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How To Find And Choose An Assisted Living Facility

Step 4. Do a site inspection

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The following suggestions are based on a Consumer Reports article together with the recommendations of the New York State Department of Health. The list is extensive to provide questions to help you focus on things that will be important to you if you become a resident. Add whatever matters are of particular concern to you before you visit any sites so you do not overlook them. Photocopy the list with your additions. Take the list with you or give it to whomever will visit the site for you. Write down your observations for each home visited so you can make a better comparison later.  

Bottom LineForm your own impressions. After you have done all of your research, your final judgment should include your “gut feeling.”

 Inspection Report:

  • Ask for a copy of an inspection report. A good way to do this is to ask for a meeting with the residence administrator. You will also be able to ask about the philosophy behind the facility.
  • Ask how any problems have been corrected.

 Visits:

  • Tour each facility on your own rather than with a staff member. If the facility won’t allow you to tour alone after the first guided visit, take it off your list.
  • Make unannounced visits. 
    • Ideally the visits should be at different times of the day and week to get a complete view of life in the facility. 
    • One of the visits should be during the evening and/or on a weekend when there are usually fewer staff members on duty.

 Physical Appearance:

  • Does the facility allow residents to personalize their rooms?
  • Does each resident have at least one comfortable chair?
  • Does each resident have his or her own dresser and closet space with a locked drawer or other secure compartment?
  • Is there an out-of-doors area where residents can walk and sit and is it used?
  • Does the equipment appear to be in good condition? For example, wheelchairs and assistive devices.
  • Is there a lounge or other area where residents can entertain visitors privately?

Safety:

  • Are the exits clearly marked and unobstructed?
  • Are there features geared toward accident prevention? For example, handrails in the hallways and grab bars in the bathrooms.
  • If you are or could be in a wheelchair, are the hallways wide enough for two wheel chairs to pass? Can they pass freely everywhere or are there obstructions?
  • Are there safety hazards to people who walk unsteadily or with impaired eyesight?
  • Is there good lighting?
  • Telephones: are there any restrictions on mobile phones?
  • Are inside temperatures appropriate? 
  • Are people assisted in walking for the purpose of exercise or retraining?

Cleanliness:

  • If there is a common kitchen, check the kitchen for cleanliness.
  • Check for smells (particularly for urine and feces).
  • Look at the overall cleanliness of the public and activities areas.

 Residents:

  • Look at the quality of the care and concern for residents.
  • Ask residents:
    • What they like about the facility.
    • What they don't like about the facility.
    • What do they do when they need something to be different. 
    • What they like about the staff. 
    • Ask visitors or volunteers the same questions you ask residents.
  • Do the residents appear to be content, enjoying the activities, interacting with each other? 
  • Do staff interact with residents in a warm, friendly manner?
  • Do staff address the residents by name?
  • If possible, speak with family members of the facility’s residents. There may even be a voluntary council of family members with which you can speak. 

Staff:

  • Visit the activities area when in session and notice how staff interacts with residents.  
  • Walk through the corridors and listen to what you hear.
  • Try to get a handle on staff turnover if you can. A high rate of turnover is not good.
  • Find out who to speak with if problems arise, and meet with that person.

Food:

  • If meals are offered by the facility:
    • Try to time a visit for meal time. Taste the food. Is food appetizing and of good quality?
    • What arrangements does the facility have for special diets? 
      • Is there a dietitian? 
      • What effort is made to make special diets taste good?
    • Is the dining room clean and attractive?
    • Is food delivered to residents who are unable or unwilling to eat in the dining room? 
  • Is there sufficient staff and equipment to help residents who canot easily feed themselves? 
  • Are snacks available?

Medical/Nursing Care:

  • Generally, you choose your own doctor, even for emergency care. 
  • Look at the medical services available in case of need. Is there a nurse on premises or on call?
  • An assisted living facility usually has a relationship with a doctor "just in case.". Find out:
    • Who the doctor is 
    • The doctor's qualifications
  • How are medical emergencies handled?
  • If you need more than routine medical care, ask:
    • If a specialist can be called in.
    • If so, how is this done?.
  • If you may need special therapy:
    • Look in the therapy rooms to assess the physical quality.
    • Speak with the staff person in charge to find out if there is any rapport between the two of you.
    • How frequently will the therapy be offered? 
    • How much involvement is there from the doctor with respect to the establishment and oversight of the therapy?

Activities Programs:

  • Ideally, a program should be designed to fit the interests and skills of each person at a variety of times on a daily basis, including weekends.
  • In general, what are the opportunities for socialization?
  • Are residents taken out for events in the community?  
    • If so, how often? 
    • Where do they go?
  • Do people in wheelchairs get to participate?
  • How often are outside events brought in for the entertainment of residents?
  • What activities are provided for bed-bound residents?

Money Issues:

  • Find out what services the facility provides and which ones cost extra.
  • How much does the nursing home charge for: 
    • A daily semi-private or private room if you need one.
    • The “extras”. For example, supplies such as diapers, catheter tubes and for special services like incontinence care. 

NOTE Prescriptions in assisted living facilities often cost double what they would at a local pharmacy. If the drug prices are gouging, demand the right to purchase drugs outside the facility.


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