Once you have determined that you would benefit from moving to a senior living setting outside of the home, you will be faced with multiple choices, unless you live in a smaller town or rural area with limited alternatives. How do you begin to sort through your options?
Everyone’s needs and desires are different. That’s why they make both hamburgers and hot dogs. But there are areas that everyone should evaluate. Checking these off your list will help you narrow your choices and make a better decision.
1. Choose the right location
This one seems obvious, but you may find everything you believe you need within, for instance, a shiny new assisted living community that’s on the other side of town. It may have the latest technology, modern apartments, designer interiors, multiple cafes and other gathering places, a putting green and all the appealing bells and whistles you’ve never even dreamed about.
If that’s what you want, go for it. But make sure you’re not isolating yourself from friends and family and the familiar places that give you peace of mind — including shopping, health and medical services, and dining and entertainment.
2. Inspect for cleanliness, housekeeping and maintenance standards
Your idea of clean and well-maintained may not align with everyone else’s. If the community management is lax in maintaining the standards to which you are accustomed, you will never be comfortable in that community. Check for pervasive odors, look behind closed doors, and inspect the kitchen.
Senior living communities require constant maintenance and housekeeping. If you don’t see someone cleaning or maintaining something during your tour, that may be a bad sign. And don’t assume that because the model apartment is spotless, the rest of the community is the same. Keep your eyes open for trouble spots.
3. Review the staff
The quality of the staff should be the most important factor in making your decision. Your initial interaction will probably be with the receptionist and then the sales or marketing director, but don’t stop there. Ask to meet the executive director and the nursing director. Is there a registered nurse always available? Talk to several care associates, and observe how they engage with the residents. Are they friendly? Are they patient? Do they listen to the residents and try to help, or are they curt and dismissive? Does there appear to be enough staff to handle the workload, or do they seem to be short-handed? How does the staffing composition differ on the night shift? Ask questions of the staff and of the residents.
4. Tour all of the living spaces
Of course you want to have a nice personal living space with room for your personal belongings, and a place to relax and perhaps entertain your family and friends. When you get close to making a decision, examine the specific apartment in which you will be living. Is it clean? Do the walls need painting? Does the carpet need replacing? Does the plumbing work well? Can you adjust the temperature to your comfort zone? Will the community fix things that need to be repaired before you move in?
Also, get a feel for the common areas, because you don’t want to spend all your time inside your apartment. Are they comfortable, or will you always feel like a visitor? Would you prefer a smaller, cozier environment, or would you rather be in a larger, livelier place with more activities? When you look through the window, what do you see? Gardens? Parking lots? Other buildings? Will you be happy with that as your vista?
5. Have a meal or two
Meals are often the highlight of the day. You want to look forward to mealtime, not dread it. Most larger communities employ chefs and other food service professionals to ensure that meals are not only appealing, but nutritious and meet everyone’s dietary requirements. But over time, we all develop individual palates and preferences. Make sure you can order meals that suit your taste.
Is the wait staff congenial? How do they handle special requests? Do they know the residents by their names? The staff needs to have developed a familiarity with the residents so they can make certain they’re getting the proper diet, their food is cut up, when necessary, and other specific dietary requirements are being met.
Communities are happy to have prospective residents join them for meals. When visiting, ask about menu choices and alternatives, dining room hours, the availability of food in cafes and other locations and room service procedures should you need to eat in your apartment.
6. Stroll around the campus
You’ve seen the inside. What about the outside? Whether you’re looking at an urban or suburban setting, make sure the outside areas provide a space to sit in the sun, stroll around, or even do some gardening. Are these areas safe or secure? Are they filled with smokers? Does the staff use the same areas for breaks? Are there scheduled activities that take place here? This is also a good time to check out the locations of all the entrances and exits and how secure they are.
7. Ask about security and safety
Which brings us to security and safety. Communities should have controlled access, including a staffed front desk during the day and locked doors with telephone or key card access at night. Visitors should be welcomed, but not able to come and go as they please without signing in and out. What procedures are in place and are these actually followed?
Inside your apartment and the common areas, make sure that bathrooms are accessible and have grab bars. There should be emergency call buttons that are simple to use. Hallways should be wide enough for walkers and wheelchairs. Communities should meet universal design and ADA standards for accessible design.
8. Understand the levels of care and personal services
Assisted living communities exist to help with the activities of daily living, and many communities offer several levels of care within the category of assisted living. Have these and their additional cost, if any, explained to you, and what triggers moving from one level to another. Is it your choice, or management’s? What happens when you get sick? Is it your responsibility to contact a doctor and arrange treatment, or will the staff handle this? How will your medications be managed? They should be controlled and distributed by the staff so that you are taking the proper dosage at the proper times.
As you talk to the residents, assess their physical appearance and even the way they are dressed. At some point, the responsibility for keeping clean, well groomed, hygienic and presentable shifts from the individual to the staff. How is the staff doing in this regard? Everyone has different needs. Does the staff seem amenable to meeting these, and are the residents treated like individuals? They should be.
Should you ever need it, is there a memory care unit onsite, or will you be forced to move to another community to receive the proper care?
9. Talk to the residents
The community will probably appoint a resident “evangelist" to tell you everything good about the community. That’s great, because you want to hear about all the features and benefits from a resident’s perspective. But make sure you talk to other residents, too, so that you may uncover any concerns that may not be immediately evident. Ask if you can talk to residents’ families as well, but make sure you get a representative sample. Unfortunately, there is usually at least one family that is unhappy due to a misunderstanding, oversight or error. Don’t let one family’s view establish your entire frame of reference.
10. Evaluate the activities and check out the amenities
Activities should be voluntary, not mandatory, unless they’ve been prescribed by a physician. If you don’t want to participate, you don’t have to, but you will certainly become more assimilated into the community and feel more at home if you do participate. There is usually something for everyone at an assisted living community, but take a look at the community calendar to see if the events and activities match your interests. Is there a library? Do they have WiFi? Are pets allowed? In addition to activities at the community, there should be scheduled outings, as well as transportation available for appointments, shopping and other engagements. Participate in an activity, if possible, to get a true idea of what to anticipate. Is the art class interesting or just paint by numbers? Do enough players show up for the poker tournament?
11. Get a written statement of the cost
You will have, no doubt, some idea of the cost or at least the price range before you take a full tour of the community, and have learned whether they only accept private funds or long-term care insurance or if they will take some form of government subsidy. In the United States, Medicare does not cover the costs of assisted living, but, in some cases, Medicaid, which is based on financial need, may provide some benefits.
So, that begs this question: if you should run out of money during your stay, will the community be able to accept Medicaid payments and allow you to remain, or will you have to seek different accommodations?
Here are some other things to consider. How much notice do you have to give if you decide to move out? What have the annual rate increases been, and what is anticipated in the future? What is the fee for each level of service within assisted living? Are there other fees, for instance for hair and nail care, outings, transportation?
You can also ask if the price is negotiable or if there are move-in incentives. Are some apartments priced lower than others because of their size or location within the community?
12. Find out about licensing
You would assume that any community you tour would have the proper state and local licensing. but there are stories in the news almost every day about those that don’t. Make sure. If they don’t, there is a reason that may impact your well being.
13. Ask if you can stay a night or two
Some communities will allow you to stay in a model apartment for a brief time to fully evaluate the experience. After all, it’s in everyone’s best interest that you make the right decision and don’t decide to move out after a short time. There may be a charge for this, but it’s well worth it. While you’re there, don’t treat this as an extended tour, but act like a resident — show up for meals and activities and participate in everything that is available. There is no better way to make your final decision.