Living Options Article

Assisted Living Choices

Assisted living residences, in both rural and urban areas, allow today's residents to be highly discriminating in their choice of a residence. A wide range of choices have become available over the past 12 years, however, may produce confusion and anxiety. With choice often comes the implied responsibility for making the 'right choice.' Family members engaged in this search sometimes feel lost and overwhelmed.

ALFA (Assisted Living Federation of America) has developed a complete checklist to be used in the evaluation and selection process. Consider the following criteria when looking for the ‘right choice’.

Atmosphere: Family members involved in the selection process must look at the residences they visit through the eyes of the person who will be living there. When touring facilities, family members often comment, 'I could imagine myself living here.' Although that is a positive reaction, what is truly relevant is whether they can imagine their loved one living in that setting. Ask yourself if your loved one would feel comfortable in this particular setting and if it would support the physical, emotional and spiritual needs of the resident.

Physical Features: A residence that is modern and tastefully decorated almost always creates an initial favorable impression. However, if the setting is not designed to maximize comfort and ease in functioning it may not be a particularly wise choice. For example, a beautifully decorated room that does not have a emergency button in the room to call for help does not allow for the safety of the resident in case of a fall. A bathroom that is too small to permit a wheelchair or walker to enter without precise maneuvering also reflects poor design. Hallways that are long and/or poorly lit without handrails may confuse and overwhelm elderly residents.

Needs Assessment, Contracts, Costs, and Finances: Assessing the contractual agreement is important. Most people are accustomed to evaluating contracts fairly routinely. But it will be important to understand the terms and conditions including any future costs for increased levels of care and service should the resident's physical and/or cognitive functioning decline. In addition, most of the contracts have a section outlining annual increases. Being prepared for that eventuality will help you decide whether that particular residence is financially feasible now and over time. Visit ALFA's Web site (www.alfa.org) to view a standard 'Consumer Information Statement' or disclosure form, which identifies questions you should ask specific to fees and services.

Education and Health Care: The majority of residents in an assisted living community are on at least two daily medications. Many choose this type of setting because medication self administration, among other things, has become difficult. Understand how medications are administered as well as the procedure for any medical emergency that may arise. Ask about the qualifications and skill level of the employee that would administer the medication and how information about medications given, refused or discarded are being logged and accessible for your review.

Services: Determining as specifically as possible the prospective resident's daily care needs is a critical step in choosing a residence. Make a detailed list of the type of assistance that will be required with each activity of daily living. Discuss the care needs with the community to find out how they would handle each of them individually to get a comfort level that the care needs can be met. It is equally important to find out what care needs the residence is unable to provide in which case a future move to another facility may be necessary. Be aware of the limitations.

Social and Recreational Activities: A diverse program of planned activities both within the residence and the outside community is vital to the happiness and contentment of residents. Who plans and directs the social events? Who decides what types of activities are being chosen? Are residents who are less social encouraged to participate in activities? Are activities designed to not only nurture the spirit but challenge the intellect? Are activities in the residence consistently well attended by residents? Make sure that a wide variety of activities are being offered to address the residents physical, emotional and spiritual well being.

Food Service: Food is a significant part of life. We look forward to meals and savor not only the food that we eat but the atmosphere in which the food is served. One of the universally significant ways in which people feel nurtured is through the food they eat. Keeping that in mind, food preparation should include fresh, diverse, and interesting ingredients. Take a look at the kitchen to find out if meals are home made daily using fresh ingredients. Ask about daily snacks and find out if the residents have a choice of meals to choose from. Mostly all dietary restrictions such as diabetic, low sodium, low salt and other specific diets should be accommodated but you should ask about your specific needs.

In addition to using the guidelines ALFA has developed for choosing a residence, use your own knowledge of the prospective resident as a guide in making your choice. In what setting will he or she feel most supported and at the same time be able to function most independently? What are the particular and unique physical, mental, emotional, and spiritual needs of this person and in what setting are those needs most likely to be recognized and met?

The goal you set in choosing a residence should not be considered met until a setting has been selected in which the prospective resident can feel physically cared for and can thrive emotionally. Many older adults who are living independently, but struggling each day with physical and/or cognitive disabilities, are isolated and afraid. Moving into the appropriate assisted living residence can relieve the daily struggle to function and release the energy to fully and joyfully engage in life again.