What To Look For

Evaluating your options when it comes to making the right assisted living choice for a loved one can feel overwhelming and confusing. Before you begin your search, make an honest and accurate assessment of your needs, including physical accommodations, financial resources, and lifestyle. Decide what’s most important to you.

One of the most important factors when choosing an assisted living facility is your own subjective assessment. Does it feel friendly, safe, and comfortable to you? Does it feel right? While a facility should be clean and well-maintained, don’t place too much emphasis on surface appeal such as designer furnishings, gourmet meals, and lavish landscaping. The facility you’ll be happiest with long term won’t necessarily be the fanciest or most expensive. The bottom line is that the right facility for you is the one where you feel most at home.

General Considerations

• Proximity and convenience for family and friends.
• Is the location pleasant and attractive? Is it an area you will be happy to visit?
• Is the facility in compliance with state licensing requirements? Ask to see licensing evaluation reports. Talk to Community Care Licensing (Department of Social Services). Call the long-term care Ombudsman’s office to see if there are any complaints about the facility. Keep in mind that most facilities are occasionally sited for minor corrections. But look for patterns of big or recurring problems. The Better Business Bureau can also be a resource in this regard.
• Ask to see a copy of the resident admission agreement contract. It is a legal document that spells out obligations. Many facilities hide additional charges for what you may consider basic services that are not included in the price you are initially given.
• Make more than one visit to the facility. Show up unannounced. Visit at different times of the day and weekend.

Facility Staff

• Is the staff helpful and friendly?
• Do they look you in the eye and acknowledge you, or do they avoid contact?
• Do they seem happy to be there, or glum and disinterested?
• Do they have time to speak with you, or does it feel rushed, as if you are inconveniencing them?
• How do they interact with residents? Is it warm and friendly, or impersonal and businesslike?
• Do they seem quick to respond to resident requests?
• What kind of training do they receive?
• How available is supervisory staff if there is a serious problem in the middle of the night?
• What is the staff’s communication like with the residents’ doctors?
• Who dispenses medications? What kind of training have they had? Are residents allowed to self-administer medication with doctor approval?
• What is the staffing ratio like at different times of the day/night? There is no absolute rule or regulation on this. Depending on the care needs of the residents, the ratio can vary anywhere from 1 to 8 (one caregiver to eight residents) to 1 to 15. And daytime requires higher ratios than evening or nighttime. These ratios do not include housekeeping or kitchen staff. Does there seem to be enough staff around to adequately respond to the residents’ needs in a timely way?
• What is the staff turnover rate? An annual turnover rate below 10% is considered very good. If it is significantly higher than that, it could indicate a problem.

Accommodations / Atmosphere

• Does the physical plant seem well-maintained or neglected?
• Does the facility feel warm and inviting, or cold and institutional?
• Is the facility clean? Are there any offensive odors that seem to be chronic or unaddressed?
• Does the physical space have an open, clean flow to it, or do things seem constricted, cramped, or chaotic? How wide are the hallways and doorways? Do they allow easy access for wheelchairs?
• Are the individual resident rooms furnished? Can you bring in your own furniture and decorate it the way you want?
• Are there handrails in the bathrooms and showers?
• Are showers available in the individual rooms, or is there a larger, specialized shower room down the hall? Are shower seats available?
• Are there private vs. semi-private room options available? What are the differences in the floor plans? What are the differences in the price? Is the price you are being quoted the final price? Does it include all the services you want and the appropriate level of care? Watch out for hidden fees.
• Does the atmosphere seem pleasant and harmonious? Or are there loud, disruptive, or hostile outbursts?
• Are the floors carpeted? Carpeting helps create a quieter environment.
• If you are looking for a facility for someone with dementia, check to see if there are alarms on the exits to prevent residents from wandering away unnoticed.
• Is there a modern fire alarm system in place with smoke detectors in each room? Does the staff conduct fire drills on a regular basis?
• Is there an emergency and disaster plan in place?
• Are there security cameras monitoring the exterior common areas around the facility allowing staff to keep an eye on those areas for resident activity.

Care and Services

• Is the response to special requests one of flexibility and accommodation? Or do things feel stiff and procedural?
• What is the process for conducting the initial care level assessment? What care level seems appropriate? How does this affect the price?
• What additional service options are available and what is the cost?
• Is a written service plan created and maintained for each resident?
• As the care requirements of the resident change, what options exist for continuing to meet those escalating needs? At what point would the care requirements exceed the capabilities of the facility to adequately provide them, thereby requiring relocation to a different facility?
• Are housekeeping and laundry services available? How often?
• Is there a caregiver call or paging system in place in every room and bathroom?
• Can Home Health agency services be arranged by facility staff?
• How is transportation to medical appointments arranged?

Food and Activities

• Ask to see a sample meal menu. Is it varied? Is there a good nutritional balance?
• Try eating lunch or dinner at the facility and sample the food for yourself.
• Are there any between-meal snacks available?
• Does everyone eat in the dining room, or do some residents eat in their rooms?
• Are menu modifications made for individuals with restricted diets?
• Ask to see the activities calendar for the current month. Is there a wide variety of planned events and activities? Are there multiple events planned each day?
• Are there outside entertainers that come into the facility to perform?

Residents

• Do they appear content? Or do they seem frustrated?
• Do they seem to enjoy interacting with one another?
• Do they look well-groomed?
• How is their interaction with staff members?
• Do they seem like people you or your loved one would enjoy getting to know?
• Ask a few of the residents how they like living here.