What is Assisting Living?

Assisted living is a kind of housing established for people who need different medical and personal care types. These communities generally provide individual rooms, apartments or shared quarters that are designed to promote independence in the residents. Most assisted living residents are seniors, including those with Alzheimer’s disease and other forms of dementia. Some communities serve individuals of any age with developmental disabilities while other communities serve individuals with particular medical conditions or needs. In most states, assisted living communities are registered, licensed or certified by an appropriate department or agency of the state that has a process for issuance of initial licenses and for renewing existing licenses.

The services offered at these facilities are meant to assist the residents with the tasks associated with daily living. The services provided by assisted living communities vary from facility to facility, however the services commonly include:

• 24-hour supervision
• 3 meals a day in a group dining room
• Personal care services (help with bathing, dressing, toileting, etc.)
• Medication management, or assistance with self-administration of medicine
• Social services
• Supervision and assistance for persons with Alzheimer’s or other dementias and disabilities
• Recreational and spiritual activities
• Exercise and wellness programs
• Laundry and linen service
• Housekeeping and maintenance
• Arrangements for transportation

The first step in finding an assisted living community is to assess what services your loved one will need. Talk with their caregivers and other family members about what services your loved one is currently receiving. Then take the time to consider what services are essential before you visit an assisted living facility. A few questions that might be helpful when talking to your loved one before choosing an assisted living community:

• What daily activities do you want help with (toileting, bathing, dressing, eating, remembering medications)?
• How often do you need help?
• What assisted living community or assisted living facility would you want to live?
• What activities and amenities do you enjoy?
• What is the most important thing to you about moving to a new community?
• Do you have any other preferences or concerns?

After you have determined the kind of services you or a loved one needs, obtain a list of assisted living communities in your area. Your personal physician, clergy, social worker, financial planner, and friends may be familiar with a community.

By visiting the communities on your initial list, you should be able to narrow the field to two or three meeting the specific services, location, and price range you desire. Talk with the administrators and tour the communities. Try to visit each community more than once. Arrange to visit the community during mealtime or arrange to have lunch with residents. This will give you a better feel for what life will be like in the community.

Below are some questions and things to look for that will help you and your family to evaluate the assisted living facilities in your area.

General Questions

• Is the residence licensed?
• What kind of insurance does the facility carry on personal property?
• How do they respond to medical emergencies?
• What is the visitation policy?

Contracts, Costs, and Finances

• What do the contract agreements include? I.E. personal care, accommodations, support services, and health care?
• Are there different costs for different levels or categories of services?
• What is the refund policy
• When may a contract be terminated?
• Are there additional services available if the resident’s needs change?
• How do you pay for temporary additional services like nursing care?
• Are there any private, government, or corporate programs available to help cover the cost of services to the resident?
• What are the payment, billing, and credit policies?
• May a resident handle their finances with staff assistance (if able), or have a family member or outsider be assigned to do so?

Staff and Facility

• Are the staff members appropriately trained and have proper certifications?
• Is staff turnover rapid or slow?
• Did you get a warm greeting from the staff?
• Do the staff members appear to be personable and outgoing?
• Are the staff members appropriately dressed?
• Do staff members greet residents by first names and interact with them warmly?
• Are the staff members available to assist residents who experience orientation, memory, or judgment losses?
• Is the facility able to meet scheduled and unscheduled needs?
• Are our staff members available to provide 24-hour assistance with activities of daily living, if needed?

Atmosphere and Residents

• Do other visitors, residents, and volunteers speak favorably about the facility?
• Do residents talk with each other and appear comfortable and happy?
• Are the residents at the same levels of functioning as you or your loved one?
• Do the residents look to be appropriate housemates for you or your loved one?

Facility Design

• Do you like the appearance of the building and surroundings?
• Is the decor home-like and attractive?
• Is the floor plan easy to follow?
• Do hallways, doorways, and rooms accommodate wheelchairs and walkers?
• Are elevators available?
• Are handrails available to aid in walking?
• Are cupboards and shelves easy to reach?
• Are carpets secured and floors made of non-skid material?
• Is there good natural and artificial lighting?
• Is the residence odor-free, clean, and appropriately heated/cooled?

Medication and Health care

• What are the residence policies regarding storage of medication, assistance with drugs, and medication record keeping?
• Is self-administration of medication allowed?
• Who coordinates visits from a physical therapist, nurse, occupational therapist, or another specialist, if needed?
• Does a nurse or physician visit the resident regularly to offer medical checkups?
• Do they use a specific pharmacy?
• Can medications be delivered?

Recreational and Social Activities

• Is there an activities program?
• Are residents able to participate in neighbor community’s activities?
• Do volunteers, like family members, come into the residence to help conduct programs?
• Does the facility need residents to undertake any chores or complete specific activities that benefit all residents?
• Are residents’ pets allowed in the unit? Who is responsible for pet care?
• Does the residence have its pets?

Food Service

• Does the residence offer three nutritionally balanced meals a day, seven days a week?
• Can residents request special diets or foods
• Are snacks available?
• Are common dining areas available?
• Can meals be provided at times the resident prefers, or are there set meal times?
• May residents eat meals in their units?
• Will they accommodate physician nutrition orders?

Once the facility has been chosen and the plans have been made, the process isn’t over. A move to an assisted living community, even if all parties are in agreement, can be a stressful time. Do not minimize their feelings of loss. This should be done even during the best situations when they were willing to move there on their own accord. Grief and feelings of loss are natural after a person moves out of the home that has been theirs for years (even decades).

Sympathize with them about these strong emotions and show understanding as you give them time to adjust through this difficult transition period.

Regular contact from friends and family will reassure your loved one that they’re still important. Continue to include them in any event possible, just like when they lived close by. If the distance is too great, make sure you have a regular call or email them so it’s not as hard for both of you!

It can be difficult to transition from a life of independence and freedom into an assisted living facility. Your loved one will likely go through some rough patches, but it’s important that you work together as they adjust. If your loved one has concerns about the new residence, hear them out! Talk things over with them so that you may come up with solutions for their problems or be prepared to look at other facilities.

Help your loved one personalize their living space. Help your loved one choose and bring over the meaningful possessions and decorations that will give the new living space the feeling of home. But be careful not to take over. Let your loved one take the lead. He or she is going to be the one living there, after all.