DIMENSIONS Spring 2001

CHOOSING AN ASSISTED LIVING FACILITY

by Julie Cleveland

One of the most difficult challenges for families of individuals with dementia is to provide a safe, secure, and pleasant living environment. When the person with dementia is no longer able to live at home, an assisted living facility may be a good alternative. Assisted living (AL) facilities are designed to provide housing, meals, and care for individuals who need supervision and help with daily activities, but do not need the skilled nursing care provided in nursing homes. Some AL facilities specialize in dementia care, others provide more general care. Choosing the best one for your family member is a matter of finding the best fit between your family member's needs and the resources of the facility.

There are many issues to consider when selecting an assisted living facility. Consult a variety of sources to gather information on facilities. Take the time to visit each of the facilities you are considering before you choose one. Be sure to honestly discuss problems such as agitation, wandering, or incontinence, so you and the staff can make an informed decision about whether the facility can meet your family member's needs. Here are some more ideas about selecting an AL facility:

Assessment and Care Plan

• Is there a written plan for the resident's care?
• What is the procedure for assessing the resident's needs, and how often are these needs reassessed?

Services and Health Care

• What kinds of services are offered: dressing, bathing, etc.? Are they available 24 hours a day? Is there an additional cost for these services?
• If more extensive services are needed, are there other levels of care available on site? Some places have "independent living," "assisted living," and "skilled nursing care." Residents may move out of one area into another as the need develops.
• What is the facility's policy for storing and administering medications?
• Does a nurse or physician visit the facility regularly to provide check-ups for residents?

People & Physical Environment

• Tour the facility. Are both private and common areas pleasant, safe and clean?
• Meet the staff. Do they seem friendly, kind and compassionate?
• Meet other residents. Are they comfortable, clean and appropriately groomed? Talk with residents and find out how they like the facility.
• Is the facility safe and secure? For example, are the aisles wide enough for wheelchair users? Are there secure areas indoors and outdoors for people who wander?
• Ask to see the facility's plan for fires or natural disasters. Can they provide the kind of assistance your relative needs in case of emergency?

Recreational Activities

• Do they have daily organized activities at the facility?
• Are there activities available outside of the facility (like the mall, theatre events, etc.)? Is transportation provided?
• Are residents allowed to have pets? Does the facility have its own pets?

Costs and Contracts

• What is included in the monthly rate? What is extra?
• What sources of funding do they accept or not accept? Do they accept Medicaid?
• Are rates fixed? If not, how are rates raised? What kind of notice do you get?
• Ask to see the facility's license and their most recent inspection report.

Assisted-living facilities vary widely in the services they provide, what type of individuals they accept, and how much they cost. By asking the right questions, caregivers can choose the AL facility that will best fit their needs and those of the person with dementia.

For information about facilities in Washington State call the Washington State Department of Social and Health Services -Aging and Adult Services Administration at (800) 422-3263.