6. Understand what you are paying for. There are two main areas of cost typically under two separate agreements:
the rental housing cost and the care or service package. The Federal Fair Housing Act applies to senior residences. Know what is included, such as medication management, and what the “hidden fees” are, such as extra housekeeping and laundry. Ensure that the care package you agree to matches your parent’s condition at present. See if the community supplements direct care with proactive technology—at the very minimum, personal emergency alerts—such as wellness tracking or a supervised telemedicine connection to local doctors, which can detect subtle declines in condition and more quickly diagnose a potential illness. Ask questions, negotiate, and flag when the answers are less than forthcoming.
7. Check the financial stability and licensure of the community
This is important since a bankruptcy or sale may affect agreements and pre-payments. Do an internet search and consult your local AAA; for nonprofits, a search using Guidestar may be helpful. Swayne recommends asking the following questions: if there is a pending facility change of ownership in the next 6-12 months, the average resident length of stay by months, if there is a waiting list, staff turnover rates, and the average length of staff employment. Check their state licensure(s) as there are different levels by state: what care is covered; any citations, fines, and violations; plus their performance on their last state home care survey.
8. Arrange for correct responsibility for payments.
An adult child may sign agreements on behalf of their parents, but that could mean becoming the guarantor of payments if the parent does not pay or runs out of money. Bradley J. Frigon, an elder law attorney and past president of the National Academy of Elder Law Attorneys (NAELA), recommends that you sign the older adult’s name as the responsible party on the contract and add “by [name of agent] acting as power of attorney” with the date.
9. Get an appropriate medical assessment before move in.
This confirms with the community that you have the right level of care assigned and avoids after move-in revisions. Swayne advises that a qualified nurse at the AL should do this so that the medical and cognitive assessment becomes part of the record before the move-in. This will be in addition to your private medical records and assessments. In addition, confirm the community’s procedures in the event of a medical emergency, which hospitals are used for admission, and disaster preparedness.
10. Family responsibility does not end with a successful move.
Once your loved one settles in, it is never ‘set and forget’. You, friends and relatives should visit frequently. See and sense that your parent is engaged. Consult quarterly with senior staff and administrators. Their accessibility is a key indicator of quality, as is yours. Always review bills and your parent’s finances into the future. Question if there is a sudden increase in care required and crosscheck this need with your parent’s doctor(s). Check their care service for performance and medical records, especially for pharmacy. Speak to aides, and always use your senses—including common sense.
- The National Center for Assisted Living (NCAL) on assisted living
- Choosing a provider (LeadingAge)
- 9 Things to Consider in Your Search for an Assisted Living Facility (US News & World Report)
- Ten Things You Need To Know About Assisted Living (ChangingAging.org)
- Ten Things Assisted Living Homes Won’t Tell You (MarketWatch)
- 10 Things to Know About Assisted Living (New York Times)