Seasonal decorations, a welcoming entrance, a floral scent covering any hint of maladies. So far, so good. It’s your first visit to a senior living community and you hope it will be one and done. You want your parent to love it here. Or like it. Or at least warm up to the idea of living here. Or some place like here.
Waiting in the lobby, you begin to take notes. There’s the cheerful desk greeter, a full calendar of events and a resident sitting in the café having coffee. These seem like good signs. Shortly thereafter, the salesperson – let’s call her Marjorie – emerges for your tour. She is friendly, enthusiastic and speaks almost musically. She greets your mother first and compliments her scarf. You breathe a sigh of relief. The tour begins in the café: snacks, available 24/7, including oranges, chips, muffins, coffee — and popcorn. You will find this popcorn machine adorable. It’s on wheels, and someone pops a fresh batch at least three times a day.
“Look Mom,” you say. “They use this for movie night. You love movies!” Marjorie chimes in to say there are movies every night. She describes the other activities: crafts, bingo games, exercise classes, trips to performances and scenic drives. There’s also a garden club and a lunch bunch. Transportation is provided to medical appointments within five miles one day a week, but there are also physicians and specialists on site monthly for appointments. So you don’t need to leave. It’s a little like being on a cruise, Marjorie might say.
Before you get too enthralled, take a step back.
When I found out unexpectedly that my mom had Alzheimer’s Disease, I rushed to the closest senior living community and plunked down a deposit and first month’s rent. She refused to move in, and I was forced to search in earnest for a place she would accept. Having organized flu clinics in senior living facilities as a public health consultant, I knew to ask questions about illness prevention, but this mission was much bigger.
In my search, I spoke with friends and sales agents, read online reviews and checked for department of health violations. Nothing was as valuable as my in-person observations. As appealing as the popcorn machine seemed to me on my first visit, by the time I visited the fifth facility, I was focused on more important things. I was looking for good people.
The most critical thing is to observe employees’ interactions with residents. Do the employees look like they want to be there? Caring for elderly people who need assistance with medication or getting dressed or using the bathroom is tiring work. Some are better at it than others. Good caretakers have a very deep well of patience and a calming manner. If your parent will need to be in memory care, employee interaction is even more important. A few residents may want activity, while others need a calm, human touch. Do you notice the caregivers responding to each individual’s needs or just biding time until their shifts end?
Take stock of the building’s physical design. Is it filled with light or is it dark? Are common spaces welcoming? Are there guide rails along the walls? Is the memory care unit secured and designed in a circular fashion so that residents don’t wind up at the end of a hall confused because they haven’t found their rooms?
Strolling down a residence hallway, you may notice wreaths on every door and a few posted signs – maybe “oxygen in use” or “knock softly.” You’ll see some model rooms. Notice the safety features – easy entry showers, electrical outlets that can be disabled, non-slip floors? Carpet is best. Marjorie will explain the different monthly costs. All meals here are included, laundry done for the residents and cleaning service weekly. You’ll probably forget to ask about the extra fees for more personal attention, such as medication administration services and incontinence supplies, but you should research those later.
Next, you’ll meet Beth who is joining you for lunch. Beth (or Ben if you’ve brought your dad) is assuredly one of the spriest residents. She’s lovely and conversational and you see your mom thriving there. The food will be better than you expected; you’ll half want to move in yourself. Before you are lulled by the delicious chicken salad, look around. Turn to the different tables. Is anyone else as lively as Beth? Are the other residents enjoying themselves?
The dining hall is more like a high school cafeteria than you think. As my mother said, months after she finally moved into a care facility, “Get to lunch early, or you’ll be crying in your soup.” What she meant was, there are good tables and not-so-good tables and this preference is entirely personal. Ask yourself, can your parent find a good table here? If most of the residents are eating alone or not talking to one another or just staring at the aquarium in the middle of the room, chances are there’s not much socialization going on at any time. That may or may not suit your parent.
There are many considerations when looking for a senior living facility, especially for someone with dementia. After several visits of my own, I developed a checklist to help me find a good place for my mom. In addition to items mentioned above, here a few considerations to keep in mind when planning and touring communities:
- Visit both the assisted living and memory care units in a facility
- Visit at least twice, once at mealtime and then at another time to view activities in progress
- Observe whether or not there enough residents who are at the same cognitive and mobility level as your parent
- Ask how long most of the employees have worked in the community and what training they receive
- Understand the costs for all different levels of care and ensure that your parent can afford to live there for at least 2-3 years
- Ask for a copy of the monthly activities sheet and determine whether or not these offerings will suit your parent
You may see and hear things that you don’t like as you visit. These negatives do not necessarily mean your parent should not live there, but it’s good to be aware of them. Assisted living and memory care communities should be able to provide a level of care and service that will help adults live to their fullest ability for as long as possible.
Rachel Bedell, MPH writes about managing care for loved ones with dementia. She lives in Northern Virginia with her husband and three kids.