consult people you know and also ask the facility for a list of references. See if you can talk to residents and their families for current testimonials? Don't be afraid to ask tough questions. The more you research and learn from people's real experiences, the more confident you will be with your selection of an assisted living community.
Meghan Ross is a freelance writer in Illinois.