How to Choose the Best Retirement Facility for Yourself or a Loved One

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Nurse with elderly patient
Alexander Raths /

There are many assisted living facilities to choose from, but finding a caring home that’s the right fit for an elderly family member requires you to shop around.

When seniors can no longer care for themselves, they often depend on relatives to identify assisted living communities that will give them the support they need. It’s a mistake to base a decision on price or location alone. There are many variables when it comes to assisted living.

Joy Loverde, the author of “Who Will Take Care of Me When I’m Old?” and “The Complete Eldercare Planner,” recommends looking for a facility in an area that’s familiar to your loved one. Moving to another state with unfamiliar surroundings and customs may make the transition more difficult, she says. If a lifelong St. Louis Cardinals fan moves into a community where everyone else roots for the New York Mets, it might not feel like home.

“The culture of each facility will depend on who owns it, who works there and who lives there,” she said. “I am a Midwesterner. If I went to assisted living in downtown Manhattan. I might feel like a fish out of water.”

The facility also should match the needs of the person you’re shopping for. If your loved one is still physically active and a home that you visit offers few activities or opportunities for outings, that’s a warning sign that it won’t be a good fit.

“While safety and security must always be first and foremost without a question, the quality of an assisted living community can be measured by how well it provides engaged programming for its residents, delivered by a caring and compassionate staff,” said Larry Pino, the founder of Tuscan Gardens, a Florida company whose senior communities offer independent living, assisted living and memory care.

Here are tips for choosing an assisted care facility that meets your loved one’s needs.

Look for cleanliness

One of the basic requirements is finding an assisted living facility that is clean. Be sure to ask how often the living spaces are cleansed. If you find unpleasant odors, ask what caused them. Observe whether the residents are well-groomed and properly dressed. If they look unkempt and disheveled, that’s a clear warning that something is wrong.

Eric Goldberg, an elder law attorney based in New Jersey, says you shouldn’t be dazzled by a facility’s expensive decor and furnishings.

“Maybe you as the adult child are drawn to chandeliers and granite countertops, but do you think your parents really care about them?” he asked. “As long as the layout and decor are safe and everything is clean, the rest shouldn’t matter.”

Make sure the staff has a good attitude

If the assisted living community seems to be staffed by angry or rude people, it won’t be a happy place for your loved one to reside. Ask to speak to the people who will be taking care of your family member. Find out about their training and experience.

“Every assisted living facility is made or broken by their staff,” said Mary Jo Dietrich, a registered nurse who owns and operates a senior home care agency. “Keep a close eye on how the staff is regarding their clients. Are they affectionate and attentive, or are they distracted and uncaring?”

If you don’t have a good feeling about the personnel, look elsewhere.

Check the quality of meals

Meals should be something to look forward to. If the food that is served is tasteless or the menu is limited, it will harm your loved one’s quality of life.

Be sure to eat there yourself so you can gauge the quality of food preparation. Ask yourself if the food that is served is something you would be happy with day after day. If not, you need to find another facility.

Talk to other residents about their care

Ask to speak with residents and their families about the care they receive. A reputable facility won’t object to your curiosity. A few complaints can be expected, but if there is a pattern of dissatisfaction, consider finding another place for your loved one.

“Always ask the residents or visiting family members how they feel about the facility,” said Dietrich. “If they are dissatisfied, they will not hold back their judgment. They are likely to be the most candid with you.”

Make sure it’s a safe environment

Ask how seniors are able to contact the staff, and make sure there is someone available at all times to assist them. What kinds of things do caregivers help with? Does the facility offer access to quality health care and registered nurses? If your loved one is receiving memory care, ask about precautions that are taken to prevent residents with Alzheimer’s or dementia from wandering away.

Goldberg says you should ask about the caregiver-to-resident staffing ratio and find out how many aides and nurses are in the facility overnight. Also, ask about the procedures in the event of an emergency. (If the residence is in a hurricane zone or otherwise prone to power outages, does it have a proper backup generator and evacuation plans?)

ProPublica provides a tool called Nursing Home Inspect for looking up deficiency reports for some 60,000 nursing homes nationwide, based on inspection data from the federal Centers for Medicare and Medicaid Services. It allows you access to any reported deficiencies, the severity rating and penalties imposed on individual care facilities, as well as look at trends and patterns in the data.

Be prepared for sticker shock

A common challenge that families face is finding an assisted care facility for their loved one that is affordable while offering quality care. The cost of assisted care for the elderly isn’t cheap. If the resident lacks long-term care insurance, the price could take a big bite out of a savings account.

Genworth Financial Inc., which does an annual price survey, in September reported that the median monthly cost of assisted care for a private, one-bedroom unit was $3,750. You can save time by screening out facilities that are not in your price range. Make sure you ask which services are included in the base price and what services will cost extra. For example, products to control incontinence often aren’t included.

If you set a budget before you start your search, you won’t end up taking your loved one to visit a facility that’s out of his or her price range, said Dietrich.

Don’t assume that all is well

Things can change over time. A facility that met your standards when you chose it may drop in quality six months or a year later. Be sure that you visit often and ask questions when you have concerns about such things as food services, cleanliness, grooming or access to medical care. Your loved one is counting on you to make sure they can maintain a good quality of life.

It helps if you choose a facility that isn’t too far from your home or the home of other relatives, said Dr. Nicole Rochester, a physician and patient advocate based in Maryland.

“It’s important for family members to be able to drop in and check on their loved ones,” she said. “No one can advocate for your loved one like you can.”

Have you been through the process of scouting or choosing assisted living facilities? Share your thoughts in comments below or on our Facebook page.

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