Seeking guidance on how to assess senior/assisted living communities

[Anonymous]

My parents are 80 and need to downsize. Until recently, we thought that they could move into a condo/apartment, but some recent health developments make clear (to all of us) that they should focus on senior/assisted living communities. We are looking for something in Maryland or NW DC; prefer no more than 30 minutes from upper NW DC. Parent 1 is dealing with some physical health issues that we hope will resolve with surgery in the next few months; Parent 2 is having short-term memory issues (which makes dealing with P1’s physical health situation more difficult).

Based on the research I’ve done so far, I’ve identified a few factors we’ll need to assess/decide on:

1. Buy-in + (lower) fees or no buy-in + higher monthly fees (leaning toward the latter so that they don’t have to sell their house first)
2. For-profit or not-for-profit (preference for the latter, but that’s based on gut so am open to other perspectives)
3. Retirement communities with no services or senior living with care levels (pretty sure we need the latter considering P2’s cognitive situation, which is fine for now but I assume will only get worse)

Any other key decision points/factors we should be considering?

Is there a list of questions I should be asking each facility I reach out to?

And if there are facilities you have experience with that you’d recommend based on what I’ve shared above, I’d be grateful.

Thanks in advance, DCUM hivemind.

[Anonymous]

The new Kensington assisted living facility in the Westbard development off River Road offers “couples care” meaning parents with differing care needs can be cared for together. In many facilities, this may not be offered. This is another factor to consider as you start checking out facilities.

[Anonymous]

Highly consider one very close to
You. There are always issues regardless of where you are. It's huge to be close especially mid-week.

[Anonymous]

Anonymous wrote:Highly consider one very close to
You. There are always issues regardless of where you are. It's huge to be close especially mid-week.

I agree with this! Our loved one is less than 10 minutes from us, and it means we can easily do short visits there or by bringing her to our place.

[Anonymous]

Ask to talk with people beyond the sales rep. You will never see the sales rep again. You want to observe the people who will caring for your loved ones. Are they treated well? Paid well?

Is the air clean or smelly?
Are snacks available?

Ignore the activities. They all have “walking club” or “watch me cook” class and bingo and “on-your-own” meditation to fill in the calendar.

[Anonymous]

The place we chose had a really low rate of staff turnover. I casually asked the front desk person how long she'd been there and it was 15 years!! She then went on to tell me how long everyone else had been there. (This was a non-profit, annual apartment rental on a campus that also has memory care and skilled nursing)

You might find your parents don't qualify for a CCRC due to health issues. And my parents were surprised that there was a years-long waiting list when they finally agreed to move at age 81.

[Anonymous]

I would look for a place with memory care in case you need it. They sound like they may need more than assisted living. “Assisted” is not very “assisted” ime.

[Anonymous]

Do try for continuing care. Otherwise they have to move.

[Anonymous]

You definitely need to visit. Personally I'm a fan of continuing care options so that you have a clear path for the future should you choose to have them remain as they age. As the spouse of someone who runs eldercare programs of all types, I don't see a difference between not for profit and for profit. And I think most are for profit in this area, though I could be wrong. They are all subject to the same regulations and hire staff from the same pool of people. Care communities that don't accept Medicaid (and that's only available for SNFs) have more money and often better services and facilities. If there is a religious preference, you might want to consider that.

[Anonymous]

I can't underscore how valuable it is to visit as many places as your schedule will allow. Even ones you don't think are a good fit. When I visited memory care facilities for my dad, I picked up little details at each one. Things to look for, things to consider. By the end I had a pretty good gut feeling for the different options.

Ask what the safety net is like for residents. What if one parent outlives their funds? Do they accept Medicaid? Is there a fund set aside for long term residents?

[Anonymous]

Have a local social worker come and do an evaluation. They will recommend places that are appropriate based on your parents level of health and activity. We have one parent who is starting to lose it and is very active, and one who could not live independently without the care of their spouse.

The evaluation was a couple of hundred dollars that was well spent. The place I had been pushing wasn't appropriate because the level of activity needed for them didn't match the average ability of the residents. SW recommended 3 places, we visited all, and it really came down to 2 of them (one they ruled out after the visit based on feel/vibes). They have now been there 6 months and are very happy, as am I

[Anonymous]

I would not do a buy in and monthly only. My dad chose Brightview and really liked it. It was monthly only.

[Anonymous]

Anonymous wrote:Have a local social worker come and do an evaluation. They will recommend places that are appropriate based on your parents level of health and activity. We have one parent who is starting to lose it and is very active, and one who could not live independently without the care of their spouse.

The evaluation was a couple of hundred dollars that was well spent. The place I had been pushing wasn't appropriate because the level of activity needed for them didn't match the average ability of the residents. SW recommended 3 places, we visited all, and it really came down to 2 of them (one they ruled out after the visit based on feel/vibes). They have now been there 6 months and are very happy, as am I

They are paid to push those facilities.

[Anonymous]

Anonymous wrote:Do try for continuing care. Otherwise they have to move.

This, and many continuing care facilities with memory care only accept residents who can pass memory test at the time of entrance.

[Anonymous]

Know what kind of contract you're looking for (A, B, or C)
https://www.stoneridgelcs.com/blog/ccrc-contract-types/


Check for CARF accreditation

Go for the nonprofit, all other factors being equal