Caregiving Challenges, Choosing an Assisted Living Facility (ALF)

Everyone is in agreement that it’s a good decision to move your loved one into an assisted living facility (ALF).  You’ve done some research and you’ve located a few in the area.  Now is the time to visit at least the top three on your list and make some comparisons.

Take your loved one with you, get their input, and honor it. What you love, they may not. What might not matter to you may mean a great deal to them. Most of the time, an older adult wants to see people of their own age doing things they like to do.

Choosing the right place at the right time will help you avoid another move in the future. Here are some things to consider and some questions to ask.

Ask the facility representative

• Is the facility licensed by the state?  

  • If yes, you may ask to see the most recent survey report.  The report will give you an indication of any problems identified, everything from minor issues to major incidents.

  • Also, inquire about the type of license held by the facility.  Some states have levels of licensure ranging from basic (no nurses on staff) to complex (RN or LPN on duty 24 hrs/day).

• Is there an RN on staff, and how often is he/she in the building?

• Do you have levels of care?  (Most facilities level care based on the amount of assistance needed. The higher the level, the higher the monthly fee.)

  • Ask for a copy of the levels with complete definitions and the fees associated with each level.

  • Ask about any fees over and above the care level, such as supply fees (briefs, bed pads, laundry services, personal hygiene items).

• Are there physicians who come regularly to assess residents?  (For example, some facilities have a psychiatrist and a podiatrist that come once a month.)

• What events would cause the ALF to ask me to relocate my loved one? Examples:

  • tries to harm another resident 

  • cannot recognize a fire alarm and follow instructions 

  • becomes bed-bound

  • becomes unable to transfer from wheelchair to toilet

• Can my loved one stay here if they are receiving hospice care?

  • Can they stay until their death and not be transferred to a nursing home?

  • How do you care for terminally ill residents?

  • What will you need from me if my loved one is in a hospice program?

• Can I visit at any time of the day?

• Are the doors to the wings/units locked?

• When and how are meals provided?  

  • What if my loved one doesn’t want to go to the dining room?

  • What if my loved one is sick and unable to go to the dining room?

  • What if I want to join them for a meal in the dining room?

  • May we share a meal in the dining room during our visit?

• Can they bring their own furniture and belongings?

• Can they lock their private space (apartment or bedroom)?

• Do you provide transportation to medical appointments?  

• Do you provide transportation to local stores? How often?

• Can my loved one have a glass of wine at dinner? 

• What amenities do you have on-site (laundry/dry cleaning, salon, bar, fitness, theater, etc.)?

  • Ask to tour them and ask for schedules and service pricing sheets.

• Is there a community or facility events calendar posted?

Talk to the residents during your visit

Be sure to ask permission from the resident to ask them some questions (name introductions are nice). Explain that you are looking for a new home for your loved one and are considering this facility.

• How long have you lived here?

• What do you like about living here?

• What do you dislike about living here?

• Would you recommend this facility to a loved one?

Talk to the staff during your visit

Talk to more than just the nurses and aides. Talk to other roles like nutrition and maintenance staff, if you see them.

• How long have you worked here?

• What do you like about working here?

• What do you dislike about working here?

• How does this compare to other facilities in which you've worked?

• Would you recommend this facility to a loved one?

Discuss with your loved one after each visit

Talk about everything you can think of regarding the visit and make sure to write it all down in an organized manner so that you may use the notes for comparison when making a final decision. Here are some questions to get you started:

• What did you like about this ALF?

• What did you dislike about this ALF?

• What is most important to you in an ALF?

  • People?

  • Private space?

  • Activities?

  • Amenities?

  • Visiting hours?

  • Something else?

• How did you like the meal (if you had one during your visit)?

No content in this app, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.