When families and seniors select an assisted living community, it’s a life changing decision. It can be such an intimidating choice that many families come down with analysis paralysis and postpone a decision out of fear of making the wrong choice.
Fortunately, the decision becomes easier as you expand your knowledge. It can be equally helpful to know exactly what not to do.
Learn more about eight common mistakes families make when searching for assisted living and how to avoid them:
1. Not Being Realistic About Current or Future Needs
It’s important to balance optimism with a dose of realism. Be realistic about you or your loved one’s current care needs as well as their anticipated needs. Ideally, you will choose a community that is equipped to provide care now and in the future, as loved ones age.
Too often, families come to us for assistance after initially choosing a facility that was not capable of offering the level of services required. Melissa Pratt, A Place for Mom’s Senior Living Advisor in Boise, Idaho, says, “Take a look at the health issues that your parent has and ask the doctor what support they will need in the future. It’s better to have a community that can handle those future needs rather than having to move your parent to another community in the near future.”
Moving a loved one from facility to facility is not only burdensome and costly to your family, it can also be emotionally and physically detrimental to the senior, particularly when that senior dementia, which can make adapting to changes especially difficult.
2. Judging a Book by its Cover
Sometimes families assume a community is right for their loved one because it has a high price and lavish features, but later realize fancy furniture and beautiful landscaping are not telltale indicators of quality care. They often find that they need to move their loved one to another community, one that’s, perhaps, less shiny but more appropriate in terms of care or atmosphere. Luxury senior living does not necessarily equate to quality senior care. A beautiful, modern and upscale facility is just as prone to oversights and errors as a community that looks a little dated. Quality of care is not something you can discern just by driving past a community to see how green the lawn is, or by poking your head in the lobby-door to gauge the ambiance and whether or not it smells nice.
Longtime A Place for Mom Advisor, Dovid Grossman, who assists families in Chicago says, “Remember to trust your intuition. After doing all the comparison and analysis you can, trust you gut instinct about which option is right.” Experts also suggest that you take time during your visits, if you have the opportunity, to speak privately with residents and staff about their level of satisfaction. Happy staff are caring staff, and a community full of cheerful residents is always a good sign.
Also look into the official backgrounds of the communities that you are exploring. The office of your local Long-term Care Ombudsman (which you can locate at www.eldercare.gov) can tell you about documented issues or problems that local communities have had in the past so that you don’t mistakenly choose a community with a history of substandard care or egregious violations.
Before committing to a long-term contract, you might also consider arranging a temporary respite stay at communities your family is exploring. Some communities even offer no-cost trial stays to qualified prospective residents.
3. Choosing a Community to Match Your Tastes Instead of Your Parent’s
Thomas Bierlein, A Place for Mom’s Director of Partner Services, told us about another common pitfall families should avoid. “Often the adult child chooses the place that they like most instead of thinking about what their loved one likes. For example, new chandeliers and a wonderful heated pool when Mom’s house is homey and she never liked swimming.”
Obviously, we encourage families to get their older loved ones as involved as possible in the decisions making process, but if your loved one is too frail or too afflicted with memory loss to participate in the decision making process or to visit communities with you, carefully consider his or her personality and preferences rather than your own as you weigh the options.
4. Overplaying the Importance of Proximity
Another mistake that Bierlein has seen families make is overemphasizing the importance of finding the closest community possible.
He told us, “Sometimes the adult child chooses the nearest community based on the intention of visiting their parent every day, even though another community one mile further away may be a much better fit. Remember that your parent will be engaged in many activities at the community and that visiting every day is usually an unrealistic expectation to put on yourself. Go with the best fit.”
5. Making a Decision Too Quickly
Earlier we noted that some families become so overwhelmed with the choice that they need to make that they don’t make a decision at all. But sometimes, families do the opposite. They are in such a rush to resolve a difficult crisis that they choose the very first open room they find in the very first facility they visit, which is probably even less effective than choosing randomly.
We recommend that families visit at least three communities before making a decision so that they can form a clear picture of the options that are available, how communities differ from one another, and what makes each community unique. After all, in order to make a good choice you need options.
6. Choosing a Community Appropriate for the Parent of Yesteryear Instead of the Parent of Today
In her book for caregivers, A Place for Mom’s spokesperson, Joan Lunden, described a mistake that she made as she searched for care for her mother with advanced dementia, “I first moved my mom into a fancy-schmancy assisted living facility. In my mind, it was a beautiful place where my mom belonged. I thought she would be able to go downstairs to the dining room and be a social butterfly with other Sacramento seniors and then retreat to a beautifully decorated apartment where she could entertain friends. The problem with my well-meaning plan was that I was making arrangements for the mom that I used to know, and not who she had become. My mom now couldn’t remember who people were, would get frightened when taken downstairs to the dining hall, and was afraid of being left alone in an apartment.”
It might be similarly misguided for a family to choose a golf oriented senior community for a father who loved the game when he was younger but now has Alzheimer’s and arthritis and hasn’t played the game in years.
7. Not Reading the Fine Print
Assisted living contracts are relatively straightforward, at least compared to other legal documents, but they still can contain confusing legalese, or involve additional fees that aren’t completely apparent. Some families are caught unprepared by fees or price increases that they would have been aware of had they reviewed their contract.
Assisted living communities have many different types of pricing structures. Make sure you understand yours. Some communities charge one fee for room and board, and a separate fee for care. A community might charge $2,500 per month for the apartment and the meals, and an additional $1,500 per month for personal care. Other communities charge individually for each service or they may rank the level of care that a resident needs on a scale, with care costs based on the level of care the nursing staff determines is needed. Some communities don’t charge a care fee at all, but instead provide an “all inclusive” pricing model whereby resident’s fees are not dependent on the care needed. At a community with all inclusive pricing, a frail resident who requires a high level of care has the same fees as a resident who is mostly or even entirely independent.
In addition to the care fees that many communities charge, when you’re reviewing your contract you may also encounter a one-time entrance fee, a fee for laundry service, medical supplies, medication delivery and so on. Furthermore, communities generally raise their prices at an approximate annual rate of 5%, which is actually twice the rate of inflation. Unless your contract clearly specifies a rent freeze or “locked rate,” your fees increase each time you renew your contract. If there is anything about the contract that you don’t understand or that concerns you, consider reviewing it with an elder attorney.
8. Going In It Alone
Many people pride themselves on their independent spirit, but when making a decision this big, it’s usually wise to gather multiple perspectives on your senior housing options. Get feedback from as many people as possible: friends who have gone through the process, your loved one’s care management team, a geriatric care manager and a Senior Living Advisor.
In Joan Lunden’s account of her search for care for her mother, she relates how, after initially choosing an inappropriate community, she found the perfect home with the help of an advisor, “…I was fortunate to secure the help of a ‘senior advocate,’ a knowledgeable professional who could answer all my questions and who could show me the residential care facilities in the area. This made all the difference in the world. I highly recommend obtaining the services of a senior advocate or eldercare advisor to help you navigate this journey. This kind of professional can help save you hours of time and stress by narrowing your choices to the places that meet your specific needs. They help families evaluate issues such as care requirements, finances, and amenity preferences.”
If you do find that your loved one is living in an inappropriate senior community, don’t be afraid to admit that you may have made the wrong decision. It’s better to pivot and make a change rather than digging into a situation that isn’t going to work out in the long run.
A Place for Mom