Four Things I Look for When Evaluating ALFs

Evaluating ALFs (Assisted Living Facilities) can be difficult. How can you really determine which community will be best? Is it possible to know if the ALFs provide quality care? Or, will they be able to meet your needs and will you be happy there? The process of evaluating ALFs and making the move is already a stressful life transition without worrying you're making a mistake.

Today, our experts share their secrets for evaluating ALFs. You’ll learn four key things we look for when evaluating ALFs and important questions to ask.

Four Top Things to Look for When Evaluating ALFs

1. The first place to look when evaluating ALFs is inward.

You cannot properly assess which community will be best without knowing your needs and preferences. There’s no point in looking at what someone else thinks are the best ALFs if they don’t meet your needs. This is one of the most common problems we see when families rely on friends’ opinions or experiences only.

Therefore, the first step is to assess the person and their situation. This includes an evaluation of the areas where they need help. What ADLs and IADLs do they need assistance with? ADLs are activities of daily living, such as bathing and dressing. And, IADLs are Instrumental Activities of Daily Living, such as shopping, managing money, and handling medications. Although an ALF will provide a basic evaluation and determination of level of care upon entry, you need to know this before you even begin looking. Some ALFs cannot handle people with a lot of care needs. And, the price may vary a lot based on the level of care or services needed.

That’s another factor to consider: budget. No one wants to look at assisted living facilities and get their heart set on one they cannot afford. A care manager can also help you figure out which programs help with costs and navigate eligibility.

Additionally, the future resident should consider things like location, activities, and facilities. What factors are important to their physical, mental, and social needs?

2. Look at how the “personality” of the ALFs fit you.

This is one of the reasons we previously discussed that referral placement businesses often don’t work well for finding your new home. What is right for one client may not be for another. You can’t say “a small facility is always best”. And, even when a family member goes and looks at ALFs they may be attracted to different things than their parent. 

We’ve seen this in the past when a client’s advisor (such as their attorney or financial professional) recommends a place they really like. In one case, the client seemed highly resistant to the idea of moving, But, when we got to know her we realized she didn’t feel comfortable in the place her advisor had recommended. When we were able to show her places more fitting with her personality and lifestyle, she became more enthusiastic.

This is why there is more to the process than a physical assessment or quick match with top facilities. Our team does not send all our clients to the same facility, no matter how much we like a particular one or think “that’s where I’d want to be.” Yes, we have a lot of experience with facilities which gives us some pretty strong opinions, but we also have to look at things from the client’s perspective. Though we use the term ALF here since it is most known, we like to talk about finding you a community versus a facility. A client has to be at home where they move, or it will never work.

3. Watch closely as to how responsive the staff is.

If the ALFs don’t have helpful, responsive staff during the process of looking, you should probably cross them off your list. This is their chance to impress you. And, while that means it is not fully indicative of how they work with residents on a day-to-day basis, it is a significant test. 

Some things you can do to look beyond the polished marketing spin:

  • Talk to different staff members at different levels and in various positions.
  • Visit on different days and at different times.
  • Ask some more unusual questions. Delve into things beyond the sales pitch. For example, you might want to ask them about some scenarios and how they handle them.
  • Check with care managers, caregivers, doctors and other professionals who have clients at these ALFs. Note: doctors may or may not have much insight into the workings of ALFs if they don’t visit clients there. However, if they’ve had bad experiences those can be telling. Perhaps they see clients of one of the local ALFs being sent to the hospital much more or have spotted problems with care. A care manager can be a valuable asset for this intelligence since they often coordinate care for clients at ALFs.

4. Care quality is the most important factor.

Of course, underlying all the other factors, the assisted living facility must provide good care. But, how do you know if they will? First, you can check their state surveys and any record of complaints. But, beyond that, it helps to talk to those who have experience with the day-to-day operations. That might include the professionals mentioned above, a care manager, and possibly even other clients and families.

The minimal requirements for ALFs sometimes surprise families. For example, in Florida the staffing minimums are based on ratios of care hours. However, there are some basic minimums such as having at least one staff person awake at all hours in facilities of 17 or more residents. In other words, smaller facilities may not have awake staff at all times. Of course, ALFs will ideally base their staffing around resident needs and go beyond minimums. We have found that having strong supervisory staff present makes a significant difference in care. Thus, it can be helpful to know those in facility management and their philosophies and priorities.

All ALFs (and home care companies for that matter) make mistakes or have problems from time to time. The important thing to know is that management addresses the problems and learns from them. You need to be able to trust in the care provided and intentions of the staff. However, even in the best cases, we advise you to make regular visits or hire a care manager to oversee and coordinate. This is often especially important in the early days when transitioning to a new home.

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