Are you unsure how to look for the right assisted living community for a parent, senior or loved one? Join Relevar Home Care in our conversation with Nicole from Parkdale Senior Living and learn from a professional in the business how to go about finding the right community and what to look for regarding the overall best care.
Table of Contents
- Identify Needs
- Tour Communities
- Consider the Financial Commitment
- Choose the Right Location
- Learn About the Facility’s Licensing
- Look at the Engagement and Longevity of Staff
- Find Out What Activities Are Offered
- Learn About the Levels of Long-Term Care Offered
- Evaluate Cleanliness
- Consider Food Quality and Accommodations
Misty: Hi, everybody. My name is Misty Delagato, and I am the owner of Relevar Home Care and Alivity Care Advocates. We help families that are worried, overwhelmed, or stressed over their aging parent’s health or safety. So if you know somebody that’s in that situation, or it might just be a neighbor that you’re concerned about or a friend, we can help with that. Today, we are going over our education program and discussing 10 tips for how to choose an assisted living. We’re really excited today because we have Nicole here from Parkdale. Hi, Nicole!
Nicole: Hello! Thank you for having me.
Misty: Yeah, we’re so excited. You and I talked not too long ago, and you had some great information about your community. It’s a beautiful community; it’s been renovated. So let me go ahead and put our screenshot up so people have your information, and then you can tell us a little bit about it, okay?
Nicole: Sounds good.
Misty: Okay, so there we are. That is your building, huh? That’s beautiful.
Nicole: That is, yes.
Misty: So tell us a little bit about Parkdale and about you.
Nicole: The Parkdale opened in June of 2021. We are an independent, assisted, and memory care community. We have Sunny Dale, an all-women’s unit of 20 here in the community, which is pretty unique to the area. It’s a great concept back there. They have their own living, dining, and activity area. We actually have a male-female unit opening mid-month next month, so we’re super excited about that. We do have maintenance-free living here in the building, so all of the utilities and things are included. Also, our care team is here 24/7, so our residents can age in place. Our residents truly can age in place. We also have a hospice program here that started back in early summer of 2022. It’s a great asset for the community and we’ve helped quite a few families out since the program has started.
Misty: Yeah, so one of the things you mentioned was the Sunny Dale all-women’s memory care unit, and that is unusual. We don’t see that too often in any of the communities. Why did you guys put that together? Why is that important?
Nicole: Honestly, when we were originally opened, we didn’t plan to have it that way, but then we just started having more women come in, and the concept worked out so great. It’s a community within the community. All of the ladies’ family members, for the most part, are very active with the ladies. When we start talking about behaviors and different things like that and safety, I feel like it just really puts the ladies of Sunny Dale’s families’ minds at ease knowing that it’s just ladies with them back there.
Misty: Sure, I hear you. And then your hospice beds—just so we could touch on that real quick—because there are some folks that might be at the end of life or nearing the end of life who don’t want their loved one, or it’s too difficult for them to handle them in the home. So you actually have beds in your community that hospice can care for them, and you can care for them.
Nicole: That’s correct. We have hospice suites set up here. Those rooms have an extra bed in them for family to stay. We welcome them to have meals here as well. Family members in the building are, of course, welcome. Any hospice company is welcome to have their patients come and stay with us. We have an open-door policy; we welcome, of course, children and animals. It is a really great thing that we’ve started here for the community with the hospice program.
Misty: That’s great. And so tell us a little bit about you. I mean, I know you and I talked; you had a ton of information, so I’m really excited to do this topic with you.
Nicole: Thank you. Yes, I’ve been in the industry for about 10 years now. I originally started my career at a home for the aged in Detroit that was mainly psych and memory care. Then I went on for six or seven years to work with an independent living company. I worked in a few different buildings within that company, the last one being one that had a tax credit program and accepted PACE and My Choice Waiver. I did get a bit of knowledge on those different programs and things, and now here I am at Parkdale.
Misty: Yeah, and Parkdale has been renovated, like you said. So when you walk in there, it’s just amazing. Everything is brand new.
Nicole: Thank you, yes. It’s definitely a very grand entrance.
10 Tips for Choosing an Assisted Living Facility
1. Identify Needs
Misty: Alright, well, let’s get to it. Let’s go through the things that people need to know about choosing an assisted living for their loved one. I know doing that can be overwhelming, so having any tips that, as collaborative industry experts, we could provide I think would be helpful. So the first thing that you suggested was to identify needs. Can you tell us a little bit more about that?
Nicole: Yes, I think it’s important to start a checklist of wants and needs. When it comes to safety, you know, we talk about pendant systems and what the bathrooms look like. Showers—are they ADA-compliant? Are there grab bars? Things like that. Are there specific hobbies that you want to continue doing, and are those available at the community that you’re looking at? Also, maybe what are deal-breakers, like “I have to have this” or “I definitely want to have”—some people will say “I definitely want to have an outside space.” Are there courtyards or activities off-site? Things like that.
Misty: Yeah, and I know one of the things you mentioned was ADA, and some people might not really understand what that means. But from my perspective, when I’m helping a family choose a community—because we kind of do that identifying needs piece—we see a lot of the older communities still have showers that people have to step over and into to shower, which can be difficult for someone going into assisted living. So is that one of the things you’re talking about?
Nicole: 100%. Some places will have full-size tubs. I know I’ve seen different communities that will do these tub cutouts where there’s just a small step up, and then there are other showers where, if a person becomes wheelchair-bound or is in a wheelchair, they can easily be wheeled in a shower chair into the shower.
Misty: Yeah, absolutely. And then, you know, when I’m talking to a family, a lot of times it’s more aesthetic—I want a two-bedroom, or I want a courtyard, or I want to sit out on the patio, something like that. Or maybe it’s a full kitchen, depending. But I think most assisted livings do not have full kitchens. Is that correct?
Nicole: That’s correct. Yeah, I think for the most part, a lot of times you’ll see just a sink and a fridge. All the meals are included, so really the residents just need some snacks and to stay hydrated and things like that.
Misty: Now, I know your community is a lockdown community. Can you explain that and why it’s important?
Nicole: Yeah, so our exit doors on the first floor have alarms on them. We only have one main door that’s used for coming and going in the community, and there’s a code that needs to be inputted. Family members get that, and then, you know, some residents or all residents, just depending, get those as well. The memory care units have a whole other type of security system for getting into those.
Misty: Right, so a lot of times when I’m helping a family member, we look for lockdown communities like that both for the residents’ safety, with strangers coming in, but also for the fact that there’s often a reason why they’re going into a community. It might be due to mild cognitive impairment or intermittent memory loss, or it might not be that bad, but we don’t know when it will get worse. So we know in a community that’s locked down, they’re really much safer than in one that isn’t.
Nicole: Yes, I totally agree. The way that our keypads work here is that after 9 o’clock, they can’t be used. There’s actually a speaker in the vestibule that residents can press, and the care staff here in the building has cell phones that are hooked up to our alert system and the vestibule keypad. They can come and let family members in because we have an open-door policy.
2. Tour Communities
Misty: And now, what about touring communities? What do you mean by that?
Nicole: I am seeing more and more assisted living, memory care, and senior living communities opening in the area, and I’m seeing more and more families touring 15 to 20 different communities, which seems extremely overwhelming to me. I think it’s important to start that checklist initially and identify the wants and needs, and maybe just tour three to five places. Get an idea of what you’re seeing, what you like, and what you don’t like, and then go from there.
Misty: Sure, I think that’s good. You know, doing the tours is important because you can’t compare one to another unless you’ve walked in the door and started to see the differences. That’s interesting that you say that because a lot of times when we’re looking for a community for folks—the most recent one near Detroit—I had narrowed it down to 22 different communities and toured only two. A lot can be done by phone to really, once you identify your need and what you’re looking for, pare that down to just a couple for the most part.
Nicole: Definitely.
Misty: Yeah, because like you said, they get overwhelmed. Then how do you make a decision, or do you?
Nicole: Right, right.
3. Consider the Financial Commitment
Misty: So what about the financial commitment? What do you mean by that?
Nicole: It’s very important to find out, obviously, think long-term, right? Financially, because nobody has that crystal ball of how long somebody’s going to live. So long-term, is this financially feasible? Are there any extra fees and things like that? And then determine the cost of living and compare it to the other communities that you already have information on.
Misty: Yeah, it’s so tough because each community has its own pricing structure. Can you talk to us about the differences?
Nicole: Yeah, so some places do all-inclusive prices, and then other places will do levels of care. I know a lot of memory care units and things have levels of care. We just do all-inclusive here. And then when it comes to our independent or assisted living, basically families can customize care plans as needed. So, you know, people live here and they may need no care whatsoever from the care team, and then other people may need assistance with their medications.
Misty: So what does all-inclusive mean?
Nicole: So it basically means that everything’s included. For example, in Sunnydale, all of the meals, housekeeping, laundry, cable, utilities—all of that kind of stuff is included. And then also all of their care. But, you know, the one thing out of pocket that would have to be paid would be any type of incontinence care products, you know, if there are any special toiletries that are wanted. But otherwise, everything else is included.
Misty: Okay, so like my one client, she wants to make sure Mom has the high-end soft toilet paper. So, if you want that, you’re going to have to buy that, right?
Nicole: Yeah, yeah.
Misty: Everybody has their own little things that are important to them, you know. We’ve got to keep our tushes comfortable.
Nicole: Yeah.
Misty: And then, in other instances, people don’t need that level of intensive care. So then they can do more, maybe what you call, you know, like your level of care. What is needed and then almost pick off of a menu what’s needed.
Nicole: That’s correct.
Misty: In that instance, if they need more, what do you guys do with that?
Nicole: So there’s an assessment done by the nurse, and then she calls the family and makes a recommendation of, you know, the extra care that a person may need to be safe here.
Misty: Okay, and how often does a nurse do an assessment there?
Nicole: You know, that’s a good question. I would say when a person returns from the hospital, there’s always an assessment done, of course. And then at least once a year unless there is some type of decline that’s been noticed. Then, of course, there will be an assessment done then.
Misty: Okay, and you’re just looking to see if their condition is changing, or what’s the purpose of that?
Nicole: Yeah, definitely. Sometimes, you know, people may be, you know, not taking medications properly or we’re noticing maybe they’re not changing their clothes or bathing properly, things like that. So then there’s a conversation that they have with the family, like, “I think they may be becoming more forgetful,” or maybe they’re afraid to get in the shower on their own. So, you know, then we can assist with those things.
Misty: Okay, and does the nurse—I know you have all levels; today we’re just talking about the assisted living—but the nurse would do that in the assisted living and at least annually? Okay, so that’s good. I don’t know that every assisted living has a nurse on staff. You guys have one on staff, correct?
Nicole: That’s correct, yeah.
Misty: Okay, yeah. Would you say that most do?
Nicole: I think so, yeah.
Misty: Okay, yeah. All right, and as far as the financial commitment goes, I know you had mentioned there are some programs out there. You know, obviously, it’s out of pocket, right? But you said there are also some other programs that if folks don’t have the ability to pay for, let’s say, your particular community, are there other supportive financial areas that could help them?
Nicole: Yes, yeah. So, in our community, the only other benefits besides private pay that we accept are the veteran benefits and then if somebody has a long-term care policy. But there are other communities that accept Medicaid, My Choice Waiver, vouchers, and then also work with PACE, which is another Medicaid program. And then there are a few communities in Macomb and Oakland County that have a tax credit program. So, that will be based on the gross annual income and the assets of the person to see if they fit in the guidelines for that tax credit program.
Misty: Okay, so mostly for folks that don’t have a lot of savings and have lower income.
Nicole: That’s correct, yeah.
Misty: Okay, and so when we go back to the financial commitment piece, I know one of the things you said was fees, you know, extra fees. What would you consider extra fees?
Nicole: So like I know a lot of places don’t include, you know, cable television or a landline or sometimes even personal laundry. So those would be questions, obviously, to ask. I know some places, when it comes to the toilet paper, they might not supply that, you know, or the hand soap in the room, things like that. Yeah, and then also even Wi-Fi, just depending. You know, that’s important to people at times. We have a hotspot throughout the building, but some communities, especially older ones, you know, they don’t have things like that.
Misty: Right. So I think what we’re saying is make sure that you ask about those, you know, what other out-of-pocket expenses I can expect in regards to, you know, monthly. Let’s say I have a $2,400 fee to be in the community. Then what else do I have to pay out of pocket after that? Because I think some folks in the industry aren’t always transparent about that right up front.
Nicole: Mm-hmm.
Misty: What about the move-in? I know sometimes there are move-in fees. Can you explain that to us?
Nicole: Yeah, so there are community fees. I think it’s a pretty standard fee in the industry. You know, when people move into rooms, they normally have new paint and carpeting and different things like that. So just depending, I think those community fees range anywhere from $500 to $3,000. I think a lot of times communities will use that as an incentive; they will discount them or waive them and things like that. So that’s always a question to ask. But normally that’s just a one-time fee and it’s not refundable.
Misty: Got it. Okay. What about just talking about financial commitment? Because my one client, we just moved recently. They had to buy new furniture. Are they required to bring furniture from home, or do you guys supply that? What would that look like?
Nicole: Just depending on the setting and the situation, honestly. We do at times do incentives where we will supply furniture. In our memory care unit, we do supply, you know, the bed, a chair, a nightstand, and a small dresser. So that is supplied there. But otherwise, you know, we encourage families to bring in the resident’s furniture that they’re familiar with and most of the time become more comfortable with.
Misty: True, yeah. Yeah, I know I had one instance where a guardian called me and said, “I need to get somebody in a place today.” Okay, we’re not moving anything from her home because she had some mold in the home. So we weren’t going to be able to bring anything. So sometimes it is important. Or, you know, folks are coming right from rehab, families are out of town, you know, there’s no moving company or company figuring out how to get them moved in in a day or two.
Nicole: Right, right, yeah.
4. Choose the Right Location
Misty: So now, why is location the next most important thing, would you say?
Nicole: Well, I think, just from a point of view, depending on the support system, it’s important for them to be, you know, close to the community because if for some reason, you know, they need them or just for visiting reasons, things like that. I also feel like a lot of the families that I work with, the seniors, they like to be in the area that they’re familiar with. I see them quite often choose places that are close to the neighborhoods where they’ve lived for the last 40, 50, 60 years. And then also, you know, our seniors, the hospitals that they go to are very important to them. So, you know, if they have a preferred hospital and there’s an emergency, you know, EMS always takes them to the closest hospital. So, you know, that definitely plays into choosing a community also.
Misty: Now, that’s a great tip. And a lot of times they want to still feel integrated into their own community. That’s where they feel most comfortable. I hear what you’re saying. And then I did have one particular client that moved out of her area and moved further north. It is a challenge when you go to a new hospital because, as much as they share records, it’s just not the same thing. You know, they did not have a handle on her medical condition. It took them a while to figure that out.
5. Learn About the Facility’s Licensing
Misty: So, talk to us about state licensing.
Nicole: Depending on the setting and things like that, obviously, there’s different licensing. There’s AFCs, so adult foster care licensing; HFAs, you know. The state normally will come in, they oversee the licensing, and make sure that the community is staying in compliance with those licensing, following the rules and regulations to keep the license, etc. So there are, senior living buildings where they have like a third-party provider that’s giving their care. Then the actual community is just in charge of things that have to do with operations like meals and housekeeping and things like that. And then there are, you know, other communities like ourselves who, you know, we employ all of our care team and then, you know, we don’t use agency and things like that. We have more control over the hiring process— you know, pay, training, things like that.
Misty: Right, so, you know, on the State Licensing—what you said, there’s two different types of Licensing: there’s HFA (Home for the Aged) and AFC (Adult Foster Care).
Nicole: Correct.
Misty: Would you—are you your particular community? Are you—which one do you hold? Which licensing?
Nicole: HFA.
Misty: Okay, so Home for the Aged. Okay. And so, there is a website folks can go to to look up your actual licensing and information about that, and we can include that in the link below. But State Licensing, for us, when we’re, you know, as care managers looking for a community, that’s our number one. We always want to look at State Licensing because, there is a body of regulation overseeing care in a way. I’m sure it’s harder to manage. Would you say the regulations?
Nicole: Yes, definitely, yeah.
Misty: Yeah. Do you feel like it brings up the overall standard of care, though?
Nicole: Oh yeah, yes 100% agree, yeah.
Misty: So, you know, I think what you were saying was that senior living communities are sometimes providing assisted-level living care, but they’re non-licensed, right? So there’s no regulation and no oversight.
Nicole: Mm-hmm.
Misty: That can be a little scary.
Nicole: Yes, yeah, it gets dangerous.
Misty: From our Care Management standpoint, the other thing that we find is it’s difficult—and let’s say you’re not getting good care with the outside agency, the contracted agency sometimes we call it—or I forget what you call them.
Nicole: Third-party provider.
Misty: Third-party provider, yeah. So, some of them will say, you know, they’re a third-party provider; we don’t have anything to do with them. And the challenge sometimes can be if you’re not getting good care, you’re kind of stuck with that, uh, you know, company and the community can’t really do much about it. So if I can avoid those types of communities, we definitely try to avoid those right off the bat. So when we’re talking about identifying our needs, that’s usually on our checklist right at the top: let’s see if we can find a place that is licensed, that, you know, is working through, uh, you know, a protocol for how to provide care, if that makes sense.
Nicole: Yep.
6. Look at the Engagement and Longevity of Staff
Misty: Yeah, so, and then you started to touch a little bit on staff because, I mean, staff’s really important.
Nicole: It is, it is. And, you know, I always encourage people—, part of that checklist should be how engaged is the staff and even residents, you know, so I think that it’s important to, when you are scheduling your tours, to ask maybe for a sample menu, a sample activity calendar, and then, you know, tour when there’s an activity going on. See if staff’s, you know, interacting with residents. Are they welcoming, you know? And even ask, like, are you happy here? You know, do you like your job? Do you like living here? These types of questions when you, see people and tour the community.
Misty: That’s a great, great tip, yeah. To talk—don’t be afraid to talk to people just because you might be with the marketing person or the sales person. You know, sometimes I’ll take a break and go to the bathroom, and when I come out, you know, before or after, you know, you can, you know, take a look at things or talk to people. And I would say most people, most employees, staff members are proud of their communities and would love to have you talk to the residents in their communities because, yeah, and the staff there are going to show, whether, you know, are they attentive, are they compassionate, are they responsive, you know?
Nicole: Yeah.
Misty: Speaking of responsiveness, one of the things that we always want to know when we’re going out is, you know, the pendants, the call lights, and the response time. How is that managed? Because sometimes communities manage it and manage it very well, and other ones, it’s just not on their radar. Do you define that as well?
Nicole: Yes, I agree. You know, the type of system that we have—I’ve never been in a community where the, pendant system actually goes to the, the phones, the cell phones that the caregivers carry, you know? So I think that, that is huge. A lot of places from my experience, like a call light will go off, and then somebody’s on a walkie-talkie saying that this is happening, you know? , so there’s kind of like this chain that happens before the person who is assisting gets it, you know? So yeah, I think that that’s very important. You know, our standard here is you know, call light answered within 15 minutes. I don’t know where other, you know, what standards are you know, throughout the other communities but that’s what ours is.
Misty: Well, I can tell you that from my experience, I had one executive director tell me she didn’t have a standard. So, I mean, it is all over the board. And I do feel like it’s one of those things that gives, uh, quality of life. Like, if I need help, I kind of want somebody there in the next 15 minutes. So I love that, you know, that that’s your standard. And, you know, is it perfect by any means? Probably not, but, you know, you’re working—I think you’re working towards that. You know, tell me about the cell phone system and how it differs from that walkie-talkie.
Nicole: This is all, basically what happens is there are there are monitors on each floor, so in the Care staff office. But what happens is these phones are linked up to the system and basically a button is pushed or a pull cord is pulled because, you know, all of our rooms are equipped with pull cords, not everybody has a pendant, you know, so, and then that call immediately goes to the cell phone and then goes to the monitor also.
Misty: Okay.
Nicole: Our concierge also has, you know, a monitor down on our main floor here by the administrative offices—multiple units throughout the building.
Misty: Okay. One of the systems that I liked is, I forget what community it was, but they had it where it would go to the caregiver on the floor or resident assistant or whatever their title was. And if that wasn’t responding in a period of time, then it would go to their manager. And if that wasn’t responded to, then it would go to their manager or the director of the community, you know? So I felt like, wow, that’s fantastic because then, you know, the director, when they’re getting tagged in, they’re probably like, “What’s happening?” You know?
Nicole: Right, right, yeah.
Misty: So, how important is—and I know we talked about this last time we were together—the longevity of staff?
Nicole: Yeah, that’s very important. You know and retention is huge obviously once one of our team members gets to know the residents and their routine and things like that, nobody wants to see a revolving door with staff, you know? So, once again, this is where the pay comes in, benefits, things like that, you know, which helps out with retention and training and things, you know. All of our staff is trained during the daytime when our residents are awake, you know. If those afternoon people or midnight people they’re always trained, you know, during the daytime and we’re lucky that we have the caregivers that we have here. It’s the most important thing if you ask me.
Misty: Right, yeah, and what about, like staff staffing levels? Is that mandated by the State?
Nicole: What do you mean?
Misty: Like by your licensing? By the State Licensing, is that mandated?
Nicole: Oh, like how many people, how many staff members we have per person and things like that?
Misty: Yeah, per shift, per resident, or—
Nicole: Yeah, yeah. So, it is mandated. For example, in Sunnydale, we have to have a minimum of two people back there at all times during waking hours. Then normally the way that it works out here is we have a medication passer on each floor, and then there’s caregivers on each floor also. So, obviously, everybody on each floor doesn’t need care, you know. So, because the residents can age in place if they are, you know, come in and they’re driving and they’re totally independent, we’re not going to ask them to move their apartment to a different part of the area unless, of course, they start needing memory care or something, you know.
7. Find Out What Activities Are Offered
Misty: Okay, all right. And let’s talk about activities. Let’s talk about the fun stuff—activities, yes, right?
Nicole: Obviously, going back to, I think, what I brought up earlier, is there any specific hobbies or maybe interests that you’ve heard, uh, that the particular person has heard about and hasn’t been able to experience?
Misty: If you know the person is no longer driving is there transportation to the grocery store and outings for meals and things?
Nicole: We actually do take our Memory Care ladies out of the building where I feel like a lot of Memory Care communities don’t do that. They have gone to the Humane Society and seen some puppies and kittens. They do rides as well, where they will take a ride through Stoney Creek or something like that and have cookies. And the Macomb County Library has been hosting a, I believe it’s called Memory Café for people with a diagnosis of dementia, so the ladies have gone there. So I think that that’s very important to find out how often the shuttle runs and then even you know, what type of live entertainment or themed parties, different things like that, you know, go on in the community. Like I know here, Friday is a really big day. It’s happy hour; that’s very important to the residents, you know, so…
Misty: We keep the happy hour coming.
Nicole: Right.
Misty: Well, and I think you’re right because prior to COVID, a lot of communities were taking their residents out. But since COVID happened, it’s like the skids. I don’t hear any of them doing that anymore.
Nicole: Yeah.
Misty: Now, in your assisted living, or what if I want to go to Meyer’s or something close by? Or do you have a bus that allows that, or no?
Nicole: Yeah, it is scheduled though. So, you know, it doesn’t take people to the bank whenever they want to go and things like that. But they do go to the grocery store, they go to Meyer’s, they go to Walmart and then they go to the movies and out to lunch and things like that.
8. Learn About the Levels of Long-Term Care Offered
Misty: Okay. So, you don’t have to feel like you’re tied down into the community; you can get out a little bit. Yeah, so let’s talk about long-term care. Now, you guys have independent, you have assisted, and Memory Care.
Nicole: Right, that’s correct so we don’t have, we are not considered, like a Skilled Nursing Facility, but we do have those three levels of care so our residents can age in place. And then, of course, we have the hospice program.
So, when it comes to special diets, chopping, pureeing, things like that, we can do for the residents. You know, we do have some Hoyer lifts and things like that here in the building. So, that’s able to be done here. So really just, I think when it comes to more like specialty things like maybe if there’s, you know obviously like NG tubes and things like that, we don’t do. Or, like, you know, a port needs to be managed for some reason, I think sometimes people do dialysis. I, you know, I don’t think that that’s something we would get involved in, that would be more of a Skilled Nursing Facility.
Misty: But in your situation—and not all of them are like this—which is, hey, I want my mom to stay here long-term, even if she needs, you know if she’s at end of life, she can stay at your community?
Nicole: 100%.
Misty: Okay, because not all communities do that. So that’s kind of an important question because that means at some point—and I’ve had this happen—where, you know, the community will give them an eviction notice and say, you know, based on their condition, they can’t stay here any longer; they have to go.
Nicole: Yeah, yeah. I’ve seen that quite often where a person will have a deep, and they go outside to rehab, and they just, they’re not coming back how they were before. And then, you know, all of this is going on, and then all of a sudden, like, they can’t go back to their home; they have to go somewhere else, which is, you know, such a sad situation. So, you know, they definitely can age in place here.
Misty: Right, so you know, I can tell you, like, one instance. I had a family call in a crisis. A 97-year-old that moved at 96, moved into an independent living community, you know. And now he wasn’t getting the care that he needed because he could barely get out of bed. Or really he wasn’t motivated to get out of bed either, but it was not the right fit. Now, he had, you know, had the family who were able to be involved in identifying needs, really ensuring that that question is asked: that we can stay here long-term, even through end of life, is important, wouldn’t you say?
Nicole: Definitely, yes. Yeah, and you know, I just dealt with a family with this situation where it was the hospital—like, she was a Saint John’s person, and that’s not somewhere our community goes. And at the end of the day, the brothers were going back and forth. And ultimately, it was decided a smaller setting would just be better, you know. So, there are these smaller assisted livings where there’s only 30, 40 people, you know, maybe even some type of group home setting or something, you know what I mean? So that’s why it’s really, like you said, important to identify those needs when you’re, you know, going through the process.
9. Evaluate Cleanliness
Misty: Right, yeah. And, you know, I would say if you’re not able to identify all those needs, we can help the family do those as well. So let’s talk a little bit about the cleanliness. You know, we talk about touring the communities, but you know, what is the cleanliness? Tell us and what do we look for.
Nicole: That’s huge, definitely. So my mom always taught me that you should definitely look at people’s bathrooms. You should never have a dirty bathroom. So, and then you know housekeeping is huge, especially most of the time. They’re washing linens and towels, they’re cleaning apartments you know, when there’s accidents and different things like that, depending on where it happens, you know, all of this needs to be cleaned up, obviously. So, you know, I think the cleanliness of a community goes a long way, you know, and I hear it all the time. I feel like that’s one of the main things that families look at when they’re coming into a community initially, you know. Obviously, there are things that are more important than that, like care, but cleanliness definitely is a huge factor in the decision-making.
Misty: What, you know, the actual residents themselves?
Nicole: Right, oh, 100%. Yeah, showering them, changing their clothes, especially with our Memory Care residents who may not, you know, most of them don’t know to, you know, change their clothes and things like that and need assistance toileting. And, you know definitely smells are important to pay attention to when you’re touring communities.
Misty: Right, yeah. I feel like a lot of people going in think most first and foremost, how does the building look and what is the smell, you know, for the most part? But like you said, you can get as deep as how clean are the bathrooms and, you know, how do the residents look, you know, absolutely.
10. Consider Food Quality and Accommodations
Misty: Okay, everybody’s love of food. How important is the food?
Nicole: It’s extremely important to our seniors, you know. So I think that at times when they move to a community they feel like they’re giving a lot of things up. And so they really focus on that food factor. I think that it’s important when people are narrowing down their search, most places offer a free meal with touring. They even offer meals to go. So maybe if that’s not something that a family wants to do is sit down and have a meal, they can always say, “Oh, but I’ll take it to go,” you know. And of course, I’m sure that dietary needs can be addressed. Is there fresh fruit? Is there fresh vegetables? You know, can you accommodate a diabetic diet or a low sodi diet? Things like this are very important.
Misty: Yes, I’m so glad you brought that up because one of my recent clients that is in one of the bigger communities, they can’t accommodate a low-salt diet. So the family’s a little frustrated, and they’re going to probably end up moving because of that.
Nicole: Yeah. You know, honestly, in the last few years I’ve just started hearing the question of gluten-free even, which I think that that’s a hard one to accommodate in communities. We did have a resident here that you know, they brought in their own gluten-free things. But I think that we’ll probably, with more food allergies and things happening, we’ll probably be seeing more and more places accommodating things like that.
Misty: Right, I think you’re right too. I think, uh, we’re missing the boat on that piece for folks.
Additional Factors to Consider
Find Out If They Use Staffing Agencies
Misty: So, just to go back to a couple other things that I had on my list because I think they’re a little bit important. And I know you brought the one up, which was driving backwards to staff and using staffing agencies. Can you talk to that a little bit?
Nicole: So to be honest, I’ve never been in a building that uses staffing agencies. But I know of, you know, a couple people that have had to. So, I think that you know since the pandemic and things that have happened over the last few years, staffing is extremely tough. So, a lot of places are using these agencies where they’ll get same-day pay and things like that. But then that also creates that revolving door of, you don’t really know the person who’s in the building, you know, and then that could lead to other issues.
Misty: Mm-hmm. Yeah, you, I mean, I get it. They need to staff up, but we’re hoping that after a period of time that it can get resolved. But there’s some communities out there that are using half of their, half of the people on staff are with staffing agencies. And, you know, like you said, they don’t get to know the residents, their routines, when they’re off, when it’s not a good day for them, maybe. Because sometimes those caregivers realize, like, hey, something’s wrong with Mary today or something like that. They can tell just because they’ve been working with her for so long.
Nicole: Definitely. Yeah. I mean, we just had something happen the other day where a lady was having a hard time transferring. And then it was like, okay, well, maybe she has a urinary tract infection, and that’s exactly what it was, you know. So, and that was from, you know, a caregiver that sees her five days a week and knows her routine, you know.
Consider the Location of the Room
Misty: To drive back a little bit about identifying the needs, which is where the room is located, how far is it from the dining room, or, you know, activities? What’s your thoughts on that?
Nicole: Yeah, so, you know, I think sometimes families, just depending on the situation, of course, but sometimes they set expectations a little bit high for people. You know, we do complimentary escorts when people initially move into the community just to help them get a lay of the land and things like that for the first two weeks or so, just depending on what they need.
But some families think, okay, well they had a fall and he needs to get stronger and all these things, so maybe distance won’t be an issue. But, you know, you have to think of what their baseline is and was before the fall, you know what I mean?
So if they’re just going from the recliner to the kitchen table to the bathroom most of the time, and like maybe they’re going grocery shopping, but halfway through they sit on the bench at the front of the grocery store because they’re tired, then going, you know, a long distance three times a day for meals might be just too exhausting for them, you know.
And then, you know, we have our other residents where it’s like if you don’t use it, you lose it. And, you know, they’re more physically independent and things like that. So then that distance is okay.
Misty: That’s a great point. So going back to identifying that particular individual’s needs, is it motivating to them or is it exhausting to them and they don’t have that stamina to be able to do a far walk?
Nicole: Yeah.
Look at Your Options Before Choosing an Assisted Living Facility
Misty: So, anything else, Nicole, that you think is important that maybe we didn’t go over?
Nicole: Not that I can think of off the top of my head. I think we covered everything. You know, I feel that a lot of families wait until something has happened where, you know, then it’s time to move my mom and dad, like, in three weeks or something. So, I always encourage people to do their homework before. If you start seeing a decline in things, you know, just get a little bit of a lay of the land and see what’s out there so then if something, you know, happens, then you’re prepared.
Misty: Yeah, don’t be in a rush. You know, rushes can cause anguish. I try and tell people if you find the right community right off that, right from the beginning, like yours, a good reliable quality community, it’s going to save you a lot of headaches later on, you know?
Nicole: 100%, yes.
Misty: You gotta not try and do this at the last minute. But we know that sometimes that happens. Yeah, again, hopefully this information has been helpful. And Nicole, you’ve been just an awesome person with great information. I appreciate you so much being with us here today, and I’m sure we’ll connect again.
Nicole: Thank you very much, Misty. Thank you for having me.
Misty: All right, everybody. Thanks again for being with us. I hope this information was helpful for you, and I will see you again on a future video. Bye-bye.