Everyone ages differently.
Few people will remain fully independent and mobile their entire lives, while most will require help in the form of assistance from family, nursing home care, home health care or assisted living.
Assisted living communities are for people who may need help with instrumental activities of daily living—transportation, appointments and scheduling, managing money and paperwork—as well as for those with some personal care needs.
Assisted living differs from retirement communities, which may or may not offer services that support aging in place; and they are not the same as nursing homes, which offer 24-hour care and direct access to more extensive medical services.
Once you or your loved one have determined that assisted living is what you are seeking, the search begins for a suitable home.
Finding the right assisted living community can be a challenge. Your area may have few places to choose from, or perhaps you can’t afford the one closest to your family or friends.
The right facility may be easier to find through a process of elimination in which you consider the cost of the facility, the care they offer and whether the culture is a good fit for your loved one.
For many people, the most important factor to consider is your monthly budget and how much your monthly rent and fees will cost. Included in that consideration are:
- Whether you have Medicaid
- Whether your insurance covers assisted living
- Whether you have long-term care insurance
- Your monthly income from retirement or pension
- Rental income or proceeds from the sale of your home
Once you know your budget, you can narrow your search with phone calls and online research about area facilities that are available to you.
- Check that the facilities are fully licensed, with trained and certified staff
- Find out which services are included and which cost extra, like laundry and housekeeping
- Ask to see their certification reports and look for patterns of reported neglect or medical errors
- Find out the staff turnover rate and the ratio of staff to patients
- Find out whether the community provides security
- Find out whether/what kind of pets are allowed
Brian K. Unwin, M.D., chief of Geriatrics and Palliative Medicine at Carilion Clinic, recommends that people consider future needs as well as current needs when considering the care each facility offers.
“It is imperative to find out about what medical care they offer, and what their policies about memory care are," he said. "Some facilities do not provide direct medical services. You may keep your primary care provider in some facilities, but perhaps not in others. If a person develops advanced dementia that exceeds the ability of the facility to provide a safe environment, the individual may have to move to another facility."
Once you have narrowed your search, visit potential facilities in person to see the layout of the buildings, what the rooms and grounds are like and what it feels like to be there. For some people, the culture of an assisted living facility may be the most important consideration of all.
“It is important to keep the values of the patient moving into the facility foremost in mind," said Dr. Unwin. "Moving into assisted living is a very difficult thing for an individual to go through, especially because cognitive impairment is a frequent cause for this move. Emphasizing that assisted living facilities may potentially provide an individual and family the best possible safe living environment is key. Embracing the idea of modified independence can be helpful.”
Consider the following as you tour the grounds:
- Are there adequate community areas for residents to use?
- Would your loved one be comfortable with the other residents there?
- Do the residents look happy?
- How does the staff interact with them?
- Is there a mix of social activities and privacy?
And don't forget your most informed resource available to you: your loved one's primary care provider. If you have additional questions about making such an important decision for yourself and your loved one, they will be able to help you.