How to Choose the Right Senior Living Facility

In this article...
  • This guide outlines the various types of assisted living options and what they offer. Learn what steps to follow and what items to cross off your checklist as you find the right senior living option when you or a loved one needs more help.

The time may come when you or a loved one are no longer able to live alone safely. Moving into a senior living center offers safety, security, continuous health care and – perhaps most important – peace of mind.

But there are many different options for senior living. It takes some research and planning to find the right facility. That’s why elder care experts recommend you start the process well before the need arises. You don’t want an unexpected event or health crisis to force you to make a quick decision.

How do you find the right assisted living facility? Here are some steps to follow now, so you are prepared if it’s time to make a move.

Know the 4 Senior Living Care Options

The National Institute on Aging lists four types of long-term care residences:

  • Assisted living facilities
  • Nursing homes
  • Board and care homes
  • Continuing care retirement communities

Assisted living facilities (ALF) are staffed to provide some help with daily living requirements, including but not limited to cleaning, cooking, medication management and transportation. An ALF is a good choice for seniors who are able to perform most if not all of the Activities of Daily Living (ADL) but would like help some or all of the time.

Nursing homes, which may sometimes be classified as skilled nursing facilities (SNF) depending on the facility, include licensed health care providers with advanced degrees who can give residents more intensive medical care, including:

  • Skilled nursing care
  • Rehabilitation services, including physical, occupational and speech therapy
  • Help getting dressed, toileting, in and out of bed and personal hygiene
  • Medical management for chronic health conditions
  • Memory care for patients suffering from dementia, including Alzheimer’s disease

Board and care homes are assisted living homes with only 20 or fewer residents who typically live in private or shared rooms.

Continuing care retirement communities (CCRC) are multi-purpose planned communities that include some or all of these senior living options, including independent housing, assisted living and a skilled nursing facility. The facilities are gathered on one campus, and residents can begin with lower levels of care and then move into skilled nursing care as their health and wellness needs change.

How to Choose the Best Nursing Home, Retirement Community or Other Assisted Living Facility

To determine which senior living facility is best for you or your loved one, the first step is to assess his or her ability to perform the Activities of Daily Living (ADL). If you aren’t sure about this, ask your loved one’s physicians to advise you on the level of care they require.

Some typical ADL include:

  • Medication Management
  • Eating
  • Personal Hygiene
  • Continence
  • Mobility

Each type of facility is designed to help with these daily activities in different ways:

  • Assisted living facilities can help manage medication but may charge a fee for that service. Nursing homes generally manage all medications as part of their basic service.

  • Most assisted living facilities can prepare meals while residents are able to eat without difficulty. Nursing homes provide more help for those who have eating and nutritional challenges.

  • Assisted living facilities may be able to help with showering and personal hygiene, generally as an add-on service at an additional cost. Nursing homes provide hygiene aid in their basic care models.

  • Assisted living may facilities charge extra for toileting assistance. Nursing homes offer this service whenever it’s needed.

  • Assisted living residents typically are mobile, whether unassisted or using a cane or walker. Nursing homes provide additional help for those who find moving at all challenging.

Narrow Your Search Using Online Resources and Medicare Nursing Home Compare

To find options in your community, a good place to start is to search a few websites, including the Medicare.gov Nursing Home Compare tool.

Other sources include:

  • Your state and local agencies on aging can help you compare assisted living options. Find your local agency at the federal government’s Eldercare Locator website or by calling 800-677-1116.

  • LeadingAge, which is a professional association of eldercare organizations, has an Aging Services Directory on its website. Use it to search for facilities in your area that belong to LeadingAge.

  • Argentum, a trade association for senior living communities, also has an online directory to search by ZIP code.

As you compare options, consider asking around. Your friends, relatives, neighbors and your loved one’s doctors are good sources for recommendations.

Plan and Make Visits

Senior living facilities all offer tours of their housing, grounds and amenities. During the COVID-19 pandemic or during other times when in-person visits may not be allowed, you may be able to conduct virtual visits through Zoom or other platforms.

This AARP assisted living evaluation checklist includes some factors you should consider to get a good sense of the facility:

  • Is it clean?
  • Are the hallways and stairways well lit?
  • Are the exits well-marked?
  • Are there safely locks on doors and windows?
  • Are security and fire safety systems obvious?
  • Are there common areas, such as dens and living rooms?
  • Is the floor plan easy to follow?

Look Over Contracts and Licenses

Ask to see what you are signing up for, in writing. Some things to check carefully include:

  • A list of what is provided
  • A list of extra services and their costs
  • How billing and payments are managed
  • Visitation policies
  • Rights and responsibilities

Also ask to see certificates of state licensing and if the facility has been reported for violations or assessed fines in a recent audit. If the facility declines to provide that information, it may be best to walk away.

About the Author

David Levine is an award-winning writer and editor whose work has been featured in the New York Times, New York Daily News, Sports Illustrated, American Heritage, U.S. News & World Report and others.

David has covered health, health insurance and health policy topics – among many others – since 2017. He earned a Bachelor's Degree in English from the University of Rochester and currently lives in Albany, New York.

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