The decision to move into an assisted living community is an important one. It marks a big change for you or your loved one and all family members involved.
The key lies in choosing the best community for the person who’s going to live there. It’s an individual choice, as there truly is no one-size-fits-all when it comes to deciding where someone wants to spend their golden years.
In this post, we’ll talk about what your loved one needs, with the understanding that all of these may apply to you as well if you are searching for assisted living accommodations for yourself. Be prepared to take some time to carefully research this decision. The more information you gather, the more likely you will be to find the right fit.
1. What your loved one needs.
This is, of course, the main concern. Be realistic about the needs you or your loved one has now, and how those needs may change or expand in the future.
It can help to sit down and make a wish list of needs and wants. Use a two-column sheet. On the “need” side, put down the things you absolutely must have, such as daily respiratory treatments or help with bathing. On the “want” side, put down things like “a private room,” “transportation to community events,” and the like.
Later, you may need to make some compromises based on what you can afford, but when you’re first thinking about assisted living, make your list with your or your loved one’s needs in mind.
2. Where your loved one wants to be located.
Often, it’s best to live close to loved ones or in a familiar community. But it’s important to realize that where the community is located may also make a difference in what it costs, the types of care it offers, and more.
Some states, for instance, limit the medical services these facilities can offer. If your loved one needs more than that, they may qualify for skilled nursing care. Alternatively, you might consider an assisted living community in a different state in which assisted living communities are permitted to provide the level of care your loved one needs. You can find specific information on assisted living communities and what they offer from state to state on the American Health Care Association’s Facts and Figures website.
Other things to think about in terms of location are:
- Surroundings: If your loved one is used to a quieter environment, will this community feel similar, or is it surrounded by a lot of traffic and noise?
- Accessibility: Can friends and loved ones easily get to this community to visit?
- Suitability: Is the location near places where your loved one needs to go, such as the doctor or to community events?
- Community: If your loved one is still independent and active, will this location nurture that? Does it offer nearby places for socializing, eating out, or enjoying a round of golf?
3. The size of the community.
The size of assisted living facilities may vary greatly in terms of square footage and the number of residents. When you’re researching possible locations, ask these size-related questions:
- How many rooms does the community have?
- What other resources are available within the community? (Dining, physical activity, and outdoor recreational areas.)
- What is the staff-to-resident ratio? If there are more staff members on duty, residents typically receive better care. If your loved one needs more attention, this is an important consideration. There are also minimum required staffing ratios, although these vary from state to state.
Usually, larger facilities have a smaller staff-to-resident ratio and offer more services and top-class amenities, but not always. These are things to look for and ask about as you are conducting your search.
4. What types of care—and transition services—they offer.
All assisted living facilities offer some level of care and assistance with activities of daily living (ADLs), but the specific care and services offered varies depending on the state you’re in and the community itself. You’ll want to find out a) if the location offers the care your loved one needs right now, and b) what happens if your loved one’s health or care needs needs change.
Start by asking what services the community provides for residents on a day-to-day basis, such as assistance with bathing, dressing, and personal care. Determine if the care offered will be adequate for your loved one. You’ll also want to ask if the community assists with medication management and helps coordinate appointments with healthcare providers, as well as what supplemental services it offers, such as physical therapy, occupational therapy, or memory care services.
Then, transition to potential changes. What if your loved one’s condition gets worse and she needs more care? Can the community help with that, or will your loved one have to move? If moving is the only option, find out if the community helps to make that transition easier. Perhaps they have a senior living community they recommend, or they may offer help with moving.
Some assisted living communities are part of larger continuing care retirement communities. If so, this can make moving from assisted living to skilled nursing communities (if necessary) a little easier.
Finally, check to see if the staff monitors for changes in your loved one’s condition. If they do, that can give you peace of mind, knowing they’ll be watching out for any worsening symptoms your loved one may have.
5. What other services they offer.
Refer back to your list of what your loved one would “want” in a senior living community. Then using that list, find out what other services each assisted living community offers. Keep in mind that more services may mean a higher cost, so it’s important to prioritize which are most important.
Common services that may be available include:
- Dining services
- Local transportation
- Exercise and wellness programs
- Art and pet therapy
- Computer and piano lounges
- Community outings
- Other activities provided on-site
Compare what the community offers with your loved one’s natural interests to see if they match. These services can mean the difference between your loved one feeling happy and engaged or suffering from isolation and loneliness.
6. How much it’s going to cost.
Most assisted living residents pay out-of-pocket, so it’s important to be sure that you can afford the place you like. In some cases, long-term care insurance, home equity financing, veterans’ benefits, or other resources can be used to help offset the costs, so be sure to check on those before making your final decision.
Assisted living communities vary greatly in terms of their payment structure. They may include everything in a monthly cost, while others start with rent and let you add other services from there. Or they may offer a tiered system with each level up including more services but costing more as well.
Try not to worry about cost too much when you first start looking, but after you’ve narrowed it down to three communities or so, schedule visits and come armed with key cost questions. You want to avoid being surprised down the road by costs that you didn’t expect.
Some good questions to ask include:
- What are your billing and payment policies?
- What is the base price per month or year?
- Are all services included in the monthly fee? If not, how is that broken down?
- Do you have a document that lists all of the costs applicable?
- What is your policy for refunds and transfers?
- Do you have any recommendations for government, private, or corporate programs that may help cover the costs?
7. Whether the place feels like home.
No matter how good a community may look on paper, there’s no substitute for a personal visit. You can thoroughly research several places online and think you know where your loved one would be happiest, only to visit the location and quickly change your mind.
Each community has its own “culture.” There’s a feel to the place that may or may not agree with your loved one. The location, buildings, accommodations, staff, decorations, and more can all play a role in whether the environment seems warm and welcoming or somehow brings up negative feelings.
No matter what else you do, be sure you visit the community at least once (2-3 times is better) before you and your loved one decide to stay there. Remember that this is going to be “home.”
8. How the place looks from the road.
You can tell a lot about a community by just driving by. How are the grounds maintained? Is there a nice lawn and flowers? Does it feel bright and cheery? In the winter, are the sidewalks properly cleared and salted?
Your first impression matters. Park the car and take a look. Do you see porch seating, a garden or courtyard, or something else that signals a welcoming tone?
9. How much they care about safety.
The last thing you want is for your loved one to fall or otherwise be injured while at the assisted living community. When visiting, keep an eye out for details that indicate the owners, managers, and staff care about residents’ safety.
Features to look for include:
- Handrails, grab bars, and zero-threshold showers
- Accessibility features like elevators, stairlifts, wheelchair ramps, and widened doors
- Cleanliness and upkeep in areas like the dining facilities and activity rooms
- Adequate lighting everywhere, including in hallways and bathrooms
- Alert buttons for emergency assistance
- Monitoring services (are there systems in place to ensure residents are present and accounted for?)
- Generators for backup power
- Nightly safety checks
10. What their staffing requirements are like.
It’s not easy to find good help these days, as they say! But the staff can make a huge difference in whether your loved one enjoys their stay or not.
The community may be beautiful, the services amazing, and the rooms homey, but if the staff is lacking, that may kill the deal. During your visits to the location, make a point to observe and talk with the staff. Are they friendly and accommodating?
It also helps to linger in common areas and see how the staff members treat the other residents. Observe one-on-one interactions if you can. Staff members should be compassionate, friendly, and patient.
Next, come ready with questions to ask about staffing. These may include:
- What is your staff-to-resident ratio?
- How many staff members are working overnight and during the day?
- Do you perform background checks on staff members? If so, what kind?
- What qualifications must staff members have to be hired?
- What is your staff turnover rate?
- What kind of training does your staff receive on a regular basis?
- Do you have a registered nurse, licensed vocational nurse, or certified nursing assistant on staff 24/7?
- Are staff members available to administer medications? If so, when?
- Are they available to assist with the activities of daily living? If so, when?
- Which organizations conduct inspections or audits of your facility? How often do they do so?
11. What kind of living accommodations they have.
Moving out of a home you’ve lived in for a long time can be difficult. Most likely, your loved one will be downsizing and will feel a sense of loss. To help ease the transition, you want to make their new home feel as comfortable as possible.
Ask about what types of rooms and apartments the community has and take the time to visit each one. Then ask about what furnishings or decorations your loved one can bring with them. Determine whether your loved one will want a private space, or may be willing to have a roommate. Cost will likely be a factor as well.
Other questions to consider include:
- Does each room or apartment have a private bathroom, or are these shared?
- Are there refrigerators or cooking appliances available (if needed)?
- Is the apartment or room designed to accommodate walkers and wheelchairs (if needed)?
- Does each room have a 24-hour emergency response system?
- Is housecleaning included or is there an extra fee?
12. Whether the community allows pets.
There are several pet-friendly assisted living communities, so if a pet is in the picture, consider looking only at those that will accommodate your loved one’s furry friend.
When visiting, ask these questions:
- What types of pets are allowed? (Your loved one’s cat may be welcome, but not her lizard or bird.)
- Are there any breed restrictions? (Some facilities may have rules about some breeds like pit bulls.)
- Is there a weight limit for the pet? (Large dogs, for instance, may not be allowed.)
- What are the vaccination requirements?
- Is there an extra pet fee?
- How many pets are allowed per resident?
- Do you offer pet care services? (Dog walking, grooming, feeding, etc.)
- What happens if the resident can no longer care for the pet?
- If the pet falls ill, do you have anyone who can assist with the animal’s care?
Keep in mind that if your loved one has a large pet, it may be difficult to find an assisted living community that will take it. Some pets are not suited to long-term indoor living. It could be too that your loved one can no longer properly care for the pet. In that case, it may be best to re-home the pet.
13. What the food is like.
When visiting a community, be sure to incorporate a meal into your time there. Good nutrition is a must for everyone, and it’s also important that your loved one like the food. No one eats food they don’t like.
Sit down and have a bite. Check the menu to see what they have available. See how it tastes to you. If your loved one has special dietary requirements, make sure the community can accommodate those.
Talk to the other residents. Ask them what they think of the food. This is the best way to get honest opinions! Then ask management about the meals.
Some good questions:
- How many meals are provided per day? Are there set times for them?
- How long is the cafeteria (or dining hall) open each day?
- If someone gets hungry after hours, what are the options for meals?
- Do you accommodate specific dietary needs, restrictions, or special requests?
- Can residents keep food in their apartments? Can they cook their own food?
- If we want to have a meal prepared for a special occasion, such as a birthday, do you accommodate such requests?
14. How often and what time of day or night you can visit.
Ideally, the assisted living community will allow you to spend time there whenever you want to. That includes stopping in for a spontaneous meal or activity or planning an overnight stay.
There were some changes to these policies during the COVID-19 pandemic that were made to try to protect residents. Some of those policies may still be in place, depending on the community you’re looking into. Be sure to ask about any changes that may occur should the community experience a spike in cases so you know what to expect.
You should also ask what management thinks about the role that family plays in the resident’s life. Their answer can give you key insights into how they feel about family visits and family involvement.
Ask whether families can meet with various departments to discuss matters concerning their loved ones. Can you volunteer if you want to? Can you participate in social activities? Do you have a say in your loved one’s preferences or needs? It’s important to know how the community handles family overall, and these questions can help you find out.
15. How the community measures resident satisfaction.
One thing that can make the difference when choosing an assisted living community is how interested they are in truly making their residents happy. What is their philosophy of care? You can ask them, then see how they follow through.
Do they, for instance, regularly offer surveys to residents to see how they’re doing? Do they have a complaint box available so residents can inform them of things they don’t like? If so, how do they handle those complaints?
If the community does anything like this, ask to see the results. Maybe you can see cases where the staff changed something because of a complaint. Or maybe you can view the results of surveys they have taken over the years.
If the community is doing nothing like this, take that as a warning sign. It doesn’t need to be a deal-breaker, but it may signal that the management is not as concerned about what their residents think of the place.
Choosing an assisted living community isn’t an easy decision. Carefully considering the points described above can help you make the best decision for yourself or your loved one. For the peace of mind of knowing that your loved one’s needs will be met regardless of changes in their health status or the care they require, a continuing care retirement community is an excellent choice. Continuing care retirement communities like Arbors of Hop Brook offer several levels of care on the same campus, allowing residents to easily transition to a community in a familiar environment as they require additional care and services. Check out our floor plans or take a virtual tour, and when you’re ready to take the next step, schedule a visit to tour our community and explore all that life has to offer at Arbors of Hop Brook.