When you start your search for assisted living for your aging loved one, you’re likely looking for a situation where he or she will be safe, happy, and well cared for the rest of their life. And that’s exactly what you should be looking for, of course. The problem is, this is a big decision — and one requiring a fair amount of research — yet many families wait to begin their search until they’re faced with a health crisis requiring urgent action.

Statistics bear this out – of the people who call Caring.com to start their assisted living search, 60 percent will move their loved one within 2.5 months and about 25 percent will do so within a month of making that initial call. That time pressure means you may not make the best match for your loved one — and the facilities that you like most may have waiting lists that prevent a quick move.

Assisted living is a living situation for people who can’t live on their own, but who do not need full-time medical care. Typically, people entering assisted living need help with at least three activities of daily living (ADLs), which include everyday routines such as eating, bathing, toileting, dressing, and transferring to and from a wheelchair, according to assisted living expert Peggy Flannigan, PhD, professor of nursing at Bradley University in Peoria, Illinois. People who need less assistance may want to consider an independent living community or a Continuing Care Retirement Community (CCRC).

Even when you’re realistic about the need to find an assisted living facility, making the best match can be challenging. Choosing an assisted living facility can be overwhelming. You might feel as if you’re drowning in brochures describing all of the different assisted living services available, as well as grappling with budget and cost considerations.

Since there is no single, nationwide standard for the types of services offered in assisted living facilities, we’ve put together a guide to help you with this difficult decision. That said, there’s no substitute for visiting facilities in person — sometimes several different times — once you’ve narrowed your selection down to a handful of facilities.

Finding the Right Assisted Living Community

With so much information coming at you, it can be hard to prioritize what to pay attention to. One of the most important decision factors is going to be location. Decide whether you need to look for an assisted living facility in the community your aging parent is currently living in or whether he might need to move close to supportive relatives or friends who can visit and coordinate care with staff, if they are out of the area.

Once you have determined where you want to look, create a list of facilities in the area and begin a strategic assessment, using the ideas we’ve set out below. You can find potential facilities through online searches, of course, and it’s always a good idea to ask family and friends, agencies that advocate for the aging, and faith communities if there are any residential care facilities they like.

Once you have a solid list of facilities, make a plan to visit your top choices. But before you tour facilities, start with the following steps.

  1. Be realistic about what needs you or your loved one has, and what they might need in the future. Make a list of priority needs and concerns.
  2. Call the communities you’re interested in and ask for information, such as brochures, assisted living services, and costs. Or head to each community’s website for more information.
  3. Develop a general outline of your budget to make this move. Remember that four out of five people pay out of pocket for assisted living services, according to AARP.
  4. Make a list of your priority questions, using our guide below and your own research.
  5. Schedule a time to tour the facilities you like best. While visiting, talk to staff and residents. Bring someone with you to help keep track of the details.
  6. Make a second visit, without calling ahead. This allows you to get a feel for the facility outside of standard touring hours.
  7. Ask for a copy of the contract to review before you sign anything. Make sure you understand the base rate, any expected rate increases, and all of the fine print, which includes understanding which services are included in the cost and which cost extra. Ask for help from family or a lawyer if you’re unsure what the contract says.

Moving out of a home your loved one has lived in for years or perhaps decades can be bittersweet. Your loved one will also likely be downsizing, which contributes to their sense of loss. Many people wait to move to assisted living past the point where they are able to comfortably take care of their home. It’s a good idea to see some of the rooms available, if you can, and ask about what furnishings and decorations your aging parent can bring with them.

Changes in your loved one’s ability to manage independently throughout the day likely underlie the decision to move to assisted living. Activities of daily living include bathing, dressing, shaving, cleaning, laundry, cooking, hobbies, and undressing. Find out which of these services are provided and whether any cost extra. It’s also important, when you visit, to assess the mood of the facility. You want a place where staff are generally cheerful and helpful.

“What will Mom eat? And where?” might top the list of concerns people have when looking at an assisted living facility. Assisted living services can include a variety of eating options, from a shared dining room with a rotating menu or buffet, to small on-site bistros and other eateries. See if you can find a time to have lunch or dinner, or a snack, at the available eating locations in the facility. Some residences also may have small refrigerators and kitchenettes so your loved one can prepare a small meal or snack if they are able.

Be sure to take a look at the activity calendar. Ask about specific activities that are of interest to your loved one and, if they’re not available, talk to the activity director about whether you can request new activities. Also, consider the age of the residents you see. Socializing is important, and it will be easier for your loved one to be with people in a similar age range and mobility level.

Find out about the options for getting around off-site. If your aging parent is still able to drive, and wants to do so, check into parking availability.

Whether your loved one wants to stay active, become more active, or find low-impact ways to stay fit, assisted living services often include fitness options. Look for fitness rooms or gyms, walking paths or tracks, group exercise classes for all abilities, and any relationships with other facilities in the community that might provide access to a pool or other fitness programs.

Even though your loved one doesn’t need full-time nursing or medical care, he or she may require daily medical assistance or assistance on an as-needed basis. Ask about care assistance available for any specific health concerns you have. Make sure you understand which of these services are covered in the base cost of the residence, and which may cost extra.

Cleaning and laundry are services that are typically included at assisted living communities. Ask about the housekeeping schedule and what is provided as part of the routine services. Also be sure to ask about any add-on cleaning services that may cost more.

There are a number of other services you can look for, including a beauty salon or barber, faith services, café or bank. Some services might be permanent on-site offerings – or professionals may visit the community on certain days to provide those services.

After you’ve visited a couple of assisted living facilities, you should have a better idea of what is available and what is most important to you. Be sure to take good notes as you visit the assisted living facilities you are considering, and take the time you need to find the best match for your loved one.

What to Look For and Ask During Your Search

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 out for each community that you’re considering. As you learn more, note your observations.

An Assisted Living Research Checklist

Online Research

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? Try Trip Advisor or Hotels.com 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?

Phone Research

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?

Assisted Living Facility Tours

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

As you head to the assisted living community, consider the following:

  • 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?

The Greeting

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. While on the tour, keep an eye out for the following:

  • 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)?
  • 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?
  • Are you able to visit the fitness areas, or can the facility demonstrate a relationship with a community fitness location where residents will have access to fitness options for all abilities?

The Pitch

  • 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?
  • Are you able to visit the fitness areas, or can the facility demonstrate a relationship with a community fitness location where residents will have access to fitness options for all abilities?

An Assisted Living Tour Follow-Up Checklist

For any facilities where the initial visit was positive, here’s how to follow up:

A Surprise Visit

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

Follow-up Conversations

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, or other medical care needs, such as medication management?
  • 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.
  • Are there outdoor spaces where residents can spend time or, if they are interested, garden or engage in other activities with plants and nature? If not, are there outings available to access such opportunities?

How a Temporary Stay Can Help You Find the Right Community

One reason to start thinking about options for assisted living is that this is a big decision to make under pressure — and far too many families find themselves shopping for assisted living because of a crisis. Many families may not realize there’s another solution: a short-term stay, which can keep your loved one safe while you take stock of your options. Here are six reasons to consider such a plan.

1. Your Loved One Can Experience Assisted Living Firsthand

While you’re certain assisted living is the right option for your parent or other loved one, she may be less sure — or even strongly opposed to the idea. In this situation, a short-term stay may give new meaning to the old saying, “actions speak louder than words,” allowing your loved one to discover for herself the benefits of a busy social calendar, convenient transportation, and good food ready without the need to cook.

Many assisted living communities have month-to-month lease arrangements in addition to long-term contracts, allowing you to give your loved one a trial period with this new way of life. While she may decide she’s not happy with a particular community, she’s likely to be much more positive about the idea of moving in general after she’s experienced it for herself.

2. One Month Can Tell You a Lot

Each assisted living community has a different “vibe” — some are intimate and cozy, some bustling and active, while still others are popular with particular social networks, such as people of a certain religion or cultural background. While visits can help you suss out such differences, there’s nothing like actually living there to give your loved one a sense of whether she fits in.

3. You’ll Buy Yourself Some Research Time

Even a quick search has probably turned up a number of residential options in your area. And you may be surprised by the variety; some are small, some large, some have extensive amenities, others are simpler but excel in staff service and community involvement.

Even if you’ve narrowed your search to a few candidates, it’s going to take time to check each out thoroughly. (If possible, it’s best to make more than one visit to any community you’re seriously considering, and some experts advise dropping by unannounced.)

4. You Won’t Be Excluded by Wait-Lists

As you may have already discovered, some of the most popular assisted living communities have wait-lists, sometimes for certain types of rooms and other times for the entire facility. Choosing the option of a short-term stay prevents you from having to make your decision based solely on the spaces currently available.

5. You’ll Have Time to Get Your Finances in Order

Geriatric care managers see the following scenario all too often: A family, faced with a crisis, chooses the best assisted living situation they can find on short notice — often not the most affordable option — then realizes their funds won’t last at this rate of spending. They’re faced with the inconvenience and disruption of a move.

So while at first glance it may seem like month-to-month rates aren’t the best deal, this scenario can save you a great deal in the long run by allowing you to make a full assessment of your financial resources and select a community that your family can continue to afford year after year.

6. Short-Term Stays Relieve Caregiver Stress

There’s a reason many assisted living communities use the term “respite care” for short-term stays; they provide a much-needed breather for caregivers as well as a change of scene for residents. And caregiver stress is a very serious issue, leading to health problems, depression, and strains on marriages and other relationships.

Whether you need this break due to work obligations, family responsibilities or to take a much-needed vacation, it gives both you and the person you’re caring for a break from your regular routine. You may also find that such a break provides the perspective you need to look ahead and start forming a long-term plan.