Assisted living (AL) is a residential option for older adults who are too frail to live independently, but do not need the 24-hour skilled nursing and medical services of a nursing home. AL facilities offer a combination of supportive, personal, and health-related services designed to maximize your loved one’s independence, privacy, dignity, choices, and safety.

Facilities typically provide three meals a day in a common dining room; housekeeping and personal laundry services; assistance with bathing, dressing, and toileting; 24-hour security and staff availability; social and recreational activities; access to health and medical services (free transportation may or may not be included); and medical supervision or assistance.

Costs vary with the type of unit and intensity of service needed by the resident, and may include additional charges for special help.

What to Look For

When considering a particular AL facility, ask for written material, particularly the "resident" or "service" agreement that describes, at a minimum, the services, prices, extra charges, admission, retention and discharge criteria, staffing, programs, and services. Think about your current and future health needs and interests and ask about continued eligibility if your health deteriorates. In most facilities, a new resident will retain his/her community physician, who performs the pre-admission and ongoing assessments that the person is eligible and can safely reside in an AL facility.

What to Ask

Be sure to ask the following questions:

• Are registered nurses on-site?
• What kind of medication assistance is provided?
• Are the services of a rehabilitation therapist provided or arranged?
• How many staff members are awake and available at night?
• Is there is a resident council and a complaint or grievance process?

Find out if the facility is affiliated with a particular hospital or nursing home and if there are reduced charges while temporarily out of the facility for medical and/or skilled nursing care.

What to Observe

Visit a prospective facility several times and at different times of day. Look at its décor, try to get a sense of the atmosphere, staff warmth, residents' appearance, overall cleanliness, and absence of unpleasant odors. Get a sense of the floor plan and whether hallways, doors, and elevators can easily accommodate wheelchairs or walkers.

Go into the dining area and observe the presentation of meals for variety of foods, attractiveness and amount, and availability of staffassistance. Can the door to a resident's apartment or unit be locked? Observe whether residents can bring some of their own furniture, hang their pictures, have a telephone and have a private bathroom. Find out the rules regarding smoking, eating in the room, overnight guests and pets.

Assisted living is a lifestyle change. It is similar to moving to a new neighborhood and has all the complexity and anxiety associated with a new physical, social, and cultural environment. For more information and guidance on choosing a facility, visit www.aarp.org, www.alfa.org, and www.ncal.org.

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