How to Tell a Good Assisted Living Facility From an Awful One

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Photo: Jacob Lund (Shutterstock)

Whether we like it or not, we’re all getting older. In fact, according to the U.S. census, the country as a whole is getting older, and the population of adults over the age of 85 is estimated to triple in the next 20-30 years. So it’s not surprising that there are close to one million people residing in assisted living facilities in this country—a number sure to grow rapidly as the country continues to gray up.

Assisted living is a great option for a lot of families because they’re flexible experiences. If your older loved one just needs some care and assistance, they can still have a pretty independent life while being supported by trained professionals and having easy access to medical care. While researching and assessing the training and qualifications of the staff is one major aspect of choosing an assisted living facility, there’s also the question of the atmosphere and “vibe” of the place.

Assuming the staff and quality of care are up to snuff, how can you tell if an assisted living facility is right for your aging loved ones? The answer is surprisingly simple: Treat the selection process like you’re buying a house.

The best times to visit an assisted living facility

The process of selecting an assisted living facility begins with research and then typically involves a site visit where you and yours get a tour of the place. You’ll get a sales pitch involving the amenities, the level of care, and the social life found in the place. And this is all great and good to know, but you have to keep in mind that it is, at heart, a sales pitch. When you’re house-hunting, the Realtor showing you a house will always highlight the good stuff and try to briskly walk you past problems, and the solution is to visit the house on your own at different times.

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So it is with assisted living facilities. Stop by on a Saturday evening after dinner—at this time the place is going to be quiet, relaxed, and more or less devoid of non-essential employees. The manager and marketing folks will be long gone, so you’ll be able to get a real sense of the place. Are the residents happy and relaxed? Do you see people who need attention left sitting alone all over the place? Are staff harried and stressed—can you even find them? Is the place in good order, or is it messy and in need of a good cleaning?

Visit again a day or two later, but this time show up at lunch. This way you’ll see how the place operates when things are busy and everyone is out and about. Is the meal a convivial, happy experience, or are the residents up in arms about problems? Is the staff polite and supportive, or are the residents getting on their last nerve? Observe whether every resident is getting enough to eat, and what the tone of their relationship with the staff is like—it’s one thing to interact with residents when managers and sales people are walking you around, it’s something else to see them during a high-stress or hectic time of day.

Why the curb appeal matters

You might think the exterior appearance of an assisted living facility is just a superficial detail, but you’re wrong. This is crucial stuff. Just like when you’re buying a house, the way a facility presents itself says a lot about how it’s maintained and operated.

If you visit a house you’re considering buying and there are missing roof shingles, overgrown landscaping, and water stains on the stucco, you’re going to get back in your car and drive away—or knock down your offer significantly. The same applies to an assisted living facility. Obvious damage and deferred maintenance, poorly maintained landscaping, and a lack of access due to low staffing or broken locks and security systems are all red flags. Even if your tour went smoothly and people seem happy, a slipshod approach to the curb appeal is a warning sign that things will be slipshod elsewhere.

Inside, pay close attention to cleanliness. Are garbage receptacles being emptied regularly? Is the paint fresh, or are the walls scuffed and dented? Are the carpets in good shape? Do the elevators and other vital bits of infrastructure work? If you notice something like an out-of-service elevator in an assisted living facility and you’re told it will be repaired, go back a few days later and see if it’s been done—if not, that’s a sign the facility has hidden problems.

What to look for in the rooms

Finally, don’t forget that this isn’t a hospital where your loved one will get care, it’s also going to be their home. Put on your house-hunting hat when touring the actual living spaces your parents or other relative will be placed in. Are the carpets clean? Are the walls freshly painted? Is there obvious damage? Are the furnishings reasonably new and in good condition? Do all the things you would do when buying a house—check the water pressure, look for water damage, note any minor problems like holes in the walls or missing hanging rods in the closets. These details are relatively minor in isolation, but taken together they tell a story of how well the facility is run and maintained.

Combined with a robust round of research, approaching an assisted living facility like buying a house can give you all the information you need to know your loved one will be in good hands.


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