NEW YORK (CNNfn) - It's one of the toughest decisions you'll ever have to make: moving yourself, or a loved one, into an assisted living facility.
Finding the right facility, however, can help make the transition easier, not to mention saving you headaches down the road. It just requires doing some homework and being a smart consumer.
"It's important to be a smart shopper and to make sure the provider you are considering specializes in whatever it is you think you will need," said Whitney Redding, of the Assisted Living Federation of America (ALFA). "You should also make sure they can handle your needs as they change and your abilities change. It's important to find a provider that is flexible."
Assisted living, the fastest growing form of housing, falls under the category of long-term care. As defined by the National Center for Assisted Living (NCAL), these facilities provide a combination of housing, personal services, and health care designed to respond to individuals who need help with normal daily activities.
They also place a premium on giving residents personal space.
"That's the thing that was sorely missing in earlier long-term care models," Redding said. "Some residences specialize in Alzheimer's patients, some are in suburban areas and some are converted homes run by families. But what unites them all is the fact that they are residential, not institutional. They share the philosophy of care that emphasizes independence, privacy and dignity."
NCAL's latest survey of the industry estimated there are roughly 28,000 assisted living facilities in the United States today, housing some 1.15 million residents. The numbers, it said, are consistent with data from a 1998 Health and Human Services Department report.
The level of care required by these residents is tough to pin down. To give you a rough idea: 26 percent need no help taking care of their daily living activities. However, the average resident requires help with about 1.7 daily living tasks, NCAL said.
The average age of assisted living facilities' residents is 83 and nearly three quarters of them are female.
Costs run the gamut and largely depend on the size of units, services provided and location of the facility. The NCAL report revealed that 49 percent of all assisted living facilities charge between $1,001 and $2,000 in average monthly rent and fees.
About 26 percent charge between $2,001 and $3,000; 7 percent charge more than $3,000 each month; and 18 percent charge less than $1,000.
"Assisted living hits what the consumer wants," said Robert Greenwood, a spokesman for the American Association of Homes and Services, explaining the industry's growth. "It offers an independent living environment with access to supportive services."
Finding the right facility, the one that best meets your needs, is critical.
You'll want to begin by identifying the assisted living facilities nearest your house, or the area in which you want to live. Give each of them a call, ask about their fees, staff, amenities and the types of care they provide.
If you have immediate medical needs or assistance requirements (or expect to in the near future), ask whether their care givers will be able to accommodate you.
Eliminate from the list the residences that do not work for you and set up appointments to meet with the staff and tour the facilities of those that do. Bring your family members along for second opinions.
Both the NCAL and ALFA provide a checklist of questions to help you make an informed decision.
Some questions you shouldn't forget to ask include whether the residence has an affiliation with a hospital or nursing home. Find out if they will hold your room for you if you require hospital care - and whether they'll charge you for the empty room.
"I think as far as the consumer is concerned, it's really important to understand what services they are going to receive, since assisted living is not a standardized definition across the country," said Nancy Gorshe, a spokeswoman for Portland, Ore.-based Assisted Living Concepts, an eldercare provider. "The range of services is huge."
She added one of the most common pitfalls is the failure to find out up front what the facilities' rules are. Some have strict anti-smoking polices, others do not allow pets.
"People don't think about that sometimes when they are going through the [decision-making] process," she said. "They have to think about what's important to them. Will they have the freedom to come and go. The philosophy of choice is a very important piece of what they are asking about."
When you show up at the residences, cast a discriminating eye at the upkeep of the grounds, the condition of the building itself and the rooms where residents live.
It's also important to talk with the residents. Find out how they feel about living there and ask how well they like the staff.
Take a look at the facility's decor. Can you see yourself living here? And don't forget to find out what the visiting policy is.
"Anytime you are looking for a new home or apartment you always want to take a look to see whether the people who already live there seem happy," Redding said. "Can you talk to them? Do you feel free and comfortable doing that?"
Next, run down the amenities checklist.
Find out if the facility has an elevator, and wide hallways and door frames to accommodate wheelchairs and walkers - should that become necessary. Does the place provide linen service. How about transportation services to the mall or the doctor's office. Is the lighting good?
Ask if there are any government or private or corporate programs available to help cover the cost of services. And find out their policy on allowing residents to stay there after their medical conditions worsen.
Gorshe said some facilities, not hers, have rules that require residents to seek other housing if they become incontinent or begin requiring hospice services.
Lastly, find out if you will be forced to purchase renters' insurance for personal property in their units.
You may also want to ask if a physician or nurse stops by regularly to provide checkups and if the facility has a procedure in place for responding to medical emergencies.
Since you'll be living in the assisted living facility full-time, don't ignore the food service. Talk to other residents to find out how they rate the menus.
Find out whether all units have telephone and cable television hook-ups and ask how the billing is handled.
Making the pick
From these questions, and the others provided by the trade groups, you should be able to narrow it down to two or three facilities that meet your needs.
It's time to break out the costs. Ask if there's a procedure in place to pay for additional services like nursing homes, when the services are needed on a temporary basis.
Some assisted living providers these days offer payment plans on an a la carte-style basis - which means you pay only for the services you need.
Others, including Assisted Living Concepts, charge residents fees depending on which category of care they fall into. The more help you need, the higher the costs.
Don't forget to ask if the facilities if they have all necessary state license requirements. It doesn't hurt to double check with your state health care regulators, which oversee the industry. While, you're at it, ask if there have been an unusual number of complaints against the provider.
Go back two and even three times to your favorite facilities before making your final choice. And most of all, just follow your instincts. If you feel comfortable during the tours, you'll probably enjoy living there.
--by staff writer Shelly K. Schwartz