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Choosing an Assisted Living Facility

Ronnie Friedland
Dec. 17, 2007

What to look for and what to ask.

Elders are usually reluctant to leave their homes to move to assisted living, but in the right facility, many seniors perk up and thrive with the readily available socialization.

Here are some factors to consider and questions to ask when looking for a facility in which your loved one would thrive.


  • Is the facility accredited?
  • If there were any problems found in the past, have they been corrected?

You may need to speak to the facility's director to learn more about its accreditation, the process for accreditation, and how problems or improvements have been handled in the past.

Caregivers' Attitude toward Residents

  • Do the caregivers seem attentive to residents, know their names and their likes and dislikes? Or is their attitude toward residents impersonal and perfunctory?
  • What are the types of caregivers at the facility: medical, assistants, geriatric specialists, social workers, activity planners?
  • Which of these people is available to help your parent on a daily, weekly or monthly basis?
  • Is there someone who evaluates staff performance?


  • Are the public rooms clean and well-maintained, with no institutional odor?
  • How often are the individual units, including bathrooms, cleaned, and how thoroughly?


  • Will the family be able to have frequent and easy communication with staff and management?
  • Will families be immediately notified of any changes in residents' mental or physical condition?
  • Are there individual care plans for each resident and can the family be part of meetings to determine these plans?


  • Will your loved one eat adequately at this facility based on menu options and quality of cooking?
  • Will this facility handle special dietary requests?
  • Will there be a staff member available to make sure your parent is eating well and on schedule?

Individual Residential Unit

Assisted living facilities can offer a range of living options and styles, so you will need to visit and see which ones your parent feels comfortable in.

  • Is the unit appealing to your loved one?
  • Is it big enough?
  • Is there adequate light?
  • Aside from the individual living space, what other rooms are available for common activities, dining, exercise, medical exams, computer use?
  • Can your parent personalize her individual living room to her liking?

Medical Care

  • Who will make decisions about medical care, both during regular daytime hours, in the evenings and on weekends?
  • What training do they have?
  • What is the protocol for emergencies?
  • Will your parent need to be transported by ambulance to another facility or to a hospital for certain types of medical issues or is treatment all in-house?
  • How will you be notified?
  • What type of permissions need to be submitted for end of life care and when?

Ratio of Staff to Residents

  • Is the ratio of staff to residents agreeable to you?
  • If your parent is suddenly ill or her condition deteriorates, will she be able to receive more personalized care at the facility, or will she need to go elsewhere?
  • If your parent becomes agitated or depressed, who will be assigned to help her and when will a medical doctor be called in for a consultation?


  • Do the residents seemed content and well groomed?
  • Are they people with whom your loved one will feel comfortable?
  • Do they share common interests or background?
  • Try to talk with some residents privately to see how happy they are with the facility, with the care they receive, with management, and with the activities offered.
  • Be sure to check about the visiting policy. Are grandchildren and friends allowed to visit at all hours or is there a set visiting schedule?


  • Are there grab bars in the bathroom near the toilet and in the shower?
  • Is the carpeting even and easy to walk on?
  • Are there emergency buttons to push throughout the individual apartment, in the bathroom, kitchen area and bedroom and living room?
  • Is there a working sprinkler system for fires, and was it inspected recently? Does the facility run background checks on all employees?


  • Are the activities planned optional or required?
  • Would your loved one enjoy any of them?
  • Is there any flexibility in the schedule to accommodate individual preferences?


  • Do you want a facility that is small and has a more home-like feeling, or would you prefer one that is larger, and though institutional, may offer more activity options?

Training and Qualifications of Staff

  • Is there always someone well trained on duty, on weekends and evenings, as well as on the week days?
  • What kind of training does the staff have?
  • Are doctors and nurses readily available to make immediate assessments of residents' needs?

Ability to Transition to Additional Care

  • Would your loved one be able to transition, if necessary, to receive a higher level of care once she is a resident at the facility?

Overall Perspective

  • Visit the facility on several occasions at different times of day to see what the atmosphere is like at different moments, whether the staff is able to manage both activities and free time adequately and pleasantly.
  • Go with your gut feeling. If you can imagine your parent happily there, then hopefully it will work out for her.
  • Many seniors take a few weeks to adjust to their new home, but frequently, many like the ease of socializing with others at meals and activities.
  • Find out in advance what steps will be taken if your parent has difficulty transitioning.

Ronnie Friedland is an editor at Care.com. She has co-edited three books on parenting and interfaith family life.

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