Hunting for assisted living can be hard. After all, you want to make sure you find the best place for your loved one -- and it also needs to be clean, well run, and within your price range. You need to get a good sense of what each community is really like, not just what its advertising says about it.
Still, the process doesn't have to be intimidating or overwhelming. Here are three simple steps you can follow to help narrow down the choices to the perfect community. First, you'll do research online and by phone. Then, you'll tour to see what each community feels like in person. Finally, for the communities you like best, you'll want to follow up for more in-depth information.
This is a checklist you'll come back to over time. Print one for each community that you're considering. As you learn more, note your observations.
- Step 1: See the Assisted Living Research Checklist or print it
- Step 2: See the Assisted Living Tour Checklist or print it
- Step 3: See the Assisted Living Follow-Up Checklist or print it
Note: If your loved one has memory impairment, please see the Assisted Living Checklist for Loved Ones With Alzheimer’s.
Start with online research to find facilities near you or your loved one. Caring.com has a nationwide directory of assisted living communities or you may be able to find facilities listed in the phone book or through word-of-mouth recommendations. The Departments of Health and Human Services for each state are also good resources for finding facilities. These questions can help narrow down the options:
- Is the location close to shops, doctor's offices, a pharmacy, and other important places? Try some of the features on Google Maps to explore the neighborhood virtually.
- Is the location convenient for family and friends to visit? Google Maps can help you figure out driving distances to and from the community.
- If the facility is not in your town, are there hotels nearby for when you visit the area? Use Trip Advisor to search for area hotels.
- Is the neighborhood generally considered safe, or is there a high crime rate? Crime Reports, Trulia, and Neighborhood Scout have tools to help you evaluate neighborhood safety and crime rate.
- What are others saying about this provider in Caring.com reviews?
- Can you find any information about the provider through the Better Business Bureau or your local Area Agency on Aging?
The first time you speak to providers on the phone, find out whether they're currently accepting new residents. If not, ask about their waiting lists. It's worth keeping in mind that families often put their names on waiting lists at several facilities, so the list may be shorter than it seems. Don't hesitate to put your name on a list just because the waiting time is significant. You also want to ask questions early on about how expensive the provider is. Pricing for assisted living can vary significantly based on your loved one's needs, so this may not be the time to pin down specific pricing. That said, it is wise to ask general questions to determine whether a provider is way out of your price range.
- What types of payment are accepted, and/or do they have programs to help residents afford care?
- If there are any negative online reviews about them, what is their response or explanation?
- When do they offer tours, and how long do tours last?
- What will they show you when you tour -- will you have a chance to try the meals or meet with residents?
Experts say that the most important part of making a decision is listening to your gut instincts. Even beautiful facilities with huge advertising budgets can be cold, dreary places, while older facilities with a little missing paint can be cheerful and happy. Going for a visit -- or several -- can help you determine if the community will be right for your loved one.
Figuring out how to tour is a little more difficult, especially if your loved one is not very mobile or if you live out of town. It may be worthwhile to tour several facilities before bringing your loved one to see the two or three you think might be best. Or ask a friend or family member to tour facilities (and take copious notes and photos).
Geriatric care managers can also help find the best assisted living facilities for older adults -- they often know a great deal about all the care options in their town. Caring.com has a directory of Geriatric Care Managers across the country.)
Before your visit, review your checklist. Underline or circle the questions you care most about. Cross off any that aren't relevant to you.
On the way in
- Is the neighborhood quiet and pleasant?
- Is there easy parking outside, including handicapped spaces?
- If your family member will be bringing a car, is parking provided?
- Is the building's exterior clean and attractive?
- Are the grounds attractive, with plants and trees?
- Is there a safe, enclosed area where residents can walk and socialize?
Most tours start in someone's office or in the lobby -- the director of marketing or another staff member will spend time talking to you about the community in general. He or she should be asking you questions about your needs and what you want to see, so the tour can be tailored for you.
- Do you like your tour guide?
- Do you feel that he or she is listening to your needs and questions?
- Do you feel pressured in any way, or like someone is "selling" you?
- Does the tour guide speak only to you (the adult child) or does he/she make an effort to include your loved one?
- Are you able to talk to staff members other than the tour guide, either in a formal session or informally during or after the tour?
The walking tour
While you're walking around, don't worry about checking things off. Instead, pay attention to what you're seeing, hearing, smelling, and feeling in each of the spaces. Try to talk to different residents and staff members, not just the director of marketing. This will help you get a fuller idea of what the community is really like.
- Are the common spaces in the community pleasant and appealing?
- How many rooms are there where the residents can spend time with each other and with visiting family members, and can you imagine your loved one using these common spaces?
- Are hallways well lit and easy to navigate, with handrails for safety and plenty of room for wheelchairs?
- Are there shared pets in the community (such as dogs, cats, miniature horses, fish, or birds)?
- Are there plants, and do they look well cared for (free of dust and well watered)?
Residents' living spaces:
- Do most residents have a private room or share a room?
- Is it possible to view all the different types of rooms available?
- Does each room have a private, handicapped-equipped bathroom, or is there one shared bathroom?
- Are residents' rooms personalized with photos, mementos, or other possessions?
- Is there adequate closet and storage space?
- Is there good lighting and are there attractive views in each room?
- Are the dining rooms clean and attractive?
- How many meals per day are provided?
- Are there snacks and, if so, how and when do residents get them?
- Can the community cater to specific dietary needs or special requests?
- Can the residents bring food back to their rooms, and/or are there kitchens in the rooms?
- Can visiting family members join the residents for meals?
- Do the residents seem to like the food?
- Can you taste the food or come for a meal to try it yourself?
- Is there a private room available for family celebrations or private family dinners?
- Is there a posted, varied schedule of activities, and are there any activities that you think your loved one would participate in?
- Do the residents have any scheduled interaction with the outside local community, whether because volunteers come into the community or residents go on regular outings?
You can expect the tour to end in the tour guide's office or in a common space. At this time the tour guide will likely ask you questions and answer any you have. You'll also probably hear "the pitch" -- the tour guide will be promoting his or her community as the best choice for your loved one. If possible, ask for a moment to review your checklist before or just after this conversation. Check off all the items that were addressed and all the questions that you've already had answered. If you're still interested in the community, go ahead and ask any of the remaining questions that you want answers for, or plan to ask them in a follow-up phone call or visit.
For any facilities where the initial visit was positive, here's how to follow up:
Pop in for an unannounced visit in the next week or so, potentially in the evenings or on a weekend. If everything looks just as pleasant as it did during the tour, that's good. If the atmosphere is completely different, it might be worth considering other facilities. And if the staff won't let you in other than during a tour, it might be a signal that you should look elsewhere.
Documents to request
It's a good idea to get as many of the following documents as possible. They can help you compare the fine details of one facility versus another.
- Sample admission contract
- A copy of the Resident Bill of Rights
- A copy of the most recent survey results from state regulatory inspectors
- A recent list of weekly activities and events
- A recent weekly menu of meals and snacks
Schedule another visit or phone call to ask these more detailed questions about costs, care, and services.
- How much will assisted living care cost for your loved one? The answer will be different depending on your loved one's needs, so allow ample time for this conversation. Be sure you feel the staff understands your needs and is communicating the answers clearly.
- Does the cost include any special move-in fees or fees for services, such as laundry?
- Is there an extra charge for transportation to doctor's appointments or outings?
- Under what circumstances might costs go up?
- How is the community funded, and is the funding stable?
- Will the community help with the paperwork involved with getting Medicare, Medicaid, V.A., and other sources to pay for care?
- What's the ratio of staff to residents?
- What's the staff turnover rate?
- Are background checks performed before hiring staff? If so, when and how?
- How much training do staff members have?
- What does the facility do to avoid staff burnout and/or retain great staff members?
- Is there an RN, LVN, or CNA on staff?
- Is an initial assessment of needs conducted and a written care plan developed? Who's involved in developing the care plan? How often are the needs reassessed?
- What specific care is available from doctors, nurses, physical therapists, occupational therapists, and others?
- Who handles medication management, and how well trained are they?
- Is the facility affiliated with a hospital or nursing home if more care is needed?
- What medical emergency procedures are in place?
- Are residents required to have renter's insurance for their units?
- Is housekeeping for units provided -- and included in the price?
- Are barber and beauty services provided -- and included in the price?
- Are pets allowed?
- Are there religious services on the property or nearby?
- Are visits to the residents allowed at any time, or are there set visiting hours?
- Are residents allowed to have overnight guests, such as a family member from out of town?
- How does the community accommodate private time for couples if only one spouse is living in the community?
- What is the facility's policy on sexual interaction between residents? A good facility will have a written policy in place.
- What is the facility's emergency preparedness strategy -- do they have a backup generator or evacuation plan?
- Does the facility have an adult day program? Sometimes older adults are more comfortable moving into a facility if they've already spent several hours having fun with some of the residents.
If you like the place a lot but still aren't completely sure, ask if your loved one can try a temporary stay for a weekend or even a week. Many assisted living facilities offer temporary stays as part of a respite program, so doing a short trial should be possible too. This trial stay is the most accurate way to tell what living there would be like.
Share your own thoughts about vetting assisted living communities via the comments section below. What are questions you've asked or plan to ask? You can also visit our assisted living online support group.