Page Contents
Evaluating a facility
Staff and management
Services and amenities
Medical services
Related costs
Residents
Help on the Internet
Site Contents
Patients & visitors
Medical professionals
Yale-New Haven
Children's Hospital
Yale-New Haven
Psychiatric Hospital
General information
Calendar
Online resource
Press information
Phone Numbers
Directory assistance
(203) 688-4242
Patient Information
(203) 688-4177
Adult emergency
(203) 688-2222
Children's emergency
(203) 688-3333
Admitting
(203) 688-2221
Children's admitting
(203) 688-3331
Psychiatric admitting
(203) 688-9907
Mailing address:
Yale-New Haven Hospital
20 York Street
New Haven, CT 06510-3202
How to pick the right assisted living facility
As people age, some find themselves living alone, single-handedly trying to manage the expense and upkeep of nearly empty homes. This time of life also brings with it an increased risk of falling, poor nutrition and difficulty managing medications.
Many struggling seniors improve visibly once they move into an assisted living facility. They can live independently with less effort, eat nutritious meals regularly, engage in exercise programs and enjoy social activities with people their age. Help is available, if needed, for bathing, dressing, and managing medications.
If more extensive assistance is needed, the facility may arrange for home health care services to be delivered in a resident's apartment. Some assisted living facilities are part of a continuum of care that includes nursing homes, making the transition to an increased level of care easier if eventually needed.
The time to start exploring the different assisted living facilities is sooner rather than later. Some facilities are open only to people who can walk in on their own, so that waiting until you truly need the services may limit your choices. Also, a good assisted living home may have a long waiting list—if you find the place you like, add your name to the list without obligation, even if you're not yet ready to move.
Evaluating an assisted living facility
“Assisted living” varies from state to state. Even in the same state, each facility offers its own options of care, services and financial arrangements. With so many options, how do you choose the assisted living home that is right for you or your loved one?
- First, decide exactly what you are looking for. Do you need medical services, assistance with daily personal care? Are you wheelchair-bound? Is there memory loss? Consult with your doctor about long-term outcomes to make sure that you anticipate your future health care needs as well.
- Decide what you can spend for the monthly fee and extra services plus any fees charged by outside agencies such as home care or transportation. Don't forget to include a reserve for personal contingencies.
- Assisted Living Checklist - Things to Know.
Download the checklist as a pdf file: Download (file size: 7KB).You will need Adobe Acrobat Reader installed in order to read the pdf file.
Once you have assessed your situation, look for information in the following areas:
Staff and management experience
Who owns the facility? This information may be available in its introductory information packet. If not, ask when you contact each place. If the company that owns it specializes in health care services, for example, or has a long-established history as a provider of assisted living services, it is likely to be more qualified to understand and provide for your needs than a company with no such experience. Furthermore it will be easier to check the reputation of a residence that has been long established in your locale.
A place that has recently opened may not have worked out all of its policies or be prepared to provide all of its planned services. Also, the longer the staff has worked together, the more time they have had to become an effective in dealing with older people with challenging health issues.
Tips:
- When visiting, find out as much as you can about the experience of key staff such as the director, the dietitian, the nursing staff and the activities director. Are they trained and experienced in working with the elderly? What training does the staff receive in dealing with situations such as fires or medical emergencies?
- State regulations require periodic, on-site inspections of assisted living services during which the medical records of a number of residents are reviewed. In Connecticut, these inspections take place every two years and the results, including any violation letters that may be issued, are available to the public. To find out the outcome of the latest inspection for an assisted living place, write to the Department of Public Health, Division of Health System Regulations, and request the information under the Freedom of Information Act.
- Ask for a copy of the facility's own patient satisfaction surveys, which are available to prospective residents. Better yet, stay for meals and get the impressions of residents and their families. This is also an excellent way to observe how the staff treats residents.
- If you are helping an aging family member, find out about the facility's procedure for keeping you informed of how your loved one is doing and whether he or she needs additional support of any kind. Establish who your contact person will be.
Services and amenities
The monthly rate may typically include all or most of the following services:
- a studio or one or two-bedroom apartment, furnished or unfurnished, either shared or private,
- up to three meals a day, taken in a common dining area,
- light weekly housekeeping and weekly linen service,
- social events and activities, and
- scheduled transportation for errands such as shopping, banking, medical appointments.
Personal care services (bathing, grooming, dressing, etc.) are available at an additional cost to residents who may need them. The facility may have a recreation room on site, a chapel, a library with computers and Internet access, or a pool or exercise room, or offer dry cleaning, a general store, a beauty salon, barbershop, gift shop or ice cream parlor. Some facilities may accept pets. There may also be a guest apartment for visiting families that can be reserved in advance for a fee.
Tips:
- When you visit notice if the place is clean, attractive and in good condition. Ask for a schedule of activities to see what interests you.
- Look for features such as fire extinguishers, handrails along the walls, overhead sprinklers and covered walkways for safe access during bad weather. Visit during the evening to see what kind of security measures are used at night such as locked doors, exterior lighting or security guards.
- Ask about regularly scheduled transportation provided by the facility. If you use a wheelchair, find out if you need to contact another agency for this service.
- An assisted living facility that includes a nursing home is a good choice for an elderly couple with different health care needs. One spouse may be well enough to live in the assisted living home, but will enjoy the convenience of visiting the other if he or she needs to be moved to the nursing center with 24-hour care provided. Request a tour of the nursing home.
- If you like a particular place, ask to stay overnight. Many assisted living facilities offer this service so that interested seniors and their families can "try it out" before making a final decision.
Medical services
Assisted living facilities are not required to provide medical services but many of them do. These could be short-term rehabilitation, podiatry, periodic on-site visits from physicians or dental hygiene. Most facilities have registered nurses and/or certified nurse's aides on staff. A registered nurse or someone designated by the nurse is required to be on call 24 hours a day in case of emergency.
Registered nurses evaluate each resident's needs and develop a plan of care that may include help with functions such as bathing, grooming, dressing or medication management. This may mean a simple reminder to take a medication or opening the resident's medication container and verifying that it is the right medication. Most assisted living facilities also offer residents a personal emergency response system, such as a necklace or safety intercom so that they can alert the staff if they are injured and need help.
Tips:
- Since health care services vary at each facility, ask about specific services that would benefit you personally such as prescription delivery, syringes for insulin injection or incontinence supplies. Ask if the facility is affiliated with any particular physician or hospital in case you need those services.
- Some assisted living homes specialize in caring for individuals in the early stages of Alzheimer's disease. For a list of facilities in your state and area, call your local chapter of the Alzheimer's Association. These facilities are not nursing homes and a transfer to a nursing home may be required if the level of care exceeds what the place can offer.
Related costs
There are several types of occupancy in the various assisted living facilities. In some cases you buy the apartment for the duration of your occupancy. The price you paid may then be applied to a room in the nursing center if the facility has one. Some facilities return a percentage of the purchase price to your estate.
Depending on the size of the apartment, and whether it is a private or shared apartment, monthly costs can range from $1900.00 to $3400.00. Ask what the average yearly increase in costs might be. A facility may also require a security deposit equal to one month's rent. Some charge an additional fee for personal care services. Depending on the level of care required, personal service programs can add $800.00 to $1200.00 per month to expenses. Other services that may be offered and possible fees: taking meals in your apartment ($5.00 per meal), personal laundry service ($9.00 per load), additional nursing assistance ($15.00 for 15 minutes).
Tips:
- Don't let higher monthly fees discourage you. In areas where the competition for residents is high, families have been able to negotiate their loved one's monthly fee. For example, you may be able to arrange a fee that covers both monthly services and some or all of the personal care services that your loved one may need. Also, some assisted living facilities have their own assistance programs, so ask about this option.
- Some states have a small number of subsidized rentals available for lower income seniors. To find out where they are located and who qualifies, contact your state Department of Aging (in Connecticut: 800-994-9422).
- Residents or their families generally pay for assisted living expenses out of their own resources, including savings, long-term care policies or life insurance policies. Check with an insurance agent to see what your coverage provides.
- Unlike nursing homes, assisted living facilities do not accept Medicare to pay for personal care services that people perform for themselves, such as bathing or dressing, although services that are medically necessary may be covered by Medicare. Contact your Medicare office toll-free at 1-800-633-4227 or visit the Medicare web site, www.medicare.gov, for a better understanding of services that qualify for coverage.
- Check on the facility's policies about holding your apartment in case of a temporary absence--for instance, hospitalization or a stay in a rehab facility. Are fees or deposits refunded in case changes in health require a permanent move to a nursing home?
Residents
If you are part of a close-knit community or active in your church or synagogue, you may want to move into a facility where people share your background or beliefs. Also, when you visit, observe the ratio of men to women as well as the mental and physical status of the people you see. Ask yourself if you would feel comfortable interacting with these people every day.
Help on the Internet
There are many Web sites with information about services such as assisted living. The Web sites listed here give the most information for the least amount of effort. If you don't have access to a computer or are not online, call your State Department of Social Services or check your library for the National Directory of Retirement Facilities.
- Eldercare Locator—Nationwide service of the U.S. Administration on Aging. Search by state and zip code for referral services that can give you information about senior services in your area. Also available by calling toll-free 1-800-677-1116.
- Carescout.com—State-by-state listings of assisted living facilities and other long-term care resources such as nursing homes and hospices. For state-specific information about regulations governing assisted living facilities, click on "Assisted Living" at the top of the home page. Scroll down to "The CareScout Network" and click on “regulations and policies.”
- CT Assisted Living Association—Trade association web site. Lists more than 80 member facilities in alphabetical order by facility name with addresses and telephone numbers for each. Links to Web sites such as AARP, Alzheimer's Association, American Diabetes Association and the American Heart Association.
This publication was jointly developed by Yale-New Haven Hospital and Athena Communities of Connecticut, owner of the Laurel Gardens family of assisted living communities.
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Call (203) 688-2000 or toll free (888) 700-6543 to speak with a health information coordinator or request an appointment. You can also get physician information or request an appointment on this web site. |
Last revised: March 5, 2004 (cfs)
