What to look for in an assisted living center

National Assisted Living Week, which this year takes place from September 13-19, provides an opportunity to consider and anticipate our own needs as we age, as well as those of the people we love. The term “assisted living” encompasses an entire world of choices — AARP reports that there are more than 28,900 assisted living facilities nationwide.

Assisted living facilities range from apartments, to single-family homes, to rooms in a community where some slight help is offered. This level of care may provide meals, emergency alert systems, and help with dressing or other personal services. However, assisted living is not for those who need around-the-clock skilled care.

Elderly person in a wheelchair watching the sunset

Some assisted living centers are part of larger continuing care retirement communities, which allow you to move on to skilled nursing facilities if more comprehensive care is needed. CCRCs are set up so that you have the care you need when you need it, within your same community.

How do I find the right facility for me?

 A good place to start is your local or state Area Agency on Aging.  Use the federal government’s Eldercare Locator  to find the nearest agency. The staff there can help you find information and take the first steps in locating the right place.  Please note that during COVID-19, many assisted living centers are not allowing in-person visitors or tours. However, you can talk to staff, ask questions, and take virtual tours of the facilities.

Be sure to check out facility ratings and reviews on Senior Advisor.  Before signing a contract, consider having an attorney look at it, so there are no surprises in the future.

AARP advises asking these questions as you review the contract:

  • What are the entrance fees, monthly rent, and security deposit?
  • What level of personal and health care services are provided?
  • What specific reasons would lead to a resident being asked to move out, and how much notice would be given?
  • Is a resident’s space held if he or she is hospitalized?
  • Does the contract put any limitations on your right to bring legal action for injury, negligence or other causes?
  • Look for arbitration clauses in the resident agreement.  Such agreements mean that any disputes which later arise between the facility and the resident, no matter how significant, will be resolved in arbitration.  That is a waiver of a right to a jury trial.  In some cases, those agreements can be extremely one-sided – providing that the facility can select the arbitrator, the location and timing of the arbitration proceeding, and rules that will apply to the proceeding.  An arbitration agreement can be easily overlooked because it’s often buried deep in the contract.  Quite often, residents or their responsible party will execute the arbitration agreement without knowing what they’ve signed.  Nevertheless, these agreements are generally enforceable in Virginia courts and rescinding them can be very difficult, and in some cases impossible. The best approach is to not sign them in the first place.

Nursing home employee making elderly woman smile

What should I look for in assisted living? 

A Place for Mom suggests taking these steps in determining the best assisted living option for you or your loved one:

  • Assess security and safety. Does the facility have on-site medical personnel? How are emergencies handled — for instance if a resident falls, how can they call for help? In the age of COVID-19, what safety measures have been put in place?  Also, be sure the facility has an emergency generator in case of weather events.
  • Use your senses. If you are allowed to visit, observe the cleanliness and maintenance of the grounds and buildings. Does it smell clean and fresh?
  • Check out the activities. What is offered for the community? Is it of interest to you? If allowed, visit during an activity and see how many people participate and if they seem to enjoy it. Additionally, assisted living centers often offer a wide range of wellness programming and facilities.
  • Talk to the staff. Are they friendly and helpful?
  • Eat a meal. Check out the dining services by eating a meal, if you’re allowed to visit. This will not only provide insight into the type of nourishment being provided at the facility but it also peels back the curtain on just how organized and efficient the facility is during a very busy time of the day. If the facility is well-coordinated during this busy time of the day, that may be a good sign that staffing levels are adequate.
  • Get outside. What are the outside amenities? Are the grounds well kept? Would you enjoy their gardens or walking paths?
  • Ask about personal services. What does the facility offer to help with daily life? Are there laundry services or help with hair, nails, or shaving? Are there options for bathing and dressing assistance?
  • Consider what happens if you need more help. Is there another level of care or will you need to move to another facility?
  • Ask about costs. Weighing the benefits and costs will be important. Also, be sure to tap into any long-term care insurance you have. For people with low incomes and/or limited assets, Medicaid offers assistance. Veterans may also receive some federal help through the Department of Veteran Affairs.
  • Check the numbers.  Families should inquire about staffing levels, average staff to resident ratios, fluctuations in staff and turnover rates.  This is important because most injuries that occur in assisted living facilities can be traced back to staffing issues.  Assisted living facilities differ fundamentally to nursing homes because the former are not required to provide medical care.  Nevertheless, some assisted living facilities do have nurses on staff to assist with things as dispensing medication.  It’s important to know the full scope of services provided before deciding which facility may be right for you or your loved one.

The Virginia Department of Social Services regulates assisted living facilities, and provides information on its website about the businesses licensed in Virginia.  The website provides information such as the services the facilities are qualified to offer, their capacity, information on complaints lodged against them, DSS-performed inspections of the facility and the nature of any resulting violations.

This year’s theme for National Assisted Living Week is Caring Is Essential. The week highlights the incredible care provided by caregivers in assisted living facilities across the country. Especially this year, given our global pandemic, we want to thank those health workers who are caring for our seniors. Your care is truly essential!