Choosing an Assisted Living Facility

HAMPTON ROADS, Va. - For folks who have been independent all of their adult lives, how do you know when the time is right to consider a move to an assisted living facility?

Generally, a lifestyle change may be needed when a loved one develops difficulty in one or more of the following areas:

- Self-care

- Diminishing health, physical or mental abilities

- Lack of community support services

- Family not available to provide care or supervision

While assisted living facilities do not provide the constant care available at a nursing home, they can provide a senior the right combination of independent living and helpful assistance when needed.

Click here for help in choosing the type of facility that may be right for your or your loved one.

As you begin to look at different facilities, be sure to ask the residence for written material, including copies of the community’s resident agreement that outlines, at a minimum, services, prices, extra charges, admission and discharge criteria, staffing, and house rules. A disclosure statement that discusses ownership and financial solvency of the provider may also be available. Also ask if the facility has a "resident's bill of rights" and a formal complaint procedure.

In the end, feeling comfortable with a facility may be the most important factor.

As you tour an assisted living facility, keep these thoughts in mind:

Click here to download an Assisted Living Facility Assessment Manual from the Virginia Department of Social Services.

Rooms/Apartment/Common Areas -
Do the homes or apartments appear to be safe and secure?
Are telephones available?
Can or do residents/tenants have telephones in their rooms/ apartments?
Are halls free of obstacles (furniture, equipment)?
Are exits unobstructed and easy to reach?
Are fire extinguishers visible?
Is there an evacuation plan posted?
Are drills held regularly?
Are floors clean and non-slippery?
Are there any obvious odors?
Are doorways/hallways, rooms big enough to accommodate wheelchairs?
Is the temperature in the facility comfortable?
Can residents regulate the temperature of their own room/apartment?
Is heat/electric/cable included in the monthly cost?
Will the room/apartment shown appear to meet his/her needs?
Are rooms/apartments attractive, clean, well-lit, well-ventilated?
Can residents/tenants use their own furnishings in their room?
Is there a bedside stand, reading light and chest of drawers for each resident?
Is closet space/storage space sufficient?
Are provisions made for privacy?
Is there space for private visits in the home?
Are there private bedrooms? Are there private bathrooms?
Are cupboards easy to reach and electrical outlets conveniently located?
Are bathrooms conveniently located?
Are bathrooms clean, well-maintained and odor-free?
Are handgrips or rails near toilet and bathing areas if needed by the residents?
Do bathrooms have showers or tubs?
Are bathrooms equipped with locks for privacy?
Are there emergency pull cords?
How many people share a bathroom?
How and how often do residents/tenants take baths/showers?
Are other living areas sufficient in size for the number of people in the facility?
Is there sufficient space for visitors, conversation, TV watching and quiet reading?
Are living areas clean, comfortably furnished and generally pleasant?

Administrative -
Does the facility have a current state license/certification/registration?
Do staff know the residents/tenants?
Do staff show interest in individual residents/tenants?
Do residents/tenants talk freely with staff?
Are residents/tenants treated with respect and dignity?
Do residents/tenants appear generally happy?
Do residents/tenants appear to receive good care?
Do residents/tenants appear to respect each other?
Is privacy respected (knocking before entering rooms)?
Are calls for assistance responded to quickly?
Is the appearance of staff neat and clean?
Does there appear to be enough staff to meet residents’/tenants’ needs?
Is the facility locally owned?
Who is responsible for the facility operation? How often is he/she in the building?
What is the educational and professional experience of the administrator?
Do the program and services appear to be appropriate to meet the needs of the prospective resident?
Does the admission agreement clearly specify:
Services provided in the monthly rate?
Daily or monthly rate?
Additional charges for services not covered in the rate?
Thirty-day notice for a change in the rate or service?
When payment is to be made?
What the refund policy is?
Does the facility have a resident’s bill of rights and complaint procedure?
Did the facility have any complaints in the past year?
If so, were they resolved?

Health Care -
Is there a nurse on staff? Is the nurse an RN?
How often is the nurse in the building?
How are maintenance issues handled?
If desired, will the facility control residents’/tenants’ medications?
Can residents/tenants retain their personal physician?
Does the facility assume responsibility for making medical appointments if residents are unable to?
Does the facility provide transportation for medical appointments? Is there a charge?
Does the facility have a plan to respond to medical emergencies and dental needs?
Are staff trained in the provision of emergency First Aid?
What happens if health changes? Will the facility provide additional
services or arrange for home health care?
Will the facility provide or arrange for specialized therapies if needed?

Recreation -
Does the facility have amenities such as a beauty shop, store, fitness area, bank?
What is the smoking policy in the facility?
Are activity calendars posted?
Do activities include a variety of interests?
Are planned activities appropriate to the age and abilities of the residents/tenants?
How often are there planned outings?
Do residents/tenants participate in planning the activities?
Are residents/tenants encouraged to participate in community activities?
Does the facility provide transportation to community activities?
Are arrangements made for residents/tenants to attend religious services and to practice their beliefs?
Are escorts to programs and meals available, if needed?
Does the facility provide help with bathing, getting in and out of bed, care for hair and teeth, dressing, exercise, and other personal care needs if residents require it?
Does the facility teach personal care activities to improve independent functioning such as feeding, grooming and dressing if needed?

Food Service -
Is the kitchen clean, well lighted and well organized?
Are foods stored in a clean, dry area?
Do staff handle food in a safe, sanitary manner?
Can residents use the kitchen?
Is the dining area pleasant, comfortable, clean and easily accessible?
Is it large enough to hold the majority of residents/tenants?
Is the atmosphere relaxing (so that mealtimes do not appear chaotic and rushed)?
Can residents/tenants choose where and with whom they will eat?
Are tables convenient for wheelchairs when needed?
Ask to eat a meal in the dining room. Was the food good? Experience enjoyable?
Is a menu available? Did the home serve what was on the menu?
Does the facility monitor nutritional needs and provide modified diets when needed?
Are hot foods served hot and cold foods served cold?
Are dishes and silverware used (instead of disposable plates and utensils)?
Does the food appear appetizing?
Do meals appear to be nutritionally balanced?
Are fresh fruits and vegetables served in season?
Do residents/tenants appear to enjoy their meals?
Is food served family style or do staff determine portion sizes?
Are residents/tenants able to have snack foods and/or soft drinks in their bedrooms?
Are provisions made for residents/tenants who are ill and unable to eat in the dining room?
Do residents/tenants have input into meal planning?