When aging parents need help with their daily activities, their lives become more challenging. Hiring caretakers to help them stay in their homes may be the best option for some families. Adult children might want their parents to move into their homes, but that option works best when a family member is always home to care for the parent. In some cases, assisted-living facilities may offer the best assurance that parents receive the help they need.
Assisted-living facilities provide residential care for people who need help with their activities of daily living. While services and living arrangements vary, an assisted-living facility will typically prepare meals, help residents manage their medications, and provide help that residents may need when they bathe, dress, eat, and use the bathroom.
Assisted-living facilities fill a need for residents who do not need around-the-clock nursing care but cannot live independently. While the facilities provide services not offered by retirement communities, those services do not include the medical care that nursing home patients receive.
Choosing an assisted-living facility requires research and careful thought. Here are 8 tips for finding a facility that will be a good match for an aging parent.
1. Decide where the parent should live.
If a parent is ready to move into an assisted-living facility, it might be convenient to find one in a city that is close to other family members. A parent who is living near adult children and grandchildren will probably enjoy their companionship more frequently. On the other hand, parents might want to remain in a familiar city so they can stay in touch with friends. A parent might also be reluctant to move away from a trusted healthcare provider. Families need to have serious discussions about the geographic location that will best meet the parent’s needs.
2. Search for facilities in the chosen geographic area.
The Eldercare Locator, a service of the U.S. Administration on Aging, will help families identify state and local agencies that maintain up-to-date information about assisted-living facilities within their geographic coverage. Many states offer searchable databases that identify assisted-living facilities within zip codes and provide the results of recent inspections of each facility. Families can also use a search engine like Google to make sure they have not missed an available facility.
3. Make a budget.
The cost of an assisted-living facility varies by location, level of care, services offered, amenities, and whether the facility is in demand. Within a facility, prices may vary depending on the size of the unit that the resident chooses.
Families should determine what a parent can afford. They should understand the income a parent will have from Social Security, retirement benefits, and other sources, including family contributions and savings. They should consider the cost of Medicare and other foreseeable healthcare expenses, as well as the cost of transportation, cable TV, and other budget entries to the extent that they are not covered by the monthly fee paid to the facility. Comparing expenses to income will help the family understand how much the parent can spend on an assisted-living facility.
4. Decide upon the kind of housing the parent wants.
In some assisted-living facilities, residents purchase and own a unit. A purchase may be beneficial for parents who sold a home and do not need to finance the purchase cost. Ownership comes with a price, as owners are usually responsible for making repairs within the unit.
When parents want to rent, they should decide whether they want a studio unit or a unit with one or more bedrooms. When two parents will be living together, they probably need more space than a parent who will be living alone.
Some assisted-living facilities are part of a larger campus that might include a nursing home and independent living facilities. Others are smaller facilities that are nestled into residential neighborhoods. The family should consider the living environment that would be most comfortable for their parent.
5. Identify facilities that meet the parent’s needs.
Parents with serious health problems might need the kind of care provided by a nursing home. Parents with dementia might need specialized care that is not available in every assisted-living facility. Family members might want to work with specialists who can recommend facilities that are best suited to meet their needs.
6. Decide upon the amenities that suit the parent’s lifestyle.
In addition to providing medication management and help with activities of daily living, most facilities offer housekeeping, laundry, and transportation to healthcare appointments. Some facilities offer recreational and social opportunities, including organized activities, game rooms, theaters, walking paths and transportation to beauty salons and other destinations. Since adding amenities generally adds to cost, families will need to consider their budget when deciding with amenities they can afford.
While certain amenities may be important to a family, they may be outweighed by other factors. Palatable meals and a friendly staff of trained professionals are more important than luxurious lobbies.
6. Read online reviews.
Consumers should always be wary of glowing reviews, as reviewing systems are easily gamed. They should also keep in mind that a scathing review might reflect an atypical bad experience, or even a competitor’s attempt to corner a market.
At the same time, reviews have value. By discounting reviews at the extremes, families can often acquire a good sense of how residents and their children feel about an assisted-living facility. While it might pay to be skeptical of reviews, a negative review may raise red flags that families should investigate before signing a contract with the facility.
7. Ask questions.
After making a list of potential facilities, present each with a list of questions:
- How many residents does the facility serve?
- How many staff members does the facility have and how many hours per week does each staff member work?
- What training does the facility require staff members to have?
- What coverage is available if a staff member calls in sick?
- Does the facility have a registered nurse present or on call?
- What services do staff members provide?
- How frequently during the day do staff members interact with residents and how much time do they spend with them?
- How do they respond to issues that are highlighted in negative reviews?
Comparing answers will help the family identify facilities that will take good care of their parents.
8. Visit facilities and talk to staff and residents.
After narrowing down the choices to a few facilities that seem most suitable, families should make multiple visits to each, ruling out the facilities that do not appeal to the parents or that have obvious problems. Visits during mealtimes are particularly important. Reviewing menus doesn’t provide the same assurance of quality meals as looking at the food that the facility actually serves.
Chats with family members who happen to be visiting residents can be informative, as are impromptu discussions with staff members. Staff members are usually busy and may have limited time to interact, but even brief encounters will convey a sense of whether staff members seem friendly or disgruntled, relaxed or stressed, under control or overwhelmed.