March 25, 2017

Savvy Senior: Choosing the best assisted living facility

By Jim Miller

Dear Savvy Senior,

What tips can you offer for choosing a quality assisted living facility for my mom? Her health and mental abilities have declined to the point that she can’t live alone anymore, but isn’t ready for a nursing home either.

Looking Around

Dear Looking,

If your mom needs some assistance with daily living activities like bathing or getting dressed, managing her medications, preparing meals, housekeeping, laundry or just getting around, an assisted living facility is definitely a good option to consider.

Assisted living facilities are residential communities that offer different levels of health or personal care services for seniors who want or need help with daily living.

There are around 40,000 assisted living facilities (also called board and care, supportive-care or residential-care facilities) in the U.S. today, some of which are part of a retirement community or nursing home. Most facilities have between 25 and 125 suites, varying in size from a single room to a full apartment. And some even offer special memory care units for residents with dementia. Here are some steps you can take to help you choose a good facility.

Make a list: There are several sources you can turn to for referrals to assisted living facilities in your area including your Area Agency on Aging Age Well at 865-0360, family doctors or local senior centers or online search services like Caring.com.

Call your ombudsman: This is a government official who investigates long-term care facility complaints and advocates for residents and their families. They can help find the latest health inspection reports on  assisted living facilities To find your local ombudsman, visit LTCombudsman.org.

Call the facilities: Once you’ve narrowed your search, call the facilities you’re interested in to find out if they have any vacancies, what they charge and if they provide the types of services your mother needs.

Tour your top choices: During your visit, notice the cleanliness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the residents and their family members, if available. It’s also a good idea to visit several times at different times of the day and different days of the week to get a broader perspective.

On your visit, get a copy of the admissions contract and the residence rules that outline the facilities fees, services and residents’ rights, and explains when a resident might be asked to leave because his or her condition has worsened and they require more care than the facility can provide.

Also find out about staff screening and training procedures, and what percentage of their staff leaves each year. Less than 30 percent annually is considered good. More than 50 percent is a red flag. To help you rate your visit, Caring.com offers a checklist of questions that you can download and print at Caring.com/static/checklist-AL-tour.pdf.

Paying for care: Monthly costs for assisted living range anywhere from $2,500 to $5,000 or more, depending on the facility you choose and the services provided. Medicare does not cover assisted living. Most residents pay out-of-pocket while some have long-term care insurance policies.

If your mom is lower-income and can’t afford this, there are many states that now have Medicaid waiver programs that help pay for assisted living. Or, if she’s a veteran, spouse or surviving spouse of a vet, she may be able to get funds through the VA’s Aid and Attendance benefit. To find out about these programs, ask the assisted living facility director, or contact her local Medicaid office (see Medicaid.gov) or regional VA office (800-827-1000).

Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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