Insider Tips for Choosing an Assisted Living Facility


While most people prefer to stay in their home through the end of their life, it’s not always feasible to do so and receive the level of care they may require. One defining point for when in-home care is no longer practical is when the patient needs on-call assistance to aid them in their activities of daily living, but scheduled care is no longer adequate for their needs. Another indication is when the loved one may become a danger to themselves or others in their home setting. Around the clock in-home care is one way to meet this need, but the cost is prohibitive for most people. Some people attempt to provide a high level of care in their home on their own, but this often comes at the expense of their own health and sanity.

An assisted living facility can be the answer, providing a safe environment with assistance available at the press of a button. While many people resist this move, I’m frequently told by administrators of these facilities that, after settling in, it’s common for new residents to report regretting taking so long to make the move. The “Old Folks’ Homes” of yesteryear have changed dramatically and are now warm, caring places where residents are encouraged to be active and engaged in life. Many residents thrive with regular, nutritious meals, medication management and opportunities for activities and social engagement. Some communities also provide transportation for outings and medical appointments.

How do you select the right assisted living residence for your loved one?

Moving can be traumatic for a vulnerable, disabled or elderly person, so be sure to do your homework before making a decision. You need to assess the needs, budget and personal preferences of your loved one to begin the process. The options range from small homes in residential neighborhoods, which typically have 8-10 residents, to large age-in-place campuses. Placement or transition specialists can help you locate and assess each one, and their services are usually free to you. They’re typically paid an amount equal to one month of the new resident’s costs by the facilities.

Determine current care needs and consider future needs

What are your loved one's capabilities and needs? Residential-style homes, also called board and care homes, typically have higher staff to resident ratios and are willing to provide for a fairly high level of care. Age-in-place campuses usually offer independent living, assisted living and memory care all in one location. Some even provide for skilled nursing care in the same community as well.

Long term care facilities differ widely in the senior care services they provide

For example, disabled or bedridden individuals require a community that can accommodate their transfer needs. Most will only do a one-person assist when helping a resident transfer and require that the patient can bear weight on at least one foot when transferring. Some residences will do a two-person transfer assist, or even use a Hoyer lift for patients who require 90-100 percent assistance to get into and out of bed. However, these are rare and require some research to locate.

When it comes to diabetic patients, most communities will only take residents that are on a regular insulin schedule because only a handful are able or willing to provide scaled insulin injections. There are a number of other medical conditions that require special assistance, so be sure that potential candidates know of these needs and are able to meet them.

Personal preferences may conflict with your budget

These facilities vary greatly in size and amenities. Expect a mid-market community for a resident with moderate care needs to range from around $3,000.00 to $4,000.00 per month. A shared room can lower the cost, but few residents are eager to have a roommate. Accommodations can range from studios to multi-room apartments of various sizes.

Some offer all-inclusive pricing, while others itemize all care and assistance. Inquire about all variables that can affect your loved one’s cost of assisted living, and be sure you understand the residency contract. It would be wise to have an attorney review it before signing.

Make sure the community has a pleasant and professional atmosphere

Be sure to conduct tours before making your decision. While visiting, make a point of watching the staff to see how they interact with the residents. Does the employee ratio seem adequate for the number of residents? Are the buildings and grounds clean, well maintained and free of unpleasant odors?

You should verify the community’s license with your state licensing division and check with your state ombudsman to see if they have had any significant issues or complaints. Online reviews can be especially helpful as well.

Entertainment and engagement are crucial for senior residents

When visiting prospects, observe the residents as well. Are they engaged and involved? Check the calendar to see if they offer activities that fit with your loved one’s interests. Do they have a full-time activities director? Exercise programs? Do they allow pets? Do they provide transportation for trips and outings?

Don't forget the food

Food is sometimes the last pleasure left to a disabled or elderly person. Look for nutritious, well-prepared meals. Facilities can offer a variety of dining options, such as all day restaurant-style dining, set meal times with limited menus, and in-room meals. Look at the menus and ask to sample the food on your initial visits.

Keeping these factors in mind when researching and selecting an assisted living facility will help you make a confident decision for your loved one. If the community is a good fit for them, then they will have a much easier time adjusting to their new living situation.

Sandy Morris was married for 32 years and was her disabled husband's caregiver for the last 15 years of their marriage. Working in the senior services sector for the last three years, her experiences on both sides of the caregiver equation allow her to provide valuable information on everything from VA benefits to common caregiver challenges.

War Veterans Association of Colorado

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Very nice article! I would like to know more about these "transition specialists." Where do you find them? Who pays them? I would also like to
add that when choosing an ALF, try and go back for as many visits as you can. Try and arrive early so you can wait and observe what is going on.
You might hear some of the residents and families complaining about something...but don't give it too much creedence, after all, we al complain! But if that's all you
ever overhear there could be a problem. Another thing to note is that it is easy to get charmed by the beautiful or most updated facility as being better than less extravagant ones. I worked at an ALF that had a sewing room, an exercise room and massage room that residents never used but were always used as selling points. They even had walk in jacuzzi tubs that the CNAs were never even trained on. The CNAs and activity staff interact more with your loved one than anyone else, so while you
are visiting, keep your eyes on them! That will tell you more than anything.
I really appreciate your comment about the services facilities provide and the residents' needs. I am helping my family to find a senior living facility for my grandpa. I will make sure to talk to my grandpa and see what services he needs. Thanks for the helpful tips!
Nice article- one thing me and my sib's are struggling with-with both 90 yr. old parents alive and on the cusp of not able to be in their own home anymore -are the complicated financial aspects. The tightrope of Medicare, Veteran's Benefits, meager assets and the Medicaid question. Plus the fact that financials/in home services that are covered are directly linked to level of disability of the person-which can fluxuate back and forth- as one say, has an operation or falls then is rehabbed then is home and "ok" for a while and so on.
My parents are still (barely) ok when together-but my mother has dementia and can't be alone anymore for any length of time. My father is very weak-and has had a few strokes and needs her there to keep an eye on him...but they are barely safe. We have hired in-home care daily which is being paid for by Veteran's Aid and Attendance and some out of our pockets. It adds up really fast.
We are trying hard to find a place that can take both of my parents plus a cat which will work out as their financial and health status changes - since most places if you start out private paying and then go to Medicaid- you have to move within or out of the place...etc.

We want to try to carry the cost for a while - spending down their small amount of savings (very small relative to how fast a facility will eat it up). We will probably have to sell the house(not a hot market) and get rid of all their possessions. Once that $$ is gone- it's Medicaid if they outlive their small (relatively) $ . It's a shame the way it plays out. Emotionally and financially stressful for everyone-and it's a pride thing as well for my father- who I know had hoped to be able to leave at least something behind to his kids. I know it bothers him which adds to the mix.
Anyways- the financials are a real trick- and only will get trickier as more and more boomers enter the elder care system and bog it down in the next 20yrs or so. The elder care industry really needs to change the model and pay more for in-home services rather than 'facilities'.