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1. Location

Often, the objective is simply to remain in the local area or to be close to loved ones. But where facilities are located also makes a difference in how they operate, due to the laws in that area. For example, some states limit how much medical assistance the residences can offer, so if you need a significant amount in those states, you may not be the right candidate for an assisted living facility after all – or you may consider looking at another state.

2. Size

The smallest assisted living facility in the U.S. has only four licensed beds; the largest has almost 500. Size matters in different ways to different people, though what may matter more is staff-to-resident ratio with “adult foster care” emerging as one type of assisted living facility that generally has few residents and as many as one staff member per five or six residents although this, predictably, can drive total prices up for residents.

3. Services

While the typical assisted living facility offers dining services, housekeeping, exercise and wellness programs, and medication management support, some provide tailored services based on specific health needs. For instance, nearly 60 percent of communities now offer an Alzheimer’s disease or dementia program, the same percentage has a diabetes program and about half of facilities house heart and depression programs.

Many facilities also invest in programs that enhance quality of life – think art and pet therapy, computer and piano lounges, and community outings.

4. Transitions to Higher Care

The idea of moving from total independence to a residence with care can be daunting, for sure, so it’s natural to resist trying to consider the next move at the same time. But doing so is worth it, says Dr. Sebastian Sepulveda, a nephrologist in Chelmsford, Massachusetts, who specializes in end-of-life care. “We graduate through different stages of life and assisted living is one of the big ones,” he says. “People should think a little bigger… and think about what’s coming. Assisted living isn’t forever.”

Specifically, some assisted living facilities are part of a larger continuing care retirement community and allow residents to move from assisted living to skilled nursing facilities if and when they need to. Others may have relationships with other health care providers they refer to once the resident’s needs exceed what the residence offers. It’s important to think about what you or a loved one might need in a year or two – and ask the facility how and if those needs can be met – and what they could cost.

5. Cost

Whether or not you can afford an assisted living facility makes or breaks whether you should consider living there. Most assisted living residents are paying through personal finances like savings, long-term care insurance, home equity, life insurance, benefits for veterans or likely some combination of resources.

Facilities differ in how you pay for them, too, whether based on an upfront cost, monthly rent, a la carte services or a tiered system. Once you narrow down your options with facilities you can afford, evaluate them the same way you would regardless of cost.

6. Culture

You can’t really know what it’s like to live in an assisted living facility until you do it. But you can get a very telling taste if you visit your potential options first. In today’s age, it’s highly understandable that folks would like to do an Internet search and find something quickly and be done, but this is also where you or a loved one is going to live for the foreseeable future – you wouldn’t buy a house from just an Internet search. Visiting the facility, talking to the staff and residents, attending a meal and getting a sense of the environment is the biggest piece of advice we can give people – make sure it feels like the right environment.