Looking Into Assisted Living Takes Legwork

By Richard Asa @RickAsa
May 05, 2016

Visit communities, get on waiting lists, and always review your contract before you sign.

Moving into assisted living is a complicated decision, with many factors to consider that makes the fit right. 

You would think that the first and most important decision would be cost, but there are other factors to consider first. 


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One should be what your needs are and what’s important to you in your life. Consider factors such as where your doctors, churches, children, and grandchildren are located. Would transportation get you to where you need to go?

Then again, moving into a lesser assisted living community closest to friends and family might have drawbacks. “It is really important to have a place that’s easy to visit, but it’s more important to find a facility that’s really good,” Catherine Hawes, director of the Program on Aging and Long-Term Care Policy at Texas A&M University told Frontline

Even is it’s further away, you should make sure you’re getting the best facility for your loved one’s needs, “and be realistic about what they need,” Hawes says. 

One of the most common types of assisted living facilities are those that allow you to “age in place,” meaning that they take a stepwise approach to your care as you grow older. 

So, you would want to think about your current and future needs before moving into an assisted living community. If you have complex, medical conditions, one place may be better than another. 

A study found that nearly half of assisted living residents had at least three chronic conditions, yet slightly more than half of facilities surveyed had a registered nurse or a licensed practical nurse on staff. 

The survey authors note, “Some residents with multiple, complex medical conditions present a challenge that some [assisted living facilities] may not be prepared to manage.”

It’s important for you and your family to visit an assisted living community several times to get a feel for how it works and learn its culture. That’s one way of knowing what you’re getting into. 

Talk to the residents and nurses, ask about the services available, and how the place is staffed at night. Check into turnover as well, which can be a sign of whether a facility is or is not meeting its residents perceived needs. 


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Get referrals. As in most things in life, word of mouth is the best marketing you can have. Talk to people who have done searches on certain communities already, and contact your local agency on aging to see if it has a list of facilities it would recommend in your area. 

A waiting list is a good sign on the quality of an assisted living facility, and most good ones have them, but that also means you can’t wait until the day you need a space. Start your search before you need to, and get on waiting lists now to avert a crisis. 

Then, there’s the fine print. For starters, make sure a facility is licensed so you’re sure it meets your state’s assisted living regulations. You can check that with the agency that licenses assisted living communities in each state. The agencies responsible for that will vary from state to state. 

Go over the admissions agreement with a magnifying glass. These agreements can be long and complicated, with many clauses that most people don’t read. But it’s worth it. Sometimes, for example, there’s language that requires 30 days notice before the facility will stop billing for services. Your loved one could have died and you could still be paying for care. 

Another “red flag” is a negotiated risk agreement, says Frontline

“These clauses are often offered as a way for residents to make preferred choices about their care, even if they present some risks. For many in the industry, they are seen as a way to help seniors preserve a sense of independence.” But geriatric care experts warn that if something goes wrong, you can’t sue under the agreement. 

Always get the contract reviewed by a lawyer prior to moving in. “People underestimate the need to have the contract reviewed,” says Craig Reaves, an elder law attorney in Kansas City, Mo.. “It depends on the facility, but there may be some provisions in those contracts you may not want.” A facility may be willing to remove them if asked. 

If there’s one bit of advice that’s universal, it’s don’t be in a hurry. If you start early and plan ahead, you can make sure you’ve done your homework on assisted living communities and know what each offers and how it would fit your needs. 

“There is a huge variation among assisted living facilities. While this can make the process of choosing seem daunting, the plus side is that you have a good chance of finding a facility that is perfectly suited to your preferences and needs,” according to HelpGuide.


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April 07, 2020

Reviewed By:  

Janet O’Dell, RN