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10 Questions You Need to Ask when Choosing an Assisted Living Facility

Deciding to make the move to an Assisted Living Facility can be difficult. Unless you have worked in the field, the sheer volume of options can be overwhelming.

Asking the right questions is important, as finding the facility that best fits your loved one’s needs directly affects their future quality of life.

1. What type of payments do you accept? Medicaid waivers, long-term care, private pay, or others?

Find out whether the facility accepts your desired form of payment. (Facilities tend to prefer private pay or long-term care insurance, but may accept other payment sources.)

Some long-term care insurances cover the costs of an Assisted Living facility, some don’t. We suggest reading through the terms of your LTC contract before exploring ALFs to see if this might be an option for you.

VA benefits can also help offset the costs, even for the spouse of a deceased veteran.

Medicare does not pay for Assisted Living care. Medicaid does offer a waiver for ALFs, but the waitlist tends to be long.

Helpful Resources:

2. Do you charge for “levels of care” or is your rate “all-inclusive”?

“Levels of care” payment structures vary the costs by needed levels of care, so fees may increase over time as more services are needed.

On the other hand, an “all-inclusive” payment structure covers all levels of care, even if they change. We recommend looking for a facility that offers this “all-inclusive” payment, as it makes it easier to budget future expenses and helps reduce the chance of financial surprises.

3. Is there a nurse available 24/7?

Not all Assisted Living facilities are required to have a nurse on staff at all times, but this can be a great benefit to the level of care your loved one receives.

For example: If your loved one requires medications, a nurse may administer medications while a Certified Nursing Assistant may not (they may only “assist,” which means simply handing medications to the resident). Regulations vary state by state; some require a nurse, especially when dementia is involved.

4. Do you offer continued care? Which type of license do you have?

Finding a facility that allows for your loved one to age in place can be a great benefit. Not all Assisted Living facilities offer extended continued care, which means you would have to find yet another facility if your loved one needs a higher level of care. Instead, try to find a place that offers “Extended Congregate Care” so your person can stay as their needs change.

5. If my loved one needs a higher level of care than your ALF can provide, will you help me find an appropriate, skilled facility?

If the Assisted Living Facility you’re considering does not offer continued care, make sure to ask whether they would help you find a more appropriate home if your loved one’s needs exceed their abilities someday. Not only will you have added support, but the facility’s staff should be more aware of your loved one’s physical care level and future changes that might make a move necessary.

6. Do you provide transportation to doctor’s appointments? If yes, is there an extra charge?

Regular doctor’s visits are important for disease prevention and/or treatment, and reduce the risk of hospitalization. Your loved one might no longer be able to drive, and having an in-house transportation service within the ALF can be a great benefit.

7. What is your staff turnover rate and staffing ratio?

Being with familiar people and faces is part of making an ALF feel like home. If the facility has a high staff turnover rate your loved one will likely have to change caregivers frequently, which can cause unnecessary stress.

An ALF with low staff turnover speaks volumes, complementing the style and quality of management. Happy employees make better caregivers, which greatly benefits your loved one.

And don’t forget to ask for the resident to staff ratio. The fewer residents you have per staff member the better.

8. Are pets allowed? If yes, is it part of the contract and are there extra fees? What happens if the resident can no longer take care of the pet?

Animals are wonderful companions, and many of us cannot fathom leaving them behind. However, allowing pets can bring additional challenges for ALFs, which is why many do not allow our furry friends to live with residents.

If you do find a facility that allows pets, make sure you discuss all aspects, such as fees, rules, and emergency situations.

9. What type of activities do you offer? Do you offer “outings”?

Activities are a requirement, but they do differ from facility to facility.

Ask to see the monthly activity calendar, and see if they would interest your loved one. Also check to see if the facility offers “outings,” such as occasional trips to restaurants or events.

10. May my loved one and I participate in lunch or dinner at your facility?

Tastes differ, and what one person considers delicious might not be liked by another. Ask to see a sample menu, and don’t be shy to ask whether you and your loved one might attend a lunch or dinner to try the food yourselves. (This can also be a great opportunity to chat with current residents and get some honest feedback about how they like living in this ALF.)

=> Extra Tip: Visit the ALF unannounced at different times of the day, to get a better idea of what life is like when your visit is not expected.

=> These are great starter questions, and should help answer some of your initial questions. However, the more you know the better off you will be. In our progam "Why, When, and How to Seek Professional Senior Care", dementia expert Teepa Snow offers honest, no-nonsense insights on how to make the best choice.

Why, When, and How to Seek Professional Senior Care

– Your Guide to Making the Right Choice

As a loving and devoted caregiver or family member of someone living with dementia, it is important to know when it’s time to seek professional care or look for a senior care community.

Learn with expert Teepa Snow:

  • Determine the best level of care and the level of skill required of the staff
  • How to set up a smooth transition
  • Understand what likes and dislikes are important to know about the person living with dementia
  • How to utilize the "four Fs" & "four Ss" to ensure your loved one's needs are being met
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