Advice on researching senior communities?

August 31, 2022 10:26 PM

I am starting research to help my dad, for whenever he wants or needs one. Do you have advice or helpful information?

The ideal community would offer both "independent living" and "assisted living" in case he ever needs the latter. Besides typical amenities, I think it would be good to have a pleasant outside area and have nearby stuff to walk to.

My dad has long-term care insurance. He has no serious health problems, but it is getting harder to go upstairs. He is in his early 80s. This is in Albuquerque, New Mexico, USA.

posted by NotLost to Grab Bag (15 answers total)

I recently stumbled onto a resource called Care Patrol when a hospital discharge planner hooked me up. They helped me find and tour multiple places in one pressure-filled week based on criteria I gave them. They make their money on a commission paid by the place you select. You pay nothing, even if you don’t select any of them. They appear to have a branch in Albuquerque.
posted by ImproviseOrDie at 10:47 PM on August 31, 2022 [1 favorite]

Best answer: Get on a list somewhere IMMEDIATELY. They can be years long, especially for what he’s looking for. In a mid-size city there are really only going to be a few places and your best bet is to go and tour them and see how they are. It’s pretty immediately obvious when you get somewhere if the people are happy to be there and well taken care of. But truly, my grandparents got on a list in their mid-70s and moved in 6 years later when a unit became available. If you wait until he’s ready to move, he’ll be stuck with something he doesn’t like or isn’t appropriate to his needs. Call the 5-10 places that seem likely, ask their prices and how they deal with long term care insurance (directly is best) and go see the ones that are in the price range.
posted by Bottlecap at 11:45 PM on August 31, 2022 [9 favorites]

Has your father actually expressed interest in living in such a place? From the way you phrased this it's not totally clear.

Maybe he would rather stay in his own home. If he's having problems with stairs maybe he could just move to a place with no stairs, or, if he doesn't move, his current home could be reconfigured so that he doesn't need to go up stairs.

If your father really does want to move to some sort of senior housing what amenities does he want? For instance, I have friends who live in one and use its golf course a lot. Do any of his friends live in senior communities?
posted by mareli at 1:29 AM on September 1, 2022 [1 favorite]

We did this last summer. I did a bunch of preliminary research, asked neighbors, posted on NextDoor (surprisingly, got some great info) and made a list. My parents went through the list, studied the websites and then we toured a few that looked promising. They ended up choosing the first one we toured and are extremely happy. It was a big decision and transition but I’m glad that we did it when we did. They are enjoying being more social and having less to worry about in their day to day lives. Good luck!
posted by pearlybob at 3:01 AM on September 1, 2022 [1 favorite]

Response by poster: Has your father actually expressed interest in living in such a place?

Trust me, I have my dad's permission for this. There would be multiple benefits.
posted by NotLost at 6:22 AM on September 1, 2022

Best answer: We did this recently. My best advice is to make sure you visit in person, unannounced in addition to scheduled, ask to talk to the family of some residents, and understand that the entire world is understaffed right now.

One thing that played in our favor is that my dad's place (a large former hotel - it is actually where people stayed for our wedding 17 years ago!) is owned by a group of people who own this and two other sites. It isn't a huge corporation. This meant a lot of flexibility - in terms of setting up what he he needed. For example, they have set "levels" of care where you get help with things like showers and daily checks and whatever. None of them were quite what we needed so the director just created a new package. Likewise, there were only two keys to dad's apartment but he has five kids - instead of having to let us all in all the time they let us put a realtor key box thing near his door so we can come and go as we please. We have the cell phone number of all the people there. One or two of his kids see him every day.

And still things get missed sometimes. Last week he fell and didn't remember to push his button. One week they spilled bleach all over his laundry. The food is great, they keep him and his apartment clean, there's lots of activities (even if he doesn't partake) and they keep his meds correct.

Oh, the other issue we had when we moved him in is that the cable didn't include the regional sports network.
They eventually got it after much complaining, but the resulting set up was such a huge change for him that he can't always find what he wants. My dad is 88, has hearing and slight memory issues - I wish we had moved him earlier so he could adjust when he was still willing to deal with change better, if that makes sense.
posted by dpx.mfx at 6:46 AM on September 1, 2022 [2 favorites]

I would start with A Place For Mom. They were very helpful, and free. I would definitely also physically visit, take the tour, not necessarily listen to the sales people. Try to go around lunch time or dinner time - sometimes they will give you a free meal and you can judge what kind of food they serve (IF dining is one of the amenities of course). Try to look at baseboards, use one of the public restrooms, and glance around to see if there are cleanliness issues or issues with maintenance not being taken care of. If your state government has an elder care ombudsman or similar there should be a way to see a report of complaints and how they were fixed - ask the A Place For Mom rep about it, they can probably tell you how to get it.

IF he moves in, remember not to visit at the same time every day/week/month. Show up at random times to get a true picture of how the staff is. For one in-law, we showed up one night after shift change. We had to ask a question at the nurses station, which is also where all of the CNAs signed in/out. We discovered that all incoming shift members were signing in _and_ out when they arrived, which meant that some of them were slipping out early all the time. It's a big temptation for them because things get really quiet when everyone's in bed by 9:30, _but_ they are supposed to be there in case of emergencies, too! The point being, with random visits they don't know you're coming so they don't have fair warning to be on their best behavior.
posted by TimHare at 10:34 AM on September 1, 2022

Best answer: Also recommend A Place For Mom, they are a good start to get you connected with a variety of places near you. No commitment at all.
There is a huge variety of places in size, amenities and cost. From thousands of residents in an all-inclusive luxury resort to a couple residents in a private home. Tour them with your father and listen to the spoken and unspoken feedback as to what kind of place feels comfortable to both him and you.
May not apply to you, but perhaps to others reading this post - if they have served in the military during war-time, and have little income/assets, look into Patriot Angels for assistance navigating the VA Aide & Assistance benefit. It will pay for itself in a couple of months.
posted by Diddly at 10:55 AM on September 1, 2022 [1 favorite]

I do NOT recommend A Place for Mom and in fact would strongly urge you to avoid them. They are free because they work on commission from some big chains and they will never help you out with anywhere that is not in their network. I tried them and looked at several places I did not like. They got very hard sell and difficult to deal with. I found a wonderful place through word of mouth that I would never have known existed if I'd relied on A Place for Mom.
posted by mygothlaundry at 12:39 PM on September 1, 2022 [2 favorites]

Sorry, meant to add: ask everyone you know and yes, post on Nextdoor, on Facebook, on all your social media. Word of mouth is really the best way to find a place. Then, make a list of every place you hear about and some you don't that look good online and visit them all. You can tell pretty quickly what's good and what isn't. One thing you do want to check into is whether they have a skilled nursing wing onsite or if they rely on other local resources. When my mother fell and smashed her pelvis she was able to stay in their skilled nursing rather than begin shuttled off to another place. Also check to see how they handle hospice and end of life care. It's better to go in knowing what to expect rather than being blindsided.
posted by mygothlaundry at 12:43 PM on September 1, 2022

Best answer: One thing we found helpful when looking for assisted living places and nursing homes was the they are licensed by state and you can look up the record.

I realize you are looking for independent living but if you want a place with continuity of care then you should definitely check the public record as part of your search.

When we were looking for a board and care facility (small home based care for up to six residents), I started with the list for our area and quickly saw that there were about a dozen that had fewer than ten violations while others had many, many more, even when adjusted for size. It gave me quick way to limit the search (especially since the smaller board and care could be hard to find). I then called to see how had openings and visited all of the ones on that short list.
posted by metahawk at 2:11 PM on September 1, 2022

Yes, groups like "A Place For Mom" work kind of on commission (that is, they are paid by the community your parent ends up in, and are very clear about that up front, in my experience). However, we were in a difficult spot with my mom and had no clue about options, and the service we found was caring, transparent, and led us to a very good facility. As difficult as it was, it would have been a nightmare without them. We were caught rather flat-footed because the independent living/assisted living place my mom moved into several years earlier (voluntarily) had no openings in assisted living when her cognitive state deteriorated quite suddenly, and the memory care she ended up needing within six months was never added as planned.

One thing that was always made clear to us that where my mom ended up was not necessarily a permanent situation, and there's no "minimum stay" required. Often if you're in a difficult position, finding a temporary living situation is necessary, and rent/care services are paid month-to-month. You can always use word-of-mouth to find something better later.
posted by lhauser at 7:45 PM on September 1, 2022

Response by poster: Thank you for all the helpful input! I am looking into your suggestions, including that state licensing.
posted by NotLost at 8:07 PM on September 1, 2022

I also wanted to add that when I was shopping around for my folks, I was surprised at how many different payment models there were, and with some places with seemingly very similar features and amenities charging quite different prices. Many high-in-demand facilities require a kind of annuity model, where you pay a large lump sum investment up front to join and keep a spot in the community. They subtract a monthly fee and then refund a graduated portion if your family member dies within certain time period. These models tended to be more "all inclusive", so there are pros and cons to that. Other places had a simpler rental model, with an annual lease, breakable upon death, and monthly rent and fees. Still other places offered a kind of hybrid of the two models, with a smaller membership investment, but more monthly rent/fees. In addition to the different payment models, some of the companies are nonprofits, others are not. That may or may not influence your choice. It all makes comparison shopping a bit challenging. We ended up going with the place that seemed to have the most transparent model, which ironically was a corporate-run facility, compared to two others in the running that were nonprofits, but had much more complex pricing models.

There are places you can look for rankings. US News and World Reports publishes a list of the best senior living communities. They seem to list nearly all providers, but note which ones have received an award ranking. JD Power also provides reviews and rankings, but I think the provider has to subscribe to this measurement service, so you won't see the smaller nonprofit organisations listed. I wouldn't go solely based on these type of listings, but they do offer another data point when comparing facilities.

We started looking for a place for both of my parents, and then my mother passed away before we could make that happen. We moved my dad after he was widowed. There was a waiting list at our top choice place, but it turned out to be only a few months. (The grim reality is that vacancies come up all the time*) so it just depends how long the waiting list is. He wasn't that happy about the move initially, but "independent living" (which is a bit of a euphemism, because they are surrounded by supports) really did increase his independence. Eventually as his needs increased, we started adding drop-in supports. This is also something to check into. By using the casual supports from an outside company, we were able to extend the amount of time he was able to stay in independent living probably by at least a year. It created a kind of middle tier, in between "independent" and "assisted".

The facility had a relationship with a couple of external providers for these services, which made it very easy and more cost effective for us, because different residents could pool supports. Most of the visiting support agencies have a 2 hour minimum, and my dad never needed two consecutive hours of anything, but this way, his aide could spend a total of 12 hours with him a week, dropping in for 30-60 minutes each morning and afternoon, while supporting other residents in the same building. The scale of clients in the building made this possible. I mention this because the independent living + 12 hours external supports was still cheaper than assisted living, and it was fantastic to have that option. Not every place we looked at allowed external companies to come in, so it's a good thing to ask about.

Like you, we were attracted to the continuing care communities where there was a range of support levels offered, making it possible to progress from independent living to assisted living to nursing. My father (who died earlier this year) had dementia as well as his health issues, so we wanted to find one place with many living options so that he could stay in the same surroundings. In the end, however, we did move him at the point he required assisted living, because the assisted living at his first community required that he move into a 1-room studio with no kitchenette. We found a different facility that had an assisted living offering with 1 BR studios with a kitchenette, which was a better fit in maintaining some independence for him. He still liked to be able to make his own coffee and having 2 rooms felt less institutional.

It may seem like a small thing, and it's not clear whether you live nearby and will be able to visit regularly, but check the internet provision for the places you consider. Some places have very minimal packages, based on the assumption that residents are mostly watching tv (ie, wifi in shared spaces only, or with very weak connections in rooms). Good internet was a lifeline to our dad during covid shutdowns. Hopefully the experience of the pandemic will have encouraged all the providers to take internet strength, speed and reliability more seriously. Crappy cable packages are also something to look out for, as dpx.mfx mentions. At my dad's second place, they had a combined phone/cable/internet package with Privatel that used VOIP, and it was terrible. Every time the internet went down (which was often), he lost his phone connectivity (he wasn't cognitively able to use a cell phone by this point). It was very scary and upsetting to him when he couldn't reach us, and we couldn't reach him. The communications and entertainment package is very important, and *none* of these places have any kind of dedicated tech support.
posted by amusebuche at 7:44 PM on September 3, 2022 [2 favorites]

* Black humor story to share. When we had narrowed down our decisionmaking to one candidate continuing care community, we made a number of visits, both with and without my dad. When an apartment finally become available after a couple of months on the waiting list, we took my dad over to look at the empty apartment before we signed the lease. After the viewing, we were standing at a bank of elevators talking to the sales rep and waiting, when one of the elevator doors opened, revealing two paramedics with someone on a stretcher zipped into a body bag. They blinked and said nothing while the sales rep momentarily stopped in the middle of a sentence, and the elevator door closed again. We looked at each other, and then at my dad, who seemed to be looking in another direction and hadn’t noticed, and then the sales rep picked right up where she left off and nothing was said about what we had just witnessed. But it basically summed up how the whole end-of-life living situation works. It was a moment when I really wished my mother was still alive and with us that day, because she would have found enormous humor in that awkward and chastening moment, and I imagine there would have been tears of laughter when we got back to the car.
posted by amusebuche at 7:45 PM on September 3, 2022