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How do you find a high quality assisted living facility for a loved one?

By Anonymous August 17, 2009 - 5:37am
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My Dad is 82 years old and a widower. He lives alone in the Scottsdale, AZ area and does pretty well. But lately he seems like he's been having a harder time keeping up his house and he actually brought up the idea of moving to a place where he can get some help with household tasks and chores. His own Mom had moved to an assisted living facility when she was in her 80s and he liked the way she was treated there, but that was years ago and up in Oregon.

I looked up assisted living places online and in the phone book and there are tons of them. And I know from reading the paper and watching the news that sometimes some of them get in trouble for not taking proper care of their residents. I want to help him as much as I can but right now it seems kind of overwhelming and I'm not sure where/how to start. He has some friends who have downsized to apartments and one or two are in nursing homes but he doesn't really want either of those options. He said he just wants someone to provide his meals and be there if he needs other help. Does anyone live in this area who can suggest some places that are nice? What do you look for and ask when you are visiting the facilities so you can know they are high quality places that care about their residents?

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EmpowHER Guest

Hi guys,

I am actually crying happy tears here. I am so amazed that you all took a lot of time from your days to help me. I can't tell you how much this all means to me. You all gave me stuff to think and ask about that I wouldn't have ever even thought up on my own. I'm going to print out these pages if my computer printer will let me do it and take them with me with my Dad and I'm sharing this with him too because he needs to keep these things in mind too. Thank you thank you everyone! I'll try to come back and let you know how it all goes.

August 26, 2009 - 11:43pm
EmpowHER Guest

I would suggest that you talk to the people who live in the facility. Elderly people love to talk and complaining is something may tend to enjoy. Ask them questions about their care that they are willing to share. In a good facility the complaints will be minor.

"They forgot that I don't like tea and brought me tea anyway."
"The bathroom is too cold!"
"I had to sit out in the hall for 5 minutes while I waited for someone to roll me into the dining room."
"The activity for this afternoon changed to bridge, I hate bride!"

If you consistently hear minor complaints, it is probably an excellent facility. No institution runs perfectly smooth and there will be minor problems on a daily basis. It's hard to keep 1-2 elderlies completely happy, imagine caring for 40 of them and them not having minor complaints and issues.

Not that minor complaints and issues are not important. But I can assure you that if everyone is complaining because their laundry was hung up wrong, it is because they don't have major problems to complain about.

Red flag complaints: Help not coming when the call bell is rung. Continent residents put in diapers because the staff is unwilling take the time to help them to help them to the bathroom. Pt unable to get ordered pain medication quickly if needed. People who need a little encouragement to eat being left alone at meal times and ignored.

These complaints are all signs that a facility is badly understaffed and they aren't meeting the residents needs very well. Check the staffing ratios if nothing else.

The exception is the confused resident. If you hear something repeated that seems outlandish, dig a little deeper, it is likely that you have met someone with forgetfulness and confusion. Ask them who the president is before you go looking around for the crazy nurse who put wet sheets on Mrs. Soandso's bed.

I would be most alarmed by a facility that had residents that never complained.

August 19, 2009 - 11:21pm
HERWriter Guide

Hi Anon

I worked in these facilities for several years - from the business end and from the caring end.

What you need to do is firstly make an unannounced visit for a tour. Don't go to facilities that require an appointment.
Take in everything :
- how the rooms/bathroom look : are beds made up? Closets tidy? Are rooms and window treatments clean?
- how everything smells - can you smell urine? Other body secretions?
- ask for a copy of this week's menu
- ask for a copy of the monthly activities lists - this will give you an idea of the quality of non-medical care. Are there trips out? An activity staff? Current events? Art? Music? Exercise?
- look to see how many people are in wheelchairs, versus walking (some facilities are notorious for placing their residents in wheelchairs no matter how ambulatory they are because it's more convenient)
- check regarding room-mates/how they are chosen and what are the options if the room-mate doesn't work out
- request the resident bill of rights as well as minutes from the resident council
- how do staff address residents and each other? Do staff knock before entering a resident's room?
- are privacy laws adhered to? Do you see resident charts lying about the nurses' stations or private information being phoned in, with names used, in a public area like a nurses station? Know your HIPAA laws (patient privacy)!
- look for basic care regarding dignity - are colostomy bags or foley (urine) bags covered? Are residents dressed in public areas or are they in gowns?
- Do staff seem happy to work there?
- The quarterly POC's (Plans of Care) should include family members. Make sure you get plenty of notice to attend.

Very importantly - all facilities must have their annual surveys available to the public. Go through it and check any/all violations. Some violations are not very important but some are quite serious like patient care, wound care, the amount of bed sores recorded etc.

Don't be afraid to have a word with residents or families that you see.

I hope this helps you - doing your homework when choosing a place is very important.

August 19, 2009 - 1:06pm

I hope you get some wonderful insight from people who have traveled this path before you. I know that finding an assisted living facility for a beloved family member is anxiety-producing, confusing and stressful when you feel that you don't know what to ask.

The magazine U.S. News & World Report ranks nursing homes, by state, and awards them stars based on how they measure up in three ways: health inspections, nurse staffing, and individual quality measures. While you are looking for assisted living instead of nursing care, it helps to also see how easily a transition would be made to a nursing facility if that was ever necessary. Perhaps it will help you to see how U.S. News ranks their Arizona facilities in terms of giving you questions to ask when you are visiting possible homes for your father:


And here's a good story from USA Today from 2004 on how to find the right assisted living center. It lists what to look for and ask, what to consider, and places to get even more information:


Hope this helps a little. For those of you who've been through this, what helped you the most in your search?

August 18, 2009 - 10:13am
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