Friday, June 26, 2015

Choosing an Assisted Living Facility

How Does One Choose an Assisted Living Facility?

Over the years I have been asked numerous times and again this week, now that I, or someone I care about is leaving rehab or the hospital, and need / want to go to assisted living, how do we choose the "best" place. 

After speaking at SUN (Senior Umbrella Network) meetings and networking with numerous people who own, work for or know of assisted living facilities, I have learned that there are some wonderful facilities run by caring and wonderful people.   But that doesn't always make it easy to choose.  I want to put together a short list of why someone should consider one assisted living facility over another.

Please consider sharing here where someone should start looking on Long Island and why.

Only positive comments requested.



Caryn Isaacs said...

I hate the term 'activities of daily living' that government and insurance companies use to define the need for assistance with bathing, dressing, shopping, cooking and other personal care things people may need help with as they get older.

I am a Private Professional Patient Advocate. Many of my clients are people who do not have anyone at home to keep them company. Even when people have children, changing the relationship of child to caregiver usually does not have a good outcome for either the child or the parent. Assisted Living can be the answer to allow people to maintain their dignity, while getting the help they need.

I believe the 'activities of daily living' consist of those things you enjoy doing, reading the newspaper and discussing it with a peer, listening to music and singing along, going for a trip or just sitting on the porch and chatting. These are the things one can find at an assisted living facility.

On Long Island, we have many choices of wonderful places. Here is my criteria for choosing one place over another:

1- The physical condition and history of the resident. Only a few can accept people who are currently in wheelchairs. These facilities have special licenses that allow for a higher level of care. If the person is currently using a walker, and may need a wheelchair in the future, they may need to move when it is most inconvenient.

2- The mental status of the resident. More and more facilities are building special units for people who have memory loss. But, memory loss is not the only changes that may occur as people age. How will the facility deal with depression or other mood changes?

3- The food. The number one complaint residents have in facilities is the food. I find that it isn't the quality of the food, it's the style. Even when the food is Kosher, differences in cooking style can cause someone to stop eating. A recent situation I ran across was when a resident hated the borscht and the gefilte fish. I helped move her to a place where she loves them now. Why? They use jars of Manischewitz. It's what she was used to.

4- Accommodations. Some people become frightened when they are in a private apartment with the door closed. Some facilities offer shared suites, where the person will not feel isolated.

5-Activities. Assisted Living Facilities try really hard to provide fun, interesting activities for the residents. They look for activities that reflect the interests of their particular population. A full day of activities may not be for everyone. People whose life has been about nothing but family may not be interested in participating in group activities. Some people are just as happy to stay in their room all day watching television or reading. Very few family members visit enough (is it ever enough) so being in the vicinity of the children isn't usually the best way to determine the right place to be.

A Professional Patient Advocate can help you to determine what your needs are before you look at prices, services and location. The research can last up to a year before you feel ready for the move. When someone is moving into a facility, they will be a lot of emotional issues to address. It's not like going on vacation, where you know your old life is waiting. It's a big step, but not the final choice. You can always move from one facility to another if you find the first one is not for you.

Julia Jenne said...

There are many very good assisted living communities they range from the expensive well-known communities to the more economical small "mom and pop" communities. Likewise, there are professionals who make it their passion to know all of them. I would suggests finding the professional who is well versed on all these communities. This individual should be willing to meet one on one with the family interested in researching assisted living communities. They should not charge for this initial consultation. At this consultation, this professional should find out why they are interested in moving to this type of community. She/he should ask about the individual's family, their health, their financial resources. They should ask about their likes and dislikes, their hobbies, etc. This vetted professional should then be willing to take the individual, and their family member(s) if they are involved with this decision, on a tour of at least three choices that compliment the information that they gleaned at the initial consult. This tour should be at no charge as well. Should the individual choose a community that they like and want to move to, the assisted living professional's policy should be to be compensated by the community that is chosen and not the individual who is moving in. I would suggest that a individual or family making inquiries to assisted living communities reach out to a certified senior adviser or geriatric manager in the area in which they live. A certified senior adviser or geriatric care manager would be an excellent first step. I would beware of companies who never meet with families and simply take your information over the phone and then send that to all the assisted living communities. This process just generates a lot of phone solicitation to the consumer. Personalized one on one is best. It is also best to get a recommendation from a trusted friend or resource for seniors in your community.
Julia Jenne
Certified Senior Adivser

Caryn Isaacs said...

I agree that there are people who get to know the assisted living facilities and can make commission deals with them to bring people there. A Place for Mom also gets commissions for placements and I sometime use these people to help me to make appointments for tours. However, as a Professional Patient Advocate, I do not accept commissions and only get paid by the client. Our policy is clearly stated on our website,

I find that this way I can remain impartial about referrals. As I posted above, I can take many months before helping the person to decide which place is the appropriate one or even if staying home might be the better choice.

So, while I agree with everything else you say, I want to make it clear that there are different kinds of professionals who work with people who are faced with life changing events that cause them to wonder about their living conditions. I also work with elder care attorney's, realtors, financial planners and others in order to make the right decision. People should be made aware of all their options and professionals should work together for the benefit of all.

Caryn Isaacs, Professional Private Patient Advocate and
Chair of the Senior Umbrella Network Advocacy Committee

Nicole Christensen said...

There really are so many factors to take into consideration when considering an assisted living facility. I agree with many of the comments made by both Julia and Caryn. As an advocate and healthcare coordinator I have assisted many older adults and their families with this process. Below is a brief list of often overlooked qualifications when searching for assisted living facilities:

Does it feel like home?-When taking a tour try to go unannounced. You want to make sure you are seeing the site as it is naturally. Ask the residents you see their opinion of the facility. (i.e.-what do they like most, what are the most attended activities, what areas could use some improvement).

Ask the staff-How long has the average staff person worked there? How long the staff has been there can be a clue as to how well the company treats their staff and that can translate into how well they care for the residents.

Quality of food-Ask if you can sample some of the food. That can be a big factor.

Access to services in your faith tradition if that is important in their lives. Also don't be intimidated to ask the percentage of residents that share that same faith, culture, etc. if that is important to you.

Speak honestly to the facility staff about your personality and things you like so you can see if the community there has things in common with you.

Find out what if any doctors they have on premise, how often they come and what hospital affiliations they have. Even if you want to keep your own doctors and specialists this can be extremely important.

As Julia and Caryn stated finding a professional to assist with the process is ideal. This could be you or your loved one's new home.

Nicole Christensen
Director, Care Answered
Healthcare Coordination and Advocacy for Older Adults and their Families

Rathbone Home said...

Great site you have here Choosing an Assisted Living Facility. It’s difficult to find high-quality writing like yours these days.I seriously appreciate individuals like you!Take care!