More Than a List of Questions- Choosing the Right Senior Living Community
Nowadays, the majority of my time at work (and let's be honest, during dinner, in the middle of weeding the garden on a Sunday morning, and occasionally while I'm getting ready for bed) is spent on the phone with families who have begun to think about Senior Living communities for their parent or parents. Occasionally, these calls come from the future residents themselves as well. I love this work, because I truly believe in the lifestyle that the right community can give back to a resident and their family. But, just as a move is stressful at any point in our lives, moving yourself or a loved one into a community brings along a set of baggage that is often wrought with guilt, worry, and a role reversal so sneaky yet blatant that it is easier to shove it underneath questions about common areas, green space, and activities calendars.
Then, what I see happen too often, is a family making a choice of community based on what looks right on paper, moving mom in, and realizing a month or two later that it's not a good fit. There's a reason why those in my role don't "close an account" until we've heard from this family at least twice in six months that everything is going well at the place they chose over ours.
Being a now thirty-something, I haven't yet found myself on the other end of that call until recently my mom called, ready to embark on the glorious journey that is senior living research for a neighbor of hers in Florida. Before she called or visited, she wanted to know what should she be asking, what should she be looking for, and what was really important. Well, I am here to lay it out for you honestly and clearly, from those of us who work in the industry and have the shared goal of helping families make the right decisions, that there are several things (including your question list) that will help to hone in on the place, or couple of places, that will be the best fit.
1. Decide if you need an advisor.
Listen, this can be a daunting and exhausting process. I've had folks that have done an internet search for "assisted living" and their zipcode, and then one by one called and asked for pricing as a way to weed through. Please, please, and again, PLEASE do not use this method. Pricing is important, definitely. BUT, it is not the most important thing, nor is it always consistent, all-inclusive, or non-negotiable. Instead, if you feel overwhelmed by the options, my recommendation is to consider an advisor to assist.
Here's the best part of Senior Living advisors- most cost you nothing. There are a lot of options, and sometimes it is hard to understand the difference between the types, so I've outlined them here for you so you can choose which you think will work best for you.
Referral Services like A Place for Mom and Caring.com These services employ local advisors who work from usually their home office and can listen to your scenario, ask a few key questions, and put you in touch with people like me at the communities that will match your requirements. After that, you can follow up with these communities however you'd like. You will not pay for this service, rather the community will pay the company once you move in. A few things to keep in mind if you're going to use a service like these...
Because these services have contracts with communities, there may be other community options that you miss out on because they are not partnered.
These services will send your information (with your permission) to typically 5-7 communities that best fit what you're looking for. You'll want to expect that the team at these communities will be reaching out trying to get ahold of you, so if you prefer to start with information via email, make sure you specify that to the advisor.
The relationship with your advisor in this scenario is typically only virtual/ over the phone. They will not visit the community with you, but may check back in after your visit to see what your impressions were.
Local Advisor Companies like Oasis or Care Patrol
Depending on where you live, you may have several companies like these, and possibly with different names. The primary difference between these services and a service like A Place for Mom is the fact that these services provide a local advisor that will tour with you, similar to a real estate agent. Similarly, you will pay nothing for this service, but your advisor will be paid by the community once you select one and the move-in is complete.
Aging Life Care Experts/ Geriatric Care Managers If you are comfortable with paying for an advisor, especially if you are not local to the communities or you or your family member has a complicated care need, an ALCE can be a god-send. Make sure that when you find one, they are accredited and have experience in the geographic area you are concerned with. An ALCE can do much more than help you find a great community. To learn more about the services and expertise they provide, check out the ALCA website.
2. Prepare a personalized list of questions/ requirements.
I cannot count the number of times that a family or future resident has asked me "What are your staffing ratios?" and when I asked them to be more specific about what they meant, they weren't sure. It's not that this isn't a good question, it's just that there are MUCH more important questions.
There are a lot of lists floating around the internet with questions to guide the "research phase" of a senior living search, and I get it. Most people don't spend their days (or dinners, weeding time on Sundays, and pre-bedtime hours) thinking about Senior Living like myself and my super-interesting colleagues. They aren't thinking about non-pharmacological interventions in dementia care while they brush their teeth. They're not talking about care fee structures at cocktail parties. Again, not everyone can be this cool. So when it comes time to do this research, they go where any normal twenty first century human would go to get some answers, Google.
What I suggest, is that first you start by listing the things that matter now. Take the time to have a conversation as a family about what the perfect place would feel like. What worries would it take away, what problems would it solve, what habits and hobbies would it support, and what would life look like living there. Then, use each one of those items on your dream list to craft a question that you'll ask each community.
I recently had a gentleman who was doing research on communities for he and his wife. They spent time doing just thing, typed it up, and sent it out to communities like mine as an attachment to an email asking for those in my role to please read through it and respond with how we could make their vision a reality (or not). I have never been so thankful! Where there were some items on the list that I didn't exactly match, I could offer a solution. For example, there might not be a swimming pool at a community you're considering, but if you have it on the list the community may offer a paid membership to a local pool as well as free transportation.
3. Plan your visit(s).
The best way to truly get a feel for a community is to visit. I recommend you visit multiple times if possible, once planned as a tour, once for a meal and community and experience, and once without warning. Here's the why behind each.
Planned Tour This is your chance to meet with a lovely person like yours truly who will likely spend some time getting to know you, your family, and what is important before taking you on a tour of the community. During this tour, make sure you take note of how clean, lively, and welcoming the space feels. Pay attention to odors, sounds, and most importantly, smiles. This might sound silly, but it's not a bad idea to keep a tally of how many smiles you see during this visit. It's a metric that will tell you how pleasant the associates are and how happy the residents and families are.
Meal Visit This visit is important for several reasons. Of course, you want to make sure the food tastes good, but you also want to watch the responsiveness of the staff, listen to the noise level of the dining room, watch to see how conversational the tables are, and observe what happens after the meal is over. Do residents linger over coffee or are they rushed out to clear a table? Are they heading from dinner to a concert or are they all going back to their apartments to get ready for bed?
Unannounced Visit My colleagues in the industry might hate me for this one, but I recommend if you've done both the planned tour and the meal visit and have narrowed it down to a couple places, do an unannounced visit. You want to know what the community feels like when they don't know you're coming, because this is what it will feel like most of the time. So one day, stop in and say you were in the area and wanted to stop by again, and see what happens. Hopefully the red carpet is always unrolled, but if it's not, this is a great way to tell.
4. Ask to speak with a resident or family member. If you have done all of the above and are still not sure, this might be a good next step. Ask for a family or a resident who has been with the community for a while, and ask for their honest feedback on the things they like and don't like about life at that community.
5. Try a respite stay.
If you find that you are still uncertain, ask your top choices about the availability of a respite stay. A respite (or short-term) stay is usually around 30 days and is a great opportunity for you and your family to "try it before you buy it" . During this stay, a resident can enjoy all of the amenities and services of regular residents without having to bring their furniture or make any commitment. If after the respite stay is over things are going well, typically moving in as a permanent resident is a very easy transition. If after the 30 days you still have doubts, most places will offer to extend the stay for longer.
Listen, making a move to a community is stressful, exciting, and maybe a bit emotional. There is no perfect place just as there is no perfect house, but the goal should be to find a place that feels like home and where the resident will feel comfortable, engaged, included, and important. If you find you're still having trouble selecting a community, there are many people in the industry and out who have been through it and can help. Never feel like you're on your own, and be ready to lean on those around you to help.
As always, I am always reachable and available to talk to anyone struggling with these issues. Feel free to reach out to me here.