Tips for Choosing Retirement & Assisted Living Communities

Many options await you. Here is a list of different types of senior housing along with definitions and questions to ask to help in your decision-making.

Retirement community options range from completely independent lifestyles through skilled nursing care. Features can include housekeeping service, from one to three meals per day in a common dining area, organized recreational and social activities, van rides to grocery, medical and other appointments, and safety features such as call bells for assistance. Facilities range from basic apartment complexes to campus style, park-like or luxury hotel style settings. Entrance fees and monthly costs vary tremendously. Care options range from very little care for healthy, independent residents, to help with daily living needs for frail individuals, to complete nursing care. Some facilities specialize in treating people with Alzheimer's or other memory problems.

Independent Retirement Apartments/Communities: Month-to-month rental facilities feature independence for seniors. This arrangement allows you to enjoy an active, independent lifestyle in a community setting with organized social and recreational opportunities, but allows you to move quickly when your needs exceed the services offered. Facilities are usually apartment or condo style units, although cottage-style living options are growing in popularity. They come with complete living units: kitchen, bedroom(s), living room and bath.

Assisted Living facilities offer independent, community style living such as described above, but also offer more care with 24-hour nursing supervision for help with needs such as medication, bathing, getting dressed and laundry.

Nursing Homes provide skilled nursing care for people who cannot live independently. These facilities offer substantial day-to-day care, have 24 hour nursing and an attending physician.

Continuing Care Communities are designed to meet residents' needs from the active, independent lifestyles experienced in independent retirement communities, through assisted living, to skilled nursing care all on site at the same facility.

Adult Care Homes provide housing, meals, and one-on-one assistance with activities of daily living. They are single family homes in residential areas, usually licensed for four-to-six residents.

Some considerations when choosing a retirement community:

Cost -- According to the U.S. Department of Labor, no more than 60% of your income (or combined income for a couple) should go toward supporting you in a retirement community. Consider entrance fees and monthly costs. Is this a non-profit or for-profit facility? Are any subsidies available? Do you have long-term care insurance, pension benefits or other resources to help with these costs? Be sure you know all services that are (and are not) provided for your monthly fee.

TIP: Total all of your current monthly expenses including housing costs, food, home maintenance, utilities, real estate taxes, housekeeping and other housing expenses and compare to the monthly expense at the community you're considering. Make sure you know what the contract covers in terms of services and meal plans.

Services - What is the full range of services available, which of these are covered in the basic fee and which are extra? Do you require help with any day-to-day activities or housekeeping chores? Fully consider all services or assistance you need now or may need soon when selecting a facility. Make sure you fully understand the contract and what it covers in terms of services.

• What is covered in the upfront fee?
• Would you (or your heirs) get any part of your upfront fee back if you move out?
• Make sure you understand the change in monthly fees should you start in independent and move to assisted living.
• If married, will you have to pay more in monthly fees if your partner needs assisted living and you want to keep your apartment?
• Consider having an attorney look over any contract before you sign it.

Transporation & Medical Services -

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Consider how frequently you need to keep medical appointments and if the community transportation schedule meets your needs or offers alternatives. Will you be able to keep your current doctor or will you need to find a new one closer to your new home? Can you transfer your prescriptions and does the new pharmacy accept your prescription coverage plan?

Meals -- Do you have special dietary needs? Do you like the menu? How often are meals served and what meals are included in the fee? Are snacks available during non-meal hours?

Activities -- Does the facility offer the types of activities and programs that you enjoy? Check out their full schedule.

Location -- Is the facility convenient to friends, family, and the activities you enjoy?

Walking & public transportation opportunities -- Although many communities offer transportation for shopping, medical appointments and excursions, is there a nearby bus stop? Check out walking trails and routes in the neighborhood. Is there a nearby library and other services that are important to you?

Affiliations -- Does the facility have a religious, fraternal or governmental affiliation?

Pets -- Do they accept pets?

Make a list of your criteria and questions, and visit several facilities that seem to meet your needs. Bring a friend or family member to compare notes and help ask questions. Use your senses - do you like the looks of the place? How does it smell? See if you can have a meal at the facility and attend some scheduled activities. Ask about the management, their experience in the business, their track record, and check out their reputation at this and any other facilities they manage. What is the staff-to-resident ratio? Does the staff seem harried or irritable? (might be a sign of understaffing). How long has key staff worked there (administrator, head nurse, social worker, marketing person)?