Not all assisted living communities are created equal, and sometimes it can be difficult to tell the difference between the good, the bad and the ugly. Add to this that government oversight of assisted living varies by state and can be confusing and it becomes clear that it’s absolutely critical for you to be an informed consumer when conducting your search.
Judson features an assisted living neighborhood at each of its three communities in Cleveland and Chagrin Falls, so we’re fielding questions on a daily basis from concerned families who are just trying to find the best home for Mom or Dad. This has given us some insight into the best questions to ask when searching for the ideal assisted living community.
And while we find that nearly all families ask the basic pedigree questions – cost, dining experience, staff-to-resident ratio, etc. – most of them don’t dig much deeper than surface-level considerations.
So if you’re searching assisted living facilities for a loved one, here are the essential questions you should ask that will reveal the true quality of any community.
What are the true costs? What is and is not included in the monthly rate?
Cost is always top of mind when considering a move to assisted living. However, some assisted living facilities will have hidden costs or extra charges you’re not made fully aware of until after the paperwork is signed or after your loved one has moved in.
As a basic rule, most of your daily living expenses should be included in the monthly fee, including:
However, facilities will often try to tack on extra charges, or “add-on fees.” Some facilities will even charge for things like bathing assistance, dressing assistance, and medication management, tacking on thousands of dollars to the monthly price tag.
Be sure you’re aware of the types of additional fees and factor them into your budget to ensure you can still afford it.
Is the facility for-profit or not-for-profit?
While for-profit communities are driven by the bottom line and will frequently try to cut variable costs to drive profit, not-for-profit housing providers are mission-driven. Their objective is to provide the highest quality and most compassionate care and services to those they serve. Not-for-profit organizations manage their financial resources in accordance with their missions.
Many of these providers were founded by faith-based and civic groups, and their long-standing values are reflected in their governance and management. They are not driven by daily pressure to increase their bottom line for owners, investors or shareholders. Instead, quality, not earnings, is the barometer of a not-for-profit organization’s efforts. They’re accountable to voluntary boards of directors who donate their time and talent to ensure the organization maintains ethical management, financial integrity and quality services.
Are outdoor spaces readily available?
Outdoor spaces are shown to have a soothing effect on the entire spectrum of humanity. Access to nature is an important aspect of our psyche, even if it’s a simple grassy courtyard or a room with a view.
Be sure the assisted living facility allows access to outdoor spaces. Even urban communities should have some type of courtyard that is readily accessible if residents want to get some fresh air.
How does the facility help residents maintain freedom and independence?
A major fear revolving around assisted living communities is that you’ll be stuck in a sterile, hospital-like room with restrictions on your independence and little control over your environment. While you’ll likely see right off the bat that the lion’s share of communities are not like that, what you might not notice is how an assisted living community proactively enables your loved one’s independence.
This should be one of the facility’s primary goals. As an example: Inquire about the dining service options. Are residents required to dine for so many meals per month or is the program flexible enough to allow you to dine as needed? Are dining hours limited?
What types of programs and opportunities for socialization does the facility provide?
This is a major indicator as to the quality of care provided by the facility, as it represents their proactive approach to their residents’ happiness and wellbeing. Asking questions about programming will help you determine the range of programs available to your loved one and the likelihood that they’ll find some that interest them.
Make sure there is regular engagement between the administration and residents. Communities with resident-driven programming typically have a committee in place that develops new and existing programs and events as opposed to a staff member making those decisions alone.
What specialized training is provided to caregivers?
Caregivers at assisted living facilities should be highly qualified to deal with a variety of situations, including interacting residents with dementia. Ongoing education is a must, but the state requires only eight hours for state tested nursing assistants (STNA) each year.
Judson requires all of its professionals working in assisted living to be STNAs. Each STNA is required to have at least 12 hours of continuing education, plus participate in ongoing daily education at morning line-ups and weekly team meetings. Training and education shouldn’t just be a scheduled task – it should be embedded in the community’s everyday culture.
How does the staff care for residents with dementia?
Rates of Alzheimer’s and Parkinson’s have skyrocketed over the past 20-30 years, with 5 million Americans currently suffering from Alzheimer’s alone. One in three seniors dies with Alzheimer’s or another form of dementia, according to the Alzheimer’s Association, and the numbers are projected to triple by 2050.
“These statistics are astounding,” says Kendra Urdzik, Vice President of Health Services and Chief Collaborative Health Officer at Judson. “The need for memory support programs and innovative alternatives to the traditional models will be imperative in the coming years.”
Any assisted living facility worth its salt will have specialized services for those living with dementia, with features including:
There is no one-size-fits-all model for memory care, which is why it’s critical for any assisted living facility to incorporate a wide array of tools and programs to address the range of conditions and symptoms that come with memory loss and aging.
Is there a 24-hour nurse on site?
Many assisted living neighborhoods have a nurse on call, rather than on site, with nursing assistants in the building. This is a sign the facility may not be up to snuff. You want qualified staff on hand at all times to assist in case of an emergency.
Judson’s assisted living facilities have a nurse on site 24 hours a day to handle any unforeseen circumstances or should an emergency arise.
What is the staff-to-resident ratio? Does this include only personal care assistants or the grounds keepers, too?
Believe it or not, there is no national standard for staff-to-resident ratios. There are however state standards that vary. And what makes the answer to this question even more elusive is that some facilities will include unrelated, non-professional positions like groundskeepers in their staffing ratios.
So the question families should be asking is not what the raw staff-to-resident ratio is, but how many qualified medical professionals are on staff at any given time. A good answer would be no less than one qualified staff for every eight residents, with Judson regularly maintaining a staff-to-resident ratio of 1:6. Ratios often do vary based on time of day.
Assisted Living Ratings
Most states have a department of health that rates the quality of assisted living communities. Ohio features the web site Long-Term Care Consumer Guide. Among other criteria, the state conducts face-to-face surveys with residents of assisted living communities to produce a resident satisfaction score for each facility. For example, Judson Park’s most recent state assisted living resident satisfaction score was 94.7 percent.