Lack of oversight and caregiving shortfalls could put residents at risk. Here's how to avoid problems.
For many frail older Americans, assisted living has become an increasingly popular alternative to remaining in their homes. You can live in a comfortable residence, receive the services that you need, such as help with bathing and dressing, as well as avoid the institutionalized setting of a nursing home.
But finding the right residence can be a daunting challenge. It's also difficult to judge the quality of care you will get.
Many more people going into assisted living facilities today have high care needs. But many of the facilities aren’t set up for high levels of care.
Smart Questions to Ask
For families seeking assisted living for a loved one, there are ways to find a facility that delivers quality care in a comfortable setting. The key is to do careful research.
Start by asking these five key questions:
1. What Kind of Help Do You Need?
Think about what kind of help you or your family member needs now and in the future. Are you looking to help your loved one enjoy more social interaction, or get help with memory loss, or more medical care? Different facilities offer varying levels of care—not all have memory units, for example. The social activities vary as well, so check to see if the book clubs or trips to the symphony fit in with your loved one’s interests.
It’s also a good idea to have your family member evaluated by a physician to have a better understanding of the level of care required and how that might change. That way, you can judge whether the facility will meet your loved one’s needs over the long term.
2. What Is the Quality of Care?
Check into the residence’s licensing and inspection records to see if there are reasons for concern. Depending on your state, you may find this data online—a good starting point is your state Agency on Aging. You can also contact your state ombudsman about the facility’s complaint record. (Go to ltcombudsman.org; use the map tool to find links for your state.
You should also ask if the facility has a registered nurse on staff. If the facility doesn’t have one, your loved one may end up going to the ER more frequently.
To get a feel for the quality of life, make multiple visits to the facility. Go for meals and during the weekends, when fewer staff are on duty. And speak with residents and their families about their experiences.
3. What Are the Real Costs of Care?
As noted above, the typical cost of care is high. And add-on fees could push those costs even higher, which will stretch, or exceed, many retirees' budgets. (Read this story for tips on affording assisted living care.)
Be sure to get a written list of fees and charges from the residence, and check to see that they’re included in the contract. While some facilities have all-in costs for room, board, and a particular level of care, others have a point system or charge à la carte. Find out what circumstances might lead to more fees, such as needing help walking to meals or falling ill for a week or so.
Given the high costs involved, it can be a prudent move to hire an elder law attorney who is familiar with local facilities to review the terms of the contract.
4. Can Your Loved One Age in Place?
One of the biggest risks for assisted living residents is involuntary discharge, or eviction, which can happen through lack of payment or when the care required exceeds the facility’s ability to provide services. These circumstances might include cognitive decline, lack of mobility, or complex medical needs.
Find out what situations might trigger a discharge, and whether you could hire private aides if more care is needed. Also ask what assistance the facility would be able to provide if a move is required.
Some nonprofit facilities, for example, may help a resident running low on funds to qualify for Medicaid, which could pay for nursing home care, or funds that may help your loved one stay in place.
5. Will Your Family Member Have an Advocate?
Once you’ve found a residence for your loved one, it’s important to have family and friends drop by regularly. That way, you will be able to spot any lapses in care quickly, which is especially important if your family member is ill or confused and cannot advocate for herself.
If you or your family are not able to visit regularly, consider hiring an aging-life-care expert or asking a friend living nearby to check in on your family member. Spotting issues early may help prevent more costly problems later. And if the assisted living management knows you’re keeping a close eye on your loved one, that can help ensure the quality of care.
For more information on assisted living, contact Spring Arbor.