What to watch out for when looking into assisted living?

Make sure it s a continuum of care facility. Assisted living, memory care and nursing home, at a minimum, on the same campus if not in the same building.

And if she runs out of money do they accept Medicaid? Do they have Medicaid beds available? How long must she private pay before Medicaid would kick in?

Medicaid is usually only available in nursing homes, in most states. If she needs a nursing home in the future will you have to move her again?

What are their policies on evicting a resident? Yes, it happens more often than we all know. My mom, in memory care, became a danger to herself and others and was kicked out. She was on hospice at that time. Hospice recommended a smaller care home where all residents had been kicked out of their previous facilities. Yes, it happens. And it was cheaper!

The smaller facility was much better suited to my mom. It was her last residence as she passed after being there about five months. They also allowed hospice to come in for the residents there. Another important consideration in choosing a facility is if hospice is allowed. Not all do.

You may want to call a well reputed hospice to ask about their recommendations for a facility.

Chloe, is your love one going into Assisted Living or into a Nursing Home? Sometimes those two terms mean the same thing, other times it does not. Just want to be sure which home your love one will be using.

Will the new home be part of a chain of Assisting Living facilities, or will it be a smaller home which has only a few residents? Does the facility provide the furniture or does the love one bring their own?

One thing to make sure, what is all included in the monthly rent? Some places charge a base rent, then other items are extra. When my Dad moved into senior living, his rent included weekly housekeeping, weekly linen service [Dad had to use his own sheets/towels], meals in the facility "restaurant". Personal laundry was an extra cost or a family member could do the personal laundry.

Physical therapy was also included if one's health insurance would approve. Medicine control was an extra monthly cost. Dad's electric bill was extra cost, so was the phone service. Dad did have cable TV which was included [Dad had to use his own TV].

Once Dad moved to the Assisted Living/Memory Care side of the building, the linen service was daily [the facility provided the sheets, pillow cases, and towels], housekeeping was almost daily. Facility also did the personal laundry. Medicine was part of the rent. I believe so was the electric, phone service, and cable TV.

Ask how is the monthly billing prepared. Is the bill paid by check or pulled from a checking account. Ask that the bill be sent directly to you. My Dad use to get a copy of the bill but that would make him grumble about the cost and him wanting to find some place cheaper :P

Usually on a tour of the facility, you and your love one can enjoy a free lunch. That will give you an idea on the variety of the menu, if there is one. My Dad was able to keep his lactose-free ice cream in their refrigerator, and the wait staff would know to ask him if he wanted desert of ice cream.

Ask if there is a Registered Nurse available around the clock, always in the facility. If your love one has memory issues and is moving into Memory Care, ask how the main doors are secure. I know that was a relief knowing my Dad couldn't wander off his floor at night time. During the day he could go anywhere in the building as the Receptionist knew not to let Dad outside without someone being with him.

Hope this helps.

Chloe99 - We went through this 4 years ago when mom was no longer able to live alone and did not need nursing home level of care.

Research! You want to be certain our loved one is well cared for. Part of this peace of mind comes from understanding the rights of assisted living residents and the obligations of the assisted living community. But this task is made more challenging because assisted living communities are not regulated nationally like nursing homes. Instead, each state has its own laws, regulations and licensing standards for assisted living communities. I suggest that you familiarize yourself with your rights and the legal obligations of assisted living communities where you live.

Look for amenities that you know are important to your loved one. Read the reviews to find out what other residents think of the community. If possible, go together to visit the community that looks like a good fit, so you can get a feel for the place and weigh in with what your loved one thinks of it before a final decision is made. From my experience, you most likely will not be able to find a AL community that’s perfect in every way and one they will love right away, but you should be able to find one that provides features your loved one needs to be happy.
There are many sites that offer great information.
·       U.S. Department of Health & Human Services
·       Elder Care services in your state
·       AARP

Good luck.

The best advice I can give you which was already mentioned is to ask everyone you know (or people who know others w/parents in homes) about the facility their parent or grandparent is in and how they regard the level of care. We hired and initially trusted an independent care coordinator and put my dad in a place she highly recommended. It turned out to be a disaster. We moved him ASAP but not before he got very sick and took a sharp mental decline. Also i found the official Medicare/Medicaid rating system to be 100% unreliable. (They may have improved in the last 2 years after an investigation and article by the New York Times.) Finally all the places are understaffed and could use more nursing assistants on any given shift. That’s a reality you have to live with.

• Pick an AL that is near to whichever sibling will be checking in the most.
• Go for a visit without your LO. Describe to the salesperson exactly what your LO can and cannot do for themselves. Be very forthcoming, don't sugarcoat anything.
• On the tour: check out the finishes and furnishings, do they look reasonably well kept up? Does the staff look engaged with the residents? Do residents look like they are engaged with each other?
• Ask what level of care they will handle. Can you LO age in place there? Some ALs only handle very basic ADLs. Can your LO get PT, imaging, blood work, podiatry visits...in-house? The more that can be handled there, the fewer visits to doctors offices.
• If it's a concern, ask what happens when your LO runs out of money.
• Ask to visit with your LO and have lunch in the dining room (maybe even with a resident) or come to a happy hour or other activity. If they refuse this, it's a red flag and they better have a very good reason why you can't.
• Get them to assess your mom. They should offer to send their nurse to do it wherever your mom is and should be able to get it done within a couple of days, often same day. The assessment will tell you exactly how much her care will cost. If you're looking at multiple ALs, have each one do an assessment, don't assume they will all assess the same.
• Once you've made a decision and are ready to reserve an apartment, it can't hurt to ask if there are any special offers (reduction in community fee, reduced rent for x months, etc).

Something a friend of mine is experiencing now is an assisted living home requesting pretty forcefully that the family provide private sitters for several blocks of time, like early mornings for getting ready for the day and evenings for getting ready for bed. This is an unexpected added expense on top of the monthly fee. You need a good breakdown of what all is included in the monthly fee, such as shower help, and other daily care activities, and if or when it’s considered too much for the staff. Then whether they handle it by moving to a higher level of care or wanting private sitters

It's also important to check with the AL about your LO's particular hobbies or daily habits. My father eats 6-8 small meals a day, including one around 3:00am so the MC with a 24 hour kitchen was a major factor. A great-aunt had a quilting hobby and some ALs wouldn't allow residents to have scissors or needles at any time. My cousins found a smaller home that would not allow my aunt to store her quilting supplies in her room (other than a quilting frame), but would bring them to her in the activities room or her room during the day.

Sometime economics or other care factors have to take priority in selecting a home, but when deciding between acceptable choices, considering these other factors can make our LO'a transition and acceptance of their new home easier.

For me, it's all about the CARE and the FOOD. Show up and watch.
Make sure both are good or it will be miserable.
If your loved one can still walk and speak up for her/himself, that's even better.
Once that's not available, assisting living facilities becomes more challenging [from my experience].

All the best to you and your family!!

Chloe, trying to separate the two terms, Assisted Living and Nursing Home isn't easy. But I will try.

From what I have seen, Assisted Living offers a private studio apartment for their residents. I use to joke with my Dad about his "dorm room". Dad needed help with showering, sometimes with using the toilet, and taking his medicine. The Aides would check on him a few times during the day. He did wear a medical alert in case he fell. He was mobile using his rolling walker.

My Mom was living in a nursing home. Mom had forgot how to walk or even stand. Yet she would constantly try to get out of bed or out of a wheelchair. Mom needed help being fed, and everything one would do for a child. She could no longer understand a request. She thought she was on vacation and staying at a hotel. She thought my Dad was her brother. Her condition would have been to overwhelming for Assisted Living.

Our AL works by a base monthly charge, and other things are added on. Medicine administration is $500/mo in our state, delivering a meal to the room is $3.50, unless on a 3-day doctors' orders to stay in room. Checking physically on the patient is extra, watching or helping to the dining room, small things - so ask for a list. Food is good but often too salty - we have to stay on them constantly although they say yes, low salt. If it's your mother and she is sex-sensitive, tell them you want to request only female aides in her room - or not. I generally like our AL over the past 3 years. Good luck.