As challenging as it might be to make the initial decision to move to a senior living community, more challenging decisions loom in the future for families, from discovering the kind of care required to finding the best community for you and your loved ones. Searching for the right community may take some time, but the effort is well worth it.
Do the Research
Depending on the area where you live, you may be able to choose from dozens (or more) of senior living communities. This range of options can seem daunting on the surface, but if you do your homework and know what you are looking for, you can find a community that meets all of your needs.
Where to Start
A simple Google search is an excellent resource to begin searching for the right community. Most websites will provide basic information: location, amenities, care options, and entertainment details, such as activities or nearby attractions. In addition to the community’s website, read online reviews to get a sense of the quality of care and staff.
Although print brochures, virtual tours, and online marketing materials all help narrow the search, nothing can beat checking out a community in person. Go on a scheduled tour with a community representative who can answer all your questions, but also pop in at other times, perhaps during a group activity or at meal times, so that you can see the interaction between staff and residents firsthand. Don’t forget to ask one or two relatives to join in the visit—you can benefit from hearing their impressions. If you are serious about a senior living community but a little unsure about a particular facility, see if you can book a temporary stay for your loved one; this can go a long way toward helping you make up your mind.
Understand the Available Options in Senior Living
If your loved one has a special medical condition, you must determine if the community can provide the support required. Some specific considerations are outlined below.
Disability, Special Needs, or Unique Medical Care
If a physical disability is present, it’s important to choose a community that meets standards for both universal design and the Americans with Disabilities Act for accessibility. These are some features that indicate a community's compliance:
- Doorways and hallways that are wide enough to accommodate walkers and wheelchairs
- Easy-to-reach cupboards and shelves
- Bathrooms fitted with grab bars and shower chairs
- Wheelchair-accessible apartments and showers
- Emergency call systems so your loved one can call for assistance if needed
- Help for the visually impaired (find out if staff members have been trained to meet the needs of residents with low vision or complete vision loss)
If your loved one needs help with any of the activities of daily living (eating, bathing, dressing, toileting, transferring/walking, and continence), it’s vital to find a community that provides the right amount of personal assistance and medical care. To find out if the residence will meet the needs of your loved one, ask the following questions:
- Does the community provide medication management?
- Does a licensed nurse complete a comprehensive individualized assessment for each resident? If so, how often are the assessments reviewed?
- How many nurses are on staff? Are they on-site or accessible 24 hours a day?
- Does the community have visiting physicians? Home health services? Onsite therapy/rehab services?
Even if memory loss isn’t an immediate concern, keep in mind that the incidence of dementia increases after the age of 65. Below are some questions to make certain the community is equipped to deal with cognitive decline:
- Does the community have a separate, secure memory care area?
- Has the staff been trained specifically to care for people with memory loss and dementia? If so, how long was the training and for which skills?
- Does the community offer memory care residents special programming, such as music or art therapies and tailored recreational programs?
"If you are serious about a senior living community but a little unsure about a particular facility, see if you can book a temporary stay for your loved one; this can go a long way toward helping you make up your mind. "
If finances are keeping you awake at night as you try to figure out how to pay for senior living, you are not alone. Questions about the cost and affordability of senior living are usually among the first questions asked by seniors and their loved ones.
First and foremost, senior living costs vary greatly across the country, which is why it’s important to compare senior living costs in your local market.
These are important factors to consider when calculating the costs of senior living: which services and amenities your loved one needs, what is included in a particular senior living community’s monthly rate, and how much it would cost to arrange similar in-home services.
Calculating Your Current Costs
Calculating current and future living expenses is a great place to begin finding out how to pay for senior living. You can compare your loved one's current living expenses to different types of senior living, and identify any services or amenities that are not currently necessary but will be needed in the future.
Many senior living options package living expenses such as housing, meals, entertainment, utilities, transportation, and housekeeping together into a flat monthly fee. In other words, it's unnecessary to pay additional monthly expenses for services such as groceries or a vehicle registration—unless your loved ones choose to purchase those things on their own. Independent senior living does provide home health services in most communities, but does not offer its own 24-hour staff.
Grab a pencil and paper or use an interactive online price calculator to add up the amount you pay for each of these expenses per month: mortgage or rent, utilities, home or renter’s insurance, property tax, groceries, entertainment, lawn care and cleaning, maintenance or repairs, transportation and vehicle costs, home health services, and other various costs such as long-term care insurance or homeowner's association fees.
Once current living expenses are calculated down to the last dime, you can gauge the monthly amount of additional money (if any) that should be added to the budget to pay for senior living.
Calculating Costs of Independent Senior Living
Independent senior living is often the most affordable senior living option. Residents typically don’t require help with everyday activities, ongoing access to medical staff, or help with medication management—so those services aren’t included in monthly fees.
Independent senior living costs do include shared or private apartments, meals, laundry and housekeeping, social activities, wellness activities, and transportation services. All of the basic living expenses will be included in monthly rates. If your loved one needs home health services, such as medication management, these will not be included in the monthly rates.
Calculating Costs of Assisted Living
Assisted living is generally more expensive than independent senior living because costs include 24-hour supervision, access to medical staff, licensed on-site nurses, and medication management services.
Residents might need help with normal daily activities such as bathing, dressing, or eating. An assessment will be performed before you progress toward drafting a personalized plan to meet your loved one's particular needs. The amount of help an individual needs with activities of daily living (ADLs) will determine the best senior care option for them and, ultimately, the total monthly costs.
In addition to personal care, assisted living costs include shared or private apartments, meals, laundry and housekeeping, social programs, wellness programs, and transportation services.
Calculating Costs of Memory Care
Individuals in the mid to late stages of Alzheimer’s disease and other forms of dementia often require memory care, which includes support with basic living, as well as additional support and programming for memory care.
Memory care costs include shared and private apartments, 24-hour supervision, access to licensed medical staff, skilled nurses on staff, meals, laundry, memory care programming, social activities, and transportation services. In all, memory care provides around-the-clock supervision and support to people with dementia.
Memory care costs fluctuate greatly across the country, but median monthly costs might exceed $7,000 in your area.
Calculating Costs of Skilled Nursing
Skilled nursing communities are generally for those who need more acute medical care, such as IVs, feeding tubes, ventilators, or injections, and support for all daily functions. This care is provided by a licensed nurse
Costs include rooms, meals, housekeeping, social programs, wellness activities, and transportation services, in addition to more extensive offerings: 24-hour supervision, access to medical staff, licensed nurses on staff, and medication management support.
Overall, the median monthly cost of skilled nursing can exceed $10,000 per month.
Adding It All Up
Your first step in calculating senior living costs should be to add up current expenses, including the costs of current or future in-home senior care needs. Then, as you calculate the costs of various types of senior living—independent senior living, assisted living, memory care, or skilled nursing—you can compare those to your current costs and identify any new expenses to be incurred. Finally, remember that senior living costs vary greatly across the country, so it’s important to diligently review costs in your specific region to get a true picture when calculating different types of senior living costs.
All of your phone calls, emails, brochure reading, and online research will help you inch closer to a decision, but you won’t truly get a feel for a senior living community without a tour. Here are some tips on what to look for and questions to ask during your loved one's visit to a potential new home.
Preparing for Your First Community Tour
When touring a potential community, several general things can be evaluated by simply looking around and asking the right questions. By beginning the tour with some idea of what you should be asking and looking for, you can ensure maximum comfort for your loved one at the community they may soon call “home.”
For most, being surrounded by staff members who are kind, sociable, and caring will trump living in a swanky environment any day. Right from the start, observe how you are greeted by the receptionist and take note of how staff members engage with residents. Do they come across as curt, cold, or dismissive? Are they friendly, nurturing, and patient? Also, be sure to ask about the staff-to-resident ratio—even the most caring workers may have little time for social interaction if they are running in all directions to meet the needs of more residents than they can handle.
Typically, it’s a good sign if the community leadership staff—managers and directors—return phone calls promptly and courteously and answer all your questions. Ask to meet the executive director and the resident care director on your tour; take note of the way they greet you, and whether or not they reach out to residents who come across their path.
Current Residents and Families
Dropping in several times should give you a general idea of a community’s social atmosphere. Are residents out and about, talking and laughing with each other, or are you left with the impression that people generally keep to themselves or sit around all day? If you feel comfortable, strike up a conversation with a resident or two for their insight on the community. Because mealtime is a great opportunity for candid conversation, you might ask to join some residents at their table for lunch or dinner. Also, ask to speak with current families who have been through the same process of placing a loved one in senior living.
Keep in mind that as people give their opinions, they are bound to talk about what they find wrong with the community. These complaints shouldn’t necessarily be dealbreakers; people will naturally like some parts of their home and dislike other parts. It will be your responsibility to weigh the good versus the critical comments to form an overall impression of the community.
In addition to housekeeping and laundry services, assisted living communities typically offer everything from wellness centers and gyms to chapels, hair salons, and concierge services. They also usually provide plenty of common spaces, such as living rooms, libraries, business and internet centers, and clubhouses.
Surroundings and Environment
There is no one standard type of senior living community; each one varies by design, ambiance, and atmosphere, ranging from high-rise apartments in the middle of a bustling downtown to campus communities surrounded by trees and greenery. As you begin a tour of any community, ask yourself if the setting appeals to you and your loved one. If being outdoors is important, make sure there are plenty of gardens and patios as well as places in which to sit in the sun, stroll around, or even do some gardening.
When you go inside, what is your general impression of the building itself? Do you find the decor attractive and homey, or does it have an institutional feel? Listen carefully during your visit; are noise levels tolerable? You may come across some communities that almost resemble vacation resorts; keep in mind that the fanciest places are not necessarily the best communities. Most importantly, the building should be clean, smelling fresh, and in good repair. Also, check for good natural and artificial lighting. Sunlight does wonders for the mind and body!
Although you and your loved ones should thoroughly appraise the dining hall, living rooms, and other common areas, pay particular attention to the model apartment you are shown. This brief checklist will help you evaluate the space for comfortable living:
- Can you imagine your furniture in it?
- Do suites come with a kitchenette or at least a microwave and a mini-fridge?
- Do you like the decor?
Activities and Entertainment
No senior living community will make their residents participate in an activity if they don’t want to, but it's important to recognize that getting involved is often the quickest way to feel at home. With that in mind, look at the community’s events calendar to see if the scheduled activities appeal to your loved one. It’s usually a good sign if the community offers a diverse range of activities, including ones geared to small-interest groups—think bird watching, book clubs, or knitting clubs—as well as larger, more inclusive events, such as garden parties or holiday celebrations. Also, find out if there are scheduled outings for trips to museums and so on.
On the tour, you may be able to speak to the activity director in order to find out if the preferences of residents are considered when developing the calendar. The best communities interview new residents and families to learn about what they like to do, as well as what they used to enjoy doing. These interviews are used to build community activity calendars so everyone can find some activities of interest.
Questions to Ask Staff and Administration
Understandably, you and your loved ones will have many questions during your tour—don’t be afraid to ask each and every one. After all, the answers you receive will go a long way toward making your decision. Keep some of these topics in mind as you learn more about a senior living community you are touring.
Food and Nutrition
Large senior living communities typically hire chefs and dietitians to ensure that meals are delicious as well as nutritious. If possible, find out firsthand the quality of the food by sampling a meal. Look at a monthly or weekly menu in order to see which meal options are typically offered. Determine if residents ever help out with menu planning, and if there are any à la carte options. If your loved one has a special diet, make sure that the kitchen can accommodate such requests.
Below are a few more questions to ask:
- When are mealtimes scheduled? Is there any flexibility around these times?
- What if a resident doesn’t like items on the menu? Are there other options beyond something simple like chicken fingers?
- Are seats assigned in the dining room, or is it open/free seating?
- Can meals be eaten in private rooms or in other locations (for example, in a café)?
- Are snacks available?
Freedom to Decorate and Rearrange
For many people transitioning to senior living, the prerogative to decorate and personalize their own living quarters is high on their list of priorities. Before any contract is signed, make sure your loved one can bring their own belongings, if this is important to them. This shouldn’t be a problem with most, if not all, assisted living communities; however, residential care facilities may have restrictions on the number of personal items allowed.
Before you make a final decision on a particular community, establish that friends and family can visit whenever they like (within reason) and join their loved one for a meal in the dining room, if desired. It’s a bonus if the community offers a separate dining room that you can book for special occasions like birthdays. It’s also a plus if the community allows the convenience and space for a grandchild or other visitor to spend the night in their loved one’s apartment, from time to time.
Options for Pets
If bringing the family tabby or hound is a must, make a point to inquire about pet policies. Some communities won’t allow pets at all, and some that do have restrictions on their number or size. If a community is pet-friendly, find out if grooming and dog walking services are offered, as well as a pet coordinator who can help residents provide pet care if necessary. Take note that some “no pet” communities do have a resident dog or cat. Some may even have a pet therapy program that allows seniors to interact on a regular basis with a therapy pet (usually a dog).
If your loved one still drives, confirm that the senior living community has a parking area for residents. If driving is no longer an option, it can make life easier and more enjoyable if the community provides scheduled transportation to doctor or hairdressing appointments as well as shopping or other activities.
For residents with recurring injuries or the aches and pains of arthritis, on-site therapeutic options such as massage, physical therapy, or occupational therapy can be convenient for rehab. Also investigate whether the community offers group exercise programs, such as tai chi, yoga, or Pilates—including seated versions for those with mobility concerns—that work to increase flexibility, balance, and strength.
Paying Attention to the Small Things
The primary features and amenities of a senior living community should be obvious during a tour. However, looking beyond the obvious—paying attention to the smaller details—is just as important in determining whether a community is right for your family. You can make a deeper assessment during a tour with these few tips:
- Request details about the specific accommodations you can expect. Ask if the unit you see on tour is similar to the one your loved one would have.
- Seek insight from friends or other family members who may think of needs you might not have considered. A second opinion is invaluable to the decision about the next chapter of your loved one’s life.
- Trust your instincts. Even if a place seems perfect on paper, listen to your gut if something tells you it’s not right.
Narrowing Down Your List
If you tour multiple senior communities, be prepared for a degree of information overload. Understandably, you might struggle to remember what you liked and disliked about each community, or which location featured the best amenities. The Arbor Company offers a free, downloadable checklist that can help you compare features among multiple communities in one convenient check-the-box chart. Use the checklist to organize your opinions of the toured communities to help narrow down your list.
Once you have settled on a few top choices, returning for a second tour—or simply revisiting a community at a different time of day—can give you additional information as you work toward a decision. On a second visit, pay particular mind to the attentiveness of staff, the mood of residents, the cleanliness of the communities, and other details you may have not noticed during the first tour. If you had gut feelings on your first visit, positive or negative, use the second to confirm those feelings or determine if you were mistaken.
A Final Decision
Think carefully about the type of lifestyle that will truly make the senior's years more enjoyable and stress-free. For instance, if their priorities are meeting people, socializing, and entertainment, a large assisted living community in a busy metropolis might be a great fit. Alternatively, if mobility is a big concern, finding a place with on-site service providers—such as a hair salon or visiting physicians—might be top-of-mind in the overall evaluation.
Although one community may not meet all of your loved one’s desires, at the very least, create a short list of must-haves versus nice-to-haves—and never look for housing based on cost alone. Sometimes a slightly higher price tag is worthwhile for a comfortable, carefree lifestyle that will allow for healthy and active senior years.