Moving aging parents or other loved ones into a senior living facility is a major event in anyone’s life. Emotions are often high, discussions among children and loved ones may be tense, and the decisions that need to be made can feel overwhelming.
[Read: What Is Life Like in Assisted Living?]
Finding the Best Senior Care Facility for You Takes Time: Start Early
The best way to ensure a smooth transition, experts say, is to start the process early, before a health crisis forces action. Starting early ensures a more deliberate, thoughtful approach, allowing time to make well-informed decisions and avoid the emotional pressure of a rushed, last-minute choice. From financial planning to getting to the top of a waitlist at the right facility, starting the process early puts you in the best possible position for the future.
It also helps to have a plan. Here are 12 steps you can take now to find the right place for a loved one, if and when the time comes.
[READ: What Is Luxury Senior Living?]
Our 12-Step Checklist to Find the Best Senior Care Options
There are many things to consider when choosing a senior living facility. This complex process, influenced by various factors and emotions, can feel overwhelming when balancing personal preferences and financial limitations to find the right match.
This 12-step senior living checklist can help you break down the process into manageable pieces and ensure you’re not leaving anything to chance:
1. Consider all of your different senior care options
According to the National Institute on Aging (NIA), there are four types of long-term care residences:
— Continuing care retirement communities
The main difference among these choices is in the level of care provided. Assisted living facilities provide some help with activities of daily living (ADL), such as cleaning, meals, medication management and transportation. This level of care works for adults who are still able to take good care of themselves but need occasional help with some daily activities.
Nursing homes, also known as skilled nursing facilities, are licensed to offer a higher level of daily care, including:
— Aid getting dressed
— Getting in and out of bed
— Frequent or daily medical management for chronic conditions
— Meal preparation and assistance
— Memory care for patients suffering from Alzheimer’s disease or other forms of dementia
— Nursing care
— Rehabilitation services, such as physical, occupational and speech therapy
Board and care homes are small, assisted living facilities of 20 or fewer residents living in private or shared rooms. Continuing care retirement communities comprise multiple levels of service, including independent housing, assisted living and a skilled nursing facility all on one campus. Residents can move into higher care as their needs change.
[Read: 11 Signs Your Aging Parent Needs Senior Care]
2. Consider your loved one’s preferences
Everyone wants to feel like their living situation is within their control, so it’s important to involve your loved one in the decision-making process. Here are some topics to cover when having an initial conversation about senior living:
— Amenities. Are there certain amenities, such as dog walking and other pet services, or in-room dining on days they don’t want to join the communal meal at the dining facilities, that they feel would make them more comfortable?
— Community size. Would they feel more comfortable in a smaller community where, as the saying goes, everybody knows your name, or would they prefer a larger community?
— Cultural or religious requirements. Are there any cultural or religious aspects to their life that they would want in their new community?
— Dietary preferences. Are there any dietary needs or preferences that your loved one feels strongly about?
— Location. Are they interested in staying close to family, friends and their current doctors?
— Social preferences. Are they looking for a more socially engaging community to combat loneliness or do they prefer a quieter environment?
Carefully considering these factors when looking for the right facility can help make the move more welcoming and less stressful for your senior.
3. Consider your loved one’s care needs
When your older loved one can no longer live independently
, ensuring their safety becomes the top priority. This involves finding the appropriate level of care to meet their specific needs. Consulting with their health care providers is an essential first step in understanding their current needs and anticipating how those needs may evolve over time.
Which facility is best for your senior? Experts in elder care measure each individual according to his or her ability to perform activities of daily living (ADLs), including:
— Toileting. Assisted living facilities and board and care homes charge for assistance with toileting. Nursing homes assist most residents with using the restroom.
— Eating. Most assisted living and board and care residents can eat independently. Nursing homes provide more help when necessary.
— Medication management. While nursing homes generally manage medications, this service is usually at an additional cost at assisted living facilities and board and care homes.
— Mobility. Assisted living and board and care residents typically can get around easily, even if they need a cane or a walker. Nursing homes provide more consistent help with moving around.
— Personal hygiene. Assisted living facilities and board and care homes can help with showering and grooming, generally at an added cost. Nursing homes provide hygiene help as part of basic care.
While health care providers will help determine the level of care needed for your loved one, the facility will also examine the prospective resident to ensure it can meet his or her needs.
4. Consider your and your loved one’s finances
The price tag for senior care varies by type of facility, services required and the facility itself. According to the 2023 Genworth cost of care survey, the national monthly average for an assisted living community is $5,350, while a semi-private or private room in a nursing home facility is $8,669 and $9,733, respectively. Keep in mind there can be wide variations in costs depending on the community, services offered and geographic location.
Many people mistakenly believe that Medicare covers long-term care costs, but it does not. Original Medicare pays on a short-term basis only for skilled care, such as rehabilitation or medical services after an illness or surgery, not custodial care like assistance with daily activities. Medicare Advantage plans, offered by private insurance companies, may help with some custodial care costs for a predetermined amount of time; however, the coverage varies significantly between plans and typically does not cover the full amount of a senior care facility.
An individual’s savings, family contributions, Medicaid, veterans and other government benefits as well as long-term care insurance are all ways to help cover the bill. Speaking to a financial planner early on can help ensure that long-term care needs are met without causing undue financial hardship or stress.
5. Research facilities that match your preferences, needs and budget
Depending on the geographic area, there can be dozens of options. AARP recommends using the following sources of information to find senior living facilities in your region:
— Area Agency on Aging. These agencies are designated by the state to address the needs and concerns of older people. They can tell you if your state has a searchable database of assisted living facilities. To find your nearest aging agency, use the federal government’s Eldercare Locator or call 1-800-677-1116.
— LeadingAge. An association of aging-related organizations, LeadingAge has an online Aging Services Directory to search for facilities in your area.
— Argentum. A trade association for senior living communities, Argentum has an online directory that lets you search by ZIP code.
— Word of mouth. Relatives, friends, neighbors and your loved one’s doctors can be good sources of information.
U.S. News also offers details of services and patient and family reviews to help you find the best assisted living choice for your loved one.
Make a list of pros and cons, keeping in mind your senior’s preferences, and confirm a facility has the right blend of services, amenities and level of care that they need.
6. Tour your favorite senior living facilities
After narrowing your options, it’s time to tour the senior living facility. If possible, include your loved ones on the tours so they can get a feel for whether this may be a good fit for them.
Don’t choose based solely on location.
“The closest facility is not necessarily the best one,” says Nora O’Brien, executive director of Willow Gardens Memory Care and Willow Towers Assisted Living at United Hebrew in New Rochelle, New York. “I’d rather drive 10 minutes farther to a better facility.”
You can get a good sense of the facility if you make note of the following:
— Is the facility clean? Does it smell fresh?
— Are there comfortable common areas, such as dens and living rooms?
— Is the floor plan easy for a senior to navigate?
— Are the rooms large enough for your loved one?
— Are their safety handrails, call buttons and safety locks on doors and windows?
— Are the hallways and stairways well lit, the exits well-marked and security and fire safety systems clearly in place?
You should also trust your instincts, O’Brien advises. Does the facility “feel” right? Ask yourself, “Will my loved one be happy here, and will their quality of life be improved?” she says.
Similarly, if you tour the facility, trust in the process of elimination, says Howard S. Krooks, an elder law attorney practicing in Florida and New York and past president of the National Academy of Elder Law Attorneys.
7. Get to know the staff
If you are able to, observe the staff and how they treat residents and one another.
“That’s a real indicative factor of how the facility runs,” Krooks says.
If possible, walk around and randomly ask different residents how they like the staff and if they feel they have the residents’ best interests at heart. Certain clues — such as whether the staff look happy to be there and if they treat the residents with respect and care — will tell you a lot about what life is like in that facility.
When evaluating the quality of staff, asking the right questions can give insight into their experience, training and overall dedication. Here are key questions to consider:
— How long have key staff members (caregivers, nurses, administrators) been with the facility?
— What are the staff members’ qualifications?
— What ongoing training or professional development do staff receive?
By asking these questions, you can gauge the professionalism, care and culture of the people who would be taking care of your loved one day to day. Observing interactions during your visit and talking to residents about their experiences are also crucial for assessing the quality of care in action and any problems.
8. Understand how the facility prioritizes safety
A senior care facility should prioritize the safety of its residents and be able to demonstrate how they do this. Observe whether the layout of the facility is designed with seniors’ needs in mind, with wide hallways, nonslip flooring and safety equipment, such as handrails and ramps for fall prevention. Residents should have access to emergency call buttons in their rooms and common areas to request assistance quickly when needed.
Senior care facilities should also implement programs to assess fall risk and other medical issues, including regular health checks, to keep residents active and safe. Safe medication handling, storage and administration protocols are crucial to prevent medication errors.
Before making any decision, speak to the administrator to learn how the facility approaches the safety of their residents.
9. Dig deep into costs and fees
Senior living costs often include more than just the base rent or care fees. There may be additional expenses for services, such as medical care, activities, transportation, meals and medication management. There may even be a one-time buy-in fee that secures your loved one’s place in the community.
Without understanding the full scope of costs before making a commitment to a facility, families may face some unpleasant surprises when the bill comes due.
Costs can vary significantly based on the services, location and amenities offered. It is in your best interest to get a list of fees and any other costs before entering into an agreement. Understanding all the associated expenses helps you compare facilities more effectively and choose one that meets both you and your loved one’s needs and financial situation.
Senior living costs often increase as more care is required, such as transitioning from independent living to assisted living or memory care. Understanding current costs and how they might change over time can help you plan for the expense of future care needs.
Get in writing a clear list of what services are provided, which services or amenities cost extra, how billing and payments are managed and any other information that impacts your decision. It’s important to ask detailed questions and carefully review contracts to avoid unpleasant surprises.
10. Learn about activities and specialized therapies
What types of activities does the facility provide for its residents? If your loved one is socially engaged or has hobbies they would like to continue to be involved in, this question can be an important one.
Some activities that may be offered:
— Art and crafting clubs
— Book clubs
— Cooking classes
— Exercise or wellness classes
— Faith-based groups
— Gardening clubs
Some communities may even plan excursions for their residents. If this is important to your family member, make sure you get a comprehensive list of offerings as well as any costs that may be associated with them. If possible, when touring the facility, ask to sit in on any clubs or classes that may be of interest.
Depending on your senior’s needs, they may require one or more specialized therapies. Some examples:
— Occupational and physical therapy
— Respiratory therapy
— Speech therapy
Verify how and where your loved one will be able to receive these services. Are there facilities on campus that provide them, or will your loved one have to travel to their appointments and, if so, is transportation provided?
11. Talk transportation
If your loved one cannot drive independently anymore but still has places to go, you’ll need alternative transportation options.
Many facilities have transportation services that help seniors get to and from appointments and other places.
Find out what transportation services the facility offers and if it travels only to pre-determined locations like doctor offices or shopping centers. Also ask if there is a cost for the transportation. Most of the time it’s offered as a complimentary service. If the facility provides transportation only to certain locations, find out if they have any arrangements with local car services that may offer discounts.
12. Ask about emergency protocols
Emergency protocols are essential for ensuring the safety and well-being of residents during an emergency. Given that this is a vulnerable population, it’s crucial that these protocols are comprehensive and updated as necessary, and that regular emergency drills are practiced. Some key emergency protocols that should be in place and discussed before making your decision:
— Disease outbreak protocol for infections, such as COVID-19 or the flu
— Fire safety tools, such as well-maintained fire alarms, sprinklers and comprehensive evacuation measures
— Medical emergency response, including staff certified in CPR and first aid as well as a protocol for contacting emergency services
— Missing resident protocol such as alarm systems or tracking devices to alert staff if a resident with cognitive impairments wanders off
— Severe weather responses such as designated safety areas and evacuation plans
— Utility and power outage protocols such as back-up generators in case of prolonged outages
For your own peace of mind, discuss what the facility’s policies and procedures are for communicating with the residents’ families in case of such emergencies.
Explore Top-Rated Senior Care Facilities with U.S. News
A comprehensive resource based on survey data from nearly 400,000 residents and families, the U.S. News’s Best Senior Living Communities is a great place to begin your search. The survey gathered feedback on key aspects of each community, including safety, caregiving, management, staff, food, activities and enrichment. It includes the top-rated communities for each level of care, such as assisted living and memory care.
Bottom Line
When choosing a senior living facility for your loved one, you’ll find different options like assisted living, board and care homes, continuous care retirement communities and nursing homes, each with different levels of care. It’s important to include your loved one in the choice and listen to what they want.
Talking to a financial advisor can help with the cost and always get a full list of fees. When you visit places, watch how the staff act, talk to the people who live there, make sure the facility is clean and up-to-date and ask about activities, transportation as well as emergency and safety protocols.
More from U.S. News
What Is a Long-Term Care Facility? 8 Types and Costs
10 Things to Look for When Touring a Senior Living Facility
How to Choose the Right Senior Living Facility: A Checklist originally appeared on usnews.com
Update 04/10/25: This story was previously published at an earlier date and has been updated with new information.
