The cost structure, rules and guidelines vary significantly among Assisted Living Facilities so it's important to ask lots of questions before selecting one and signing a contract. It is also important to understand that your needs will typically increase with age, so be sure to ask about additional costs for services such as bathing, dressing, medication management, incontinence care and dementia care, as well as the facility's guidelines regarding your ability to remain there if your needs change.
Some facilities are better equipped to help you through the continuum of care as you age, however in others, if your skills decline further, you may be forced to move out and find yet another home. This means leaving behind newly made friends, researching more places again, and packing and moving all over again.
Even the facilities that are better-equipped to help with changing needs tend to have separate areas for the different levels of care, which means at the very least you will need to move between apartments within the facility as your needs change. Packing and moving many times over the upcoming years is surely not what you have in mind as your setting off to pick a new home– so be very careful and pick wisely.
What is the base monthly cost?
What are the costs for services that are not provided in the monthly base cost?
Are transportation services provided? Do these services accommodate all mobility levels (E.g. ambulatory and wheelchair users)? Cost of services?
Are there any additional sign-up fees?
How often will rates increase and is there a limit on the amount they can increase over a set time period?
If you need to go to the hospital temporarily, will some fees (or all) continue to apply when you are not present in the facility?
What are their policies regarding incontinence care, memory impairment, and level of mobility skills required to remain a resident? Ask for a copy of their policies.
How do they determine if your skills no longer meet the facilities requirements? Is this a subjective determination by their staff alone? What is the appeal policy?
Can you set your own time schedule for your daily routine or is this fixed by the facility?
Do you have to eat in a public dining room or do you also have the option to have meals delivered to your room?
What is the staff to resident ratio and how are staff members selected? Do they require background checks for employees? What type of training do they receive?
How often does staff check on residents?
Is there a nurse on staff? Physical therapist? Podiatrist? Hospice Care?
Do they regularly monitor your health, weight and vital signs?
Are there call bells present in the bedroom and in the bathroom that you can use to alert people you need help if you have an emergency?
Do they use any fall detection or wander alert technology?
What type of activities do they offer? Do they have community outings? If so, how often?
Are there accessible gardens and grounds?
What if you have a noisy or disruptive neighbor that plays their TV loud, snores or yells? How are these situations handled?
What is the policy if a facility fire or a staff member damages your property?
What happens if you do something that results in property damage to the facility? Are you responsible to cover the costs?
Have any complaints been filed against the facility?
You can tell a lot about a facility by talking to the residents and staff, so try talking to as many residents and staff members as possible. Check online for reviews, as well as the word "complaints" in connection with the facility's name. The Better Business Bureau and Yelp are two good places to start.
Review all contracts thoroughly and consider consulting with an Elder Law Attorney before you sign any documents. Your care and your well-being will be in the hands of the facility – so it is important to do everything possible to be certain that you are in good hands!