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What should I look for during a visit to an assisted living facility?

Cindy Keith
Geriatrics Nursing

All great answers to this question! I would also add that if you care searching for a facility for a loved one with some form of dementia, such as Alzheimer's, then you should be asking the following questions in addition to the ones answered elsewhere:

  • How much dementia training has your staff had, and is it on-going?  (If the State requires 6 hours/year and that is what the facility provides, then look elsewhere for a facility that provides more than the State requirements)
  • Is your facility secure?  In othe words, how do they know if a dementia resident has left the facility? A "locked" or secure unit is preferred for those who can still walk.
  • What is your policy for transferring my loved one to an emergency room for a fall? Some facilities require they must go the the ER if they have hit their head during the fall. You should know that will likely result in CT scans or multiple trips to the ER since all people with dementia will fall. 
  • Do you have a separate unit for people with dementia? The residents who do not have dementia usually dislike those who do, and they are not shy about making their dislikes known. This creates tension and problems for the staff. A separate dementia unit will greatly reduce the stress and trauma for both the residents with dementia and for the staff who care for them. 
Anthony Cirillo
Geriatric Medicine

In my book, Who Moved My Dentures? I have an entire chapter devoted to choosing facilties. And since I had to choose a rehabilitation center for my mom, you might be interested in a blog I wrote about that experience.

http://blogs.hcpro.com/mdscentral/2011/05/when-its-personal-its-different-choosing-–-choosing-rehab-for-mom/

Here are some excerpts from my book when touring a facility:

  • Visit a facility all hours of the day.  Visit often.
  • How diligent was security when you entered? 
  • See if the Director of Nursing is out in the halls.  Is he/she walking by everyone not making eye contact, not saying anything?
  • Same with the administrator.  Is the administrator out there asking how you are doing, how are you feeling?
  • Ask for a copy of any state inspections. 
  • Observe the residents. Do they look happy? Are their clothes clean and in good repair? Are they wearing footwear? Does any one look cold and not have a sweater? Do the wheel chairs look clean and cared for with no sharp edges or tatters?
  • Ask to have a meal in the dining room.  If residents are dining observe them for a few moments.
  • If you are looking assisted living there may be a program that allows you to live there for a weekend to try it out.
  • Ask a lot of questions.  Go in and talk to the staff and find out what it is like there.  How experienced are they in what they are doing?  How do they like working there?
  • Find out about staffing ratios. Facilities with staff that have been in place a long time are facilities that provide better care because they have experience.
  • Often a resident will need some type of therapy such as physical or speech therapy. Go and observe a therapy session.
  • Ask for references of families who have loved ones there. 
  • Ask to participate in an activity.
  • Take a nurse with you when you go to visit a place that you are thinking about.
  • Sit in on a family council meeting.  Talk to family council members privately.  How are families involved in their loved ones life?
  • Sit in on a residents' council meeting and talk to residents privately as well.
  • Look beyond the wallpaper.  TYou are paying for a level of care.  That is primary.  Whether it is run like a fancy hotel is secondary.
  • Request a copy of the contract that you would sign if you opted to stay there.  Review it with an attorney.

 

 

 

 

 

Assisted living facilities tout any number of amenities to attract new residents. One suggestion that Guardian Nurses makes with our clients is to ask if the facility has an RN (registered nurse) on staff.  Having an RN on staff can be a valuable asset to a resident who, while independent, is on many medications, has alot of complex medical diagnoses or has had a recent hospitalization.  A family's and a resident's peace of mind can be improved knowing that the facility has a licensed, clinical resource available when needed for residents.  
Depending on numerous factors, including your loved one’s needs and health status, rating aspects of an assisted living facility will be of particular interest to you. Here are some of the key factors to consider.
  • Is the residence clean?
  • Is the residence cheerful?
  • Do you feel good about it?
  • Are stairs and hallways well lit?
  • Are exits well marked?
  • Do rooms and bathrooms have handrails and call buttons?
  • Are there safety locks on the doors and windows?
  • Are there security and fire safety systems?
  • Is there an emergency generator or alternate power source?
  • Is the floor plan logical and easy to follow?
  • Are rooms large enough for a resident’s needs?
  • Are there kitchens or kitchenettes?
  • Are there enough common areas, such as dens and living rooms?
  • What special services are available? (bank, café, beauty salon, etc.)

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.