Selecting a Long Term Care Living Community

by Adrienne Glusman, Family Caregiver
As mom's Parkinson's progressed I determined it was unsafe for her to live alone, and made the decision to move her to a senior living community - at that point, Independent Living.  Mom was still able to drive, was still mobile and able to walk, albeit using a cane, and could perform the majority of the activities of daily living.  In the three years mom lived there, Independent Living became harder as her mobility gradually declined and progressed to an increased number of falls. She also became disengaged in activities and social interactions due to her increased apathy, a side effect of her disease.

Moving mom down to South Florida was a big decision and undertaking.  I needed to ensure I was choosing the appropriate living arrangement based on her current needs which, at that point, was an assisted living community.  Deciding when to make the transition is tough, but once that's resolved, finding the right place is the next challenge.  This is a life-changing decision for your loved one, there are lots of resources now that help you identify what to look for including level of cleanliness, staff friendliness, resident activities/engagement, quality of care including care plans and levels of care available and safety/security.  

Looking for the best fit in a senior living community reminds me a lot of my search for the perfect college - they serve the same general population and support the same general goals, but they vary widely by size, culture, specialties, cost, dining and perks.  After what was a mentally draining and arduous search, here are some common mistakes I've learned that can easily be made/overlooked and how to best avoid them:   

Consideration #1:  Selecting a community that you like vs. considering if it is the best fit for your loved one
I'll be the first to admit I was in denial of having to take the next step in senior living for mom.  My grandmother was living in a facility and I'd seen the vast difference between the communities and residents.   I wanted her to have a nice space where she could feel at home and, above all else, I didn't want her surrounded by people who were drastically older and at different mental and physical states than she was.  It's hard not to want to choose a community based on your loved ones current needs, but instead how they used to be.  I had a big wakeup call that told me I needed to accept where my mom was in her disease progression and make the quality of her care my first priority as opposed to all the bells and whistles.  

Consideration #2:  Choosing a community alone vs. asking for help 
Because I'm an only child, I started the search for an assisted living facility on my own. There were so many options; I wasn't sure where to start.  Many communities I visited ended in me walking out crying, desperate that I wouldn't find something that made me feel comfortable and would properly meet mom's needs.   If it's available to you, I highly recommend seeking out a senior advocate/advisor or placement agency who can help make the search for a long-term care community less daunting.  I like to think of it as a real estate agent for long term care.  They will save you time and money by only providing you options that fit within your budget and support your loved ones needs.  
Consideration #3:  Think about the future, not just the present
I am very much a "live in the present" type of gal, but when it came to what I was looking for, I did not consider the benefits of a larger continuing care community to make the transition easier over the years as mom progresses.  Fortunately, there is a memory care center where she lives that will be an available option if/when the time comes.  While touring, I would recommend asking about facilities that may be appropriate for your loved one as they age.  Ensure that you will be comfortable when the transition needs to be made.  

Consideration #4:  Don't make a hasty decision
It's a daunting and emotionally draining process that I wanted to be over before it even started, but unlike other life decisions (especially since you are making it on behalf of and/or with your loved one), this shouldn't be a quick one.  I blocked time into my weekly schedule and on the weekends, months in advance of moving mom, to visit every well-rated community in close proximity.  I took note of how they differ and are unique and when I finally narrowed down a few choices.  I then went back to the communities to observe the happenings of the residents, talked to the staff and attended a meal to get a sense of the environment before making the final decision.   

Consideration #5:  Overplaying the importance of proximity
There is not an overabundance of senior living communities in the Miami area, which meant my search would take me further north.  Could I have chosen to settle on a community twenty minutes from where I lived? Sure, but I can say that extending my commute by an additional twenty minutes has allowed me to find the best possible fit for mom, which is worth the extra drive time to visit.   

Consideration #6:  Cost
Most assisted living residents are paying through personal finances like savings, long-term care insurance, home equity life insurance, benefits for veterans or likely some combination of resources.  We are fortunate to have the assisted living facility cost covered by mom's long term care insurance policy.  When assessing your finances, continue thinking long-term.  There may be a time when your loved one is no longer able to care for themselves in assisted living and may need a part time or full time home-health aid.  You made decide at that point it is best for you to care for you loved one in yourself or in your own home.   Factor the future into your budget. 

Consideration #7:  Trust your instincts 
Probably the biggest lesson of all.  If it doesn't feel right - it isn't.  I can think of five different communities where I simply walked in and walked right out or had a bad feeling when touring.  My instinct told me it wasn't a good fit.  So listen to that nagging voice inside of you instead of brushing it under the rug in favor of the proximity to where you live, the appeal of the community or the cost.  


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