What to know before choosing an assisted living community option for aging loved ones

Interest in senior living communities skyrockets during and after the holidays, according to a senior living expert who has advice for families considering whether an elderly loved one needs help.

“The adult children all get together, they all see what’s going on, and they basically agree that either immediately or right after the holidays, they’ll start looking at options … that’s what happens every year,” said Andrew Carle, a faculty member at the Program in Senior Living Administration at Georgetown University.

Looking to move a loved one out of his or her home involves myriad options.

“First of all, understand the difference between a professionally managed senior living community, and one that is may be more of a ‘mom and pop,’ that doesn’t mean that some of the mom and pops aren’t good,” Carle said. “But it’s a difference between, you know, Starbucks, where you know what you’re going to get, and Joe’s coffee shop where maybe the coffee is good, but maybe it’s not.”

The professionally managed ones are the very large national providers, such as Life Care Services, Brookdale, Sunrise Senior Living. Carle recommends beginning your search with large national providers that, at least in theory, have the resources to perform well.



Maryland, Virginia and D.C. all have licensing survey results of facilities publicly available.

“You’re not looking for a perfect score,” Carle said. “There’s sometimes these little things that are fixed before the surveyor even leaves. You’re looking for major deficiencies, (such as) major staffing things, fines — if they’ve ever been fined, and how recently have they been fined? A fine from 10 years ago maybe isn’t relevant, but how are they doing today?”

Carle, who has been designing memory cares for 25 years, describes it as the ICU of senior living, and probably the most complicated.

“Memory care services vary dramatically in this country,” he said. “Some of the providers have gotten very, very good at it. Some basically just put up a keypad secured door entrance and not much else.”

Carle recently designed the new Shenandoah Memory Care at The Virginian in Fairfax, that won the Environments for Aging gold award as the best senior living renovation remodel project in the nation last year.

While he says it’s near capacity for residents, “I would say go to The Virginian and see what the memory care looks like there. So, you can at least compare it to something that just won a national award. You really, really need to understand the difference in memory care.”

When it comes to dementia and Alzheimer’s disease, a person’s needs change at different stages of the disease — and each family’s situation is unique.

“There is no one-size-fits all formula when it comes to Alzheimer’s care,” said Cindy Schelhorn, Senior Director of Communications and Marketing with the Alzheimer’s Association National Capital Area Chapter. “The Alzheimer’s Association is here to help. Visit our Care Options webpage to learn about different types of care and how to choose care providers.”

The group’s 24/7 help line at 800-272-3900 is staffed with specialists and master’s-level clinicians who can answer questions and provide assistance.

Before choosing an assisted living facility of any kind, Carle recommends making multiple visits.

  • Spend some time.
  • Visit on different days of the week and varied times.
  • Have a meal.
  • Chat with residents. If they’re not comfortable letting you chat with some folks that’s a red flag.
  • Ask to see the activities, life enrichment calendar.

“Pick out an activity that looks like it might be of interest to your mom,” Carle said. “Ask if you can visit during that activity to see what’s going on in the room, how many residents are attending, it’s one thing to have a calendar, it’s another thing to have residents routinely showing up for the activity.”

Consider a respite stay.

“Almost all these communities will let you move mom or dad in for — it’s usually a minimum of two weeks because there’s a lot of paperwork,” Carle said. “But two weeks to 30 days — this is a good chance for a family caregiver to take a break by the way and to let mom or dad know that they need a break.”

He said multiweek visits sometimes can change a reluctant person’s mind about transitioning into a new living situation.

“The mom or dad who insisted they would never leave their home when you come back to pick them up realizes they love the place, and they don’t want to go anywhere,” he said.

Are senior care facilities affordable?

Carle said assisted living for two to three years is a “big purchase” that should be carefully researched, but not an unaffordable one for any senior living in a home (they would sell that) they have owned for many years, and is likely paid for.

Kristi King

Kristi King is a veteran reporter who has been working in the WTOP newsroom since 1990. She covers everything from breaking news to consumer concerns and the latest medical developments.

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