Carolynn Nagao-Marcotte, dementia certified Aging Life Care Manager for the CLO program at (SCES)

By Carolynn-Nagao Marcotte

Assisted Living can be a great option for older adults who are isolated or looking to downsize. But finding the assisted living situation that best fits your needs can be complicated; there are many factors to consider and the task can feel daunting when you first begin to familiarize yourself with the Assisted Living model.

It is a big decision, and getting it right can mean the difference between a successful transition to an enjoyable new lifestyle—or needing to relocate, either because a higher level of care is required or the assisted living  is just not the right fit. 

I recently saw this dynamic play out with a client. He is an older gentleman, with no immediate family, who lives in a nice assisted living facility. Unfortunately, he recently endured some setbacks, which required a series of medical evaluations, specialist visits, and physical therapy.

While the facility was great about adjusting the client’s care plan to meet some of his new needs, there were certain things– such as managing medical appointments and ensuring he got there- that were simply outside its scope of services.

Without a backup support system that could check in regularly and ensure his medical needs were met, he would have been facing relocation to a nursing home– which was not what he wanted.

Working together, we were able to help maintain his current situation, but our experience underscored some important considerations for evaluating assisted living options. Here are some key points:

Understand the Needs There is often a misconception that assisted living facilities take care of everything, once people move in. But most facilities host fairly independent, active communities.

The level of independence varies, so it is a good idea to start by understanding the prospective resident’s needs, ranging from routine to emergency. Developing a specific plan for how those needs will be met should be a central part of evaluating assisted living options.

Know Exactly What’s Included Meals, cleaning services, and access to social activities are fairly standard assisted living offerings, but the options vary. It is also crucial to understand what is not included.

For example, assisted living facilities are not medical providers, so that means the resident (or their family) will need to take the lead on things like hospital discharge planning, follow-up appointments and ordering/setting up new medical equipment or assistive technology devices. Depending on the family situation– if there are relatives nearby or if they are willing to travel, possibly multiple times in the event of a crisis– this can be a major factor in the final decision.

Read the Care Plan This is key, because the care plan outlines whatever assistance the resident can expect from the assisted living facility. You do not have to worry about developing the care plan yourself– typically a nurse meets with new residents to develop that– but you will want to have a good understanding of how the facility handles care plans.

The key variables are the types of assistance offered, and the number of hours per week within the standard care plan. Since needs often change, you should be clear on if the care hours can be increased, or if you may be asked to bring in outside help.

Know What the Facility Can Accommodate People often view relocating to assisted living as a permanent move, but sometimes circumstances change. Some facilities offer tiers of care, which are designed to help people stay in the same location as their needs change. That arrangement can make a lot of sense when dealing with a progressive condition, such as Parkinson’s disease or dementia.

Consider the Financial Aspect Assisted living is generally not covered by government benefits, so the financial piece is important. Long-term care insurance is one option. Failing that, a prospective resident will need to review their financial situation and create a budget based on a plan for long-term spending. The assisted living will often help residents get an idea of how long they can afford to stay, when they review the costs.

It is worth noting that some facilities have subsidized apartments, but typically those are only for residents who have been there for some time and have depleted their assets.

Consider Hiring a Professional An Aging Life Care Manager (ALCM) can assist with a variety of assisted living challenges. Depending on need, an ALCM can serve as a surrogate for family, by providing regular well-being checks, in-home services, and assistance with medical appointments. An ALCM can also provide the up-front needs assessment, evaluate which facilities are the best fit, and coordinate all aspects of the relocation.

So to recap: There are many important considerations when seeking the right facility. It can be a little overwhelming, but my advice is to keep the focus on the prospective resident’s needs and wishes and how they will be met. Assisted living facilities can make life easier in some ways, but an outside support system is still vital– and that should be part of the planning process when evaluating assisted living options.

Carolynn Nagao-Marcotte is a dementia certified Aging Life Care Manager for the CLO program at Somerville-Cambridge Elder Services (SCES), a non-profit elder services agency dedicated to supporting the independence and well-being of older adults. For a free CLO consultation, contact SCES at 617-628-2601.