Assisted-living, memory care: How did you find a good facility?

@SusanEllen66, I made your post into a new discussion to help gather tips from people who have looked for assisted living and memory care for themselves or for a loved one. You're so wise to start looking now.

@trishaanderson @sueinmn @bayviewgal @maryvc, can you start off the discussion? How did you get started to find assisted living care? What were your non-negotiables? In looking at facilities, what have you learned to look for?

I’m not sure where you live, but in my state (NC), there is financial help from the state to pay for Assisted Living and Memory Care facilities or units. Most Memory Care units in our state are located inside Assisted Living facilities, but not all. Most Nursing Homes also have dementia sections. But nursing home residents get their help from Medicaid for those who qualify.

The assistance here is called Special Assistance and there are income and asset criteria for qualification. You might check your state to see if there is a comparable program. An estate planning attorney might be able to explain legal ways to qualify. And, the director at a facility can help provide info on this too.

My state has a website that list all the Assisted Living and Memory Care facilities, along with the results of their state inspections, along with recommendations and followups. They provide a star rating to show compliance with rules and guidelines. You can search by name, city or county to see how facilities fare.

I searched for a facility in a more rural county when needing to place my cousin, because it was smaller and the operator was experienced as her own mother had had dementia. Their staff had been there for years with little turnover. It was old, but very clean. I went for visits without my cousin, prior to her admission. The place I selected treated us like royalty. I toured 4 other facilities too. The one I chose was not the most luxurious, but felt right for her and I never had any regrets.

Good luck with your search. I hope you find what you are looking for.

We looked up all the places within our preferred geographical range, essentially in our city and surroundings. Then visited the ones that looked appealing. We visited a number of them. Most were ok; one was smelly. We went with a large corporate-owned one. It was very good but did not have the personal attention we wanted. So we found a residential care house, several residents in a large house with professional aides. Their cooking is also professional and a world of difference from the large, corporate place! It's been perfect.

Trust your gut and your eyes and ears. Visit every potential candidate, and visit their website to see if there are any negative reviews. The State Board may have a rating or even public records of censure/fines/infractions. The AARP might help, FB and Twitter might have pages dealing with this type of search.

Food quality is sometimes hit and miss. It might be brought in from a commercial kitchen, it may be cooked on the premises. Neither case is predictive of quality. Too salty, too much breading, too much fat, there may be many complaints.

@SusanEllen66
I applaud you for planning ahead. I found a good government resource about long term care facilities. Toward end of article are list of resources that should help find out what is available in your area. There is also a link with tips on how to choose a facility.

National Institute on Aging:
https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes
You might also search your state's Human Services website.

Do you have a timeframe when plan on moving?

@SusanEllen66 When we needed to find care for my mother-in-law, my husband couldn't leave work during the day, so he arranged to visit at or after supper time. It turned out to be a perfect strategy! We saw how the staff operated after administration left for the day, and the level of staffing on hand during the very heavy care time. It was very revealing, and quickly narrowed his choice to just one place. We also needed assurance that medical assistance was accepted after her funds ran out.

When my Mom was making her own choice, she knew exactly where she wanted to go, a continuum of care facility that was familiar to our family (long history of residence) that again would eventually accept MA. This place was also close to my sister and me, and coincidentally by the time she moved in my daughter was a staff nurse.

What attracted Mom, and us, was open friendly staff who interacted with every resident on their level, activities that appealed to her, meals made on-site from scratch, on-site hairdresser, and it was clean and bright. Also location was important to Mom - away from busy roads with homes and trees outside the windows, not parking lots and high rise buildings, and a safe yard/patio for relaxing and visiting with energetic great-grandchildren.

Finally, important to me as the money person, each place had an on-site bookkeeper/ accountant. When services needed increased that was important for me to get answers for new charges (and sometimes to dispute them)

I started with touring a Memory Care facility. And i made sure I had all my questions ready...from how often can i visit, how often can i take my husband out and about...to, what did they do to calm him down or to refuse to do what is asked of him. I made it very clear I didn't want sedation!!!
I really liked the director...the layout...and also met another "young" resident. My husband is only 63 and most of the residents looked to be in their late 70's - 90's so it was nice to see someone else in their 60's.
My suggestion is maybe ask around, read reviews, etc. but mainly tour the facility and see how things are run and how the nurses interact with the residents.

Can all the contributors share the name of the facility and state? It may be helpful to someone.

That would be helpful!

I visited all the assisted livings in our county, decided on the one which had a “mom and pop” vibe versus the “medical model” vibe. I also looked for an architectural design that had an “open feel”, with lots of windows for natural light and a patio or entry area that provided opportunities for fresh air. I looked for central natural gathering areas which could be easily accessed by residents, promoting “organic” get-togethers.
You would be surprised how many AL designs feature long hallways with out-of-the way living room areas that no one goes to, central seating areas with hallway spokes which necessarily have no windows, maybe a dirty skylight. The outside entry way isn’t big enough for those in wheelchairs to sit and not block the door, the inside foyer area isn’t big enough to be a gathering place for those who can make it down the long hallways or big enough to accommodate those coming in wheelchairs.
My husband’s AL has a big central natural gathering area where he wheeled himself over to a guy wearing a Navy ball cap, a new friend! Another Navy guy spotted them, the three now hang out together. His table mates have formed a guy club, they find each other in the central space and go out to the patio area to sit and chat, three have dementia and the leader a bad stroke- he organizes the group to order out, with delivery, he’s the only one that can work a cell phone and handle the money.
It’s an absolute truism that the staff will change, people will call off, COVID will make its way in, the cook won’t show up, etc. The best advice I ever got was not to look for chandeliers, but for nice people, a clean place, a good physical lay-out, and a good vibe.
Once you choose, it’s very important to be nice to the staff- at move-in, introduce yourself, ask people’s names and remember them (I put them in my phone notes and laugh that my gray hair makes my memory not so good, the staff- mainly young women all laugh).
Compliment staff often, I call into the kitchen that whatever is cooking smells great (afternoon cooking is often supper’s dessert), if staff’s kids are along on a weekend or school holiday, I say something nice to the mom, if there’s been a haircut, I poke my head in the nursing office and say thanks for getting him on the list, he looks very sharp today! The point is to make yourself a positive person that they don’t cringe when they see you and will go the extra mile to quickly fix anything that you do need to get fixed.
I introduce myself and learn the names of the residents who are usually out and about and greet them as I go by to my husband’s room. Three times now, residents have told me about issues with my husband that I needed to address with him and staff, you have more folks watching out for him and staff trusts you as a reasonable person, not someone constantly complaining and looking to get them in trouble.
Leaving you with a laugh- the facility’s outdoor layout has a loop sidewalk which goes by a roadway that has a bus stop, with a bus shelter with a bench. The Navy and table mate groups think it’s hilarious to walk to the shelter, pushing the wheelchair guys, sit on the bench, and wait for the next bus. The drivers pull in, look with total horror at what awaits, and the guys laugh and laugh and call out that they’re just resting. The drivers laugh and it’s all good! Humanity beats dementia!