Choosing the right assisted living residence involves evaluating a number of factors, many of them intangible. It is important not to judge on first impression, since a home with elegant furniture may not always offer the best care.

Consider using a checklist as you assess the different options available:


  • One of the first things to consider is basic safety. Some safety factors are readily apparent. For instance, the floors should be clean and be composed of materials on which residents will not easily slip and fall.
  • Whether or not there are handrails along the walls, and especially in the bathrooms, is another feature that should be present.
  • Fire extinguishers should be visible, and there should be an exit plan posted, and fire drills should be held at least four times a year. Make sure that the exits can be reached easily.
  • At the very least, there should be an emergency call system in the bathroom.
  • Many assisted living residences provide alert buttons that are worn around the neck or on wrists, so that the residents can summon help in case of emergency.

General Atmosphere

  • Try to gauge the general atmosphere. The staff members should be friendly and respectful of the residents and residents should be interacting socially with one another.
  • Do the staff members respect the privacy of the residents? For example, staff should knock first before entering a resident’s room.
  • The residence should be clean and not have any detectable odors.


  • There should be activities planned on a regular basis, both onsite and outings to other places. You might check if there is a schedule of activities posted.
  • Activities should be varied to cater to different interests. Consider your loved one’s particular interests. Ask the residents what they have done lately.
  • There should be some activities planned that younger family members can participate in, so the whole family is likely to come and visit.

Staff to Resident Ratio

  • Staff to resident ratio will vary depending on the amount of care required for the residents. The usual ratio is one staff member for every 12 residents.
  • Residences with seniors that require a lot of nursing care may have one staff member for every three residents.
  • Several states require there to be one staff member for every 25 residents at night and for every 15 residents during the day.


  • The hallways and doorways should be wide enough so that people in wheelchairs or using walkers can pass through them.
  • If the residence has more than one story; there should be elevators, so that people with mobility issues can travel safely.
  • Bathrooms and showers should be highly accessible and usable for residents of varying levels of ability and mobility.

Privacy and Comfort

  • Whether or not there is a private bathroom is important to many seniors. If not, determine if the bathrooms are connected to individual rooms, or shared and adjacent to the rooms.
  • The bathrooms should have locks, so that they can be kept private.
  • Ideally, residents should be able to adjust the temperature of their own rooms.
  • Confirm that there are locks on resident apartment doors.
  • Inquire about the policy for entering a resident’s room. In most cases, entrance should require consent in a non-emergency.

Level of Services Provided

  • Since health care needs can change over time, it is important to plan for the future in deciding on an assisted living facility. Determine if the residence will provide more services if your loved one’s health changes.
  • Some residences will have specialized care for Alzheimer’s and other dementia patients, while others do not.

Admissions Agreement

  • Go over the fine print and check the admission agreement of the residence. It should clearly delineate the services provided, the monthly rate, and whether or not there are charges for additional services.
  • Is there a 30 day notice in case the rate changes? Determine if there is a refund policy.
  • One important factor is to determine whether or not the resident can return to the same unit if they need to be hospitalized.

Internet Access

  • Ideally, there should be Wi-Fi access in all of the rooms.
  • There should at least be Wi-Fi in the bistro or other common areas, so that visitors can play games and use computers.

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