Before an elder moves in to any type of senior living community, the facility should conduct a thorough, first-hand assessment of the elderly person's physical and cognitive health.

The facility shouldn't rely on doctor's notes, but rather, conduct an in-person assessment before admission to determine the elder's care needs and other important factors that determine what type of care (and cost) is appropriate for the senior's needs.

At HarborChase of Naples, FL, a nurse sits with every prospective resident and in some cases their families and conducts a thorough evaluation of the elder's ability to conduct activities of daily living, from morning until night.

Based on the 8-page evaluation, the elder is ranked on a "point system" which determines the level of care they require. Care levels at Harborchase range from Basic Care, Level 1, Level 2 and Level 3, which is the highest level of care. This process ensures the resident will get their care they require, and it also determines the monthly fee they will pay.

Not all Assisted Living facilities will use a point system similar to HarborChase, but the key is that the assessment is conducted, that it be thorough, that detailed questions are asked and that there is a formal process for using the assessment to determine the best care for residents.

Typically an assessment for prospective residents will rank a person's behaviors, chronic illnesses, communication, tendency to wander, ability to dress, bathe and use the bathroom, need for assistive devices, mobility problems, previous falls, diet and more.

As an example, here are just a fraction of the questions that HarborChase uses during the assessment process.


To assess a person's orientation:

  • Is oriented to person, place and time
  • Has occasional confusion and some difficulty recalling details. Needs occasional prompting
  • Requires regular prompting due to confusion and disorientation
  • Severe deficits with past history of poor judgment, creating potential unsafe behaviors

Bathroom Assistance:

  • Is continent of bowel and bladder and manages toileting independently
  • Is continent of bowel and bladder and manages protective and/or assistive devices independently
  • Requires occasional reminders to go to the bathroom
  • Has intermittent episodes of incontinence
  • Requires reminders for protective garment use
  • Requires assistance to manage bowel and/or bladder
  • Requires two person lift/assist

Fall incidents:

  • Has had no falls
  • Has had 1 fall in the last 3 months
  • Has had more than 1 fall in the last 3 months


  • Independent in mobility
  • Requires reminders to use assistive devices
  • Requires assistive of one person transferring
  • Requires assistance to push wheelchair because of a physical limitation
  • Two person assistance required for transfer

After going through your short list of potential senior homes, and you, your family and parent choose a community, be sure that a new resident assessment is conducted. And if your parent agrees to it, attend the meeting. Caregiver feedback is equally as important as resident feedback, and senior living communities typically like caregivers to attend whenever possible.

Or the staff may conduct separate assessments, one with the caregiver and one with the elder, so both parties feel comfortable being 100% honest. Assessments should continue intermittently for all residents, to assess changes in needs and health as the residents age. In short, resident assessments are a crucial tool for any senior living community for all seniors, from new residents just moving in to seniors who have lived in the community for many years.