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What to Know When Choosing an Assisted Living Facility

Tips and advice to help caregivers find the best fit for a loved one


people at an assisted living facility
Getty Images

There may come a day for your loved one when living independently is no longer the best option. Perhaps they struggle with daily activities such as bathing, dressing, making meals or managing medication, or a lack of mobility leaves them feeling isolated and alone.

“Most Americans want to stay at home for as long as possible. But the reality is that there comes a time when an individual’s health needs can no longer be met at home,” says LaShuan Bethea, executive director of the National Center for Assisted Living (NCAL), the assisted living arm of the American Health Care Association.

Selecting the right assisted living facility is a major decision, with many factors to consider, including your loved one’s preferences, health care needs and budget. By beginning your research before a move is necessary, you can avoid a rushed decision if a transition to assisted living is needed sooner than anticipated.

“Starting the search early allows time for financial planning, can relieve some of the anxiety and build confidence when it is decision-making time,” Bethea says.

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Here’s what you can do to support family caregivers:

The earlier you search — and the more informed you become — the easier it will be to spot red flags and sidestep potentially troubling situations so you can find a home that truly meets your loved one’s mental and physical needs.

To guide you through the process, AARP gathered advice, answers and insider insights from experts in the assisted living space. Here’s what to know:   

How does assisted living work?

Assisted living is a middle ground between independent living and full-time care, such as in a nursing home. Facilities range from small, intimate settings to sprawling communities with amenities like pools, fitness centers, salons and multiple dining options. Some have fewer than 10 units, while others exceed 100, averaging 37 units.

Some communities offer tailored care for specific conditions, such as memory care units dedicated to individuals with Alzheimer’s or other forms of dementia.

What does assisted living provide?

Assisted living typically offers residents a private room, three meals a day and around-the-clock supervision and services such as housekeeping and laundry, medication management and personal care help with tasks like bathing, dressing and using the bathroom.

Many also provide exercise programs, transportation services and social activities.

“Assisted living communities offer a unique mix of companionship, independence, privacy and security in a home-like setting,” says Bethea.

What are some pro tips for evaluating assisted living?

Just because an assisted living facility has an impressive website, comes highly recommended or makes a great impression during your visit doesn’t mean it’s the ideal fit. It’s critical to dig deeper. Here are some of the top things to keep in mind and key actions to take.  

  • Be aware of sales tactics. The person you speak with is likely a marketing or sales representative, even if their title is “community liaison.” Their job is to promote the facility, so ask detailed questions and don’t rely solely on their presentation.
  • Look into leadership stability. Ask how long leaders like the executive director and director of nursing have been there. Assisted living ownership is shifting from medical providers to real estate investors, notes Laura Vaillancourt, founder of counseling and care management firm Eldercare. In turn, many facilities are becoming more business-focused than health care–focused. As properties are bought and sold, it can be disruptive to employees, residents and families.
  • Review an organization chart. Understand the facility’s structure, from the director of nursing to the laundry manager, so you get a clear idea of how the facility is run and whom to contact for specific requests. Also, ask who your primary points of contact will be and how often they will update you on your loved one.
  • Cross-check referral agency recommendations. Agencies may receive compensation from facilities. So, while they can be helpful, watch for potential conflicts of interest. Always do your own research on the facility as well.
  • Ask about the staff-to-resident ratio. Learn how they handle staff shortages, such as whether they use a temp agency.
  • Capitalize on the pre-entry assessment. Before admission, a nurse or another staff member will likely assess your loved one. This is a prime opportunity to confirm the facility can meet your loved one’s needs and verify any claims made.
  • Ask what happens if your loved one runs out of money. See if the facility has a Medicaid contract, and if so, get details on how it works with Medicaid.
  • Do a trial stay. If you are considering a facility, ask if your loved one can spend a few nights there so they can experience daily life before committing.

What are the advantages of assisted living?

  • Autonomy with support. Residents get access to needed care in the privacy of their own living quarters. 
  • Social engagement. There is communal dining and access to activities like book clubs, movie outings and trips to local events.
  • Fewer household responsibilities. Included maintenance, housekeeping and laundry services reduce the hassle of doing everyday chores.
  • Improved health outcomes. Exercise programs, social engagement, nutritious meals and continuous care can improve well-being. According to research from the National Investment Center for Seniors Housing & Care and NORC at the University of Chicago, residents in senior housing have lower rates of emergency admissions for issues like injury, COPD, dehydration and UTIs.
  • Peace of mind for caregivers. Caregivers get a reprieve and the knowledge that their loved one is in a supportive environment.

What are the disadvantages of assisted living?

  • High costs. Expenses vary based on the level of care, amenities and location, yet the median annual cost was $70,800 in 2024, according to the insurance company Genworth. Most residents pay with personal savings or long-term-care insurance.
  • Limited federal financial assistance. Medicare doesn’t typically cover assisted living, and Medicaid support depends on your state. (Contact your state’s Medicaid agency or Area Agency on Aging to learn more.) Veterans may get help through the Aid and Attendance benefit, although that covers only additional services, not room and board. (Contact the VA pension management center that serves your state or your regional VA office for details.)
  • Less personal space. Residents have private rooms but share common areas. They may also need to adjust to a smaller living space than they had previously.
  • Adapting to a new environment. Residents leave behind familiar surroundings and need to get used to new routines and facility rules.

How do I find the best assisted living facility for my loved one?

Involve them in the research and decision-making process whenever possible, says Vaillancourt.

They may prefer a smaller, quieter community, a larger social setting or a room with a view of nature over access to more activities. Knowing your loved one’s preferences can make finding the right place easier and the overall transition smoother.

Throughout your search, keep AARP’s policy guidance in mind: “Supportive housing should promote residents’ autonomy and decision-making while ensuring high-quality services. Consumer protections should ensure safety, encourage a home-like atmosphere and offer an individualized approach that ensures personal dignity and autonomy.”

Steps to find the best assisted care facility for your loved one  

Get organized. Create a central area to keep your research, such as a notebook or spreadsheet. (AARP’s Caregiving Checklist is a helpful tool.)

Do online research. Here are some resources that can help you find facilities to consider:

Seek recommendations from friends, family and health care providers with relevant experience. Vet each suggestion; what works for someone else may not suit your loved one.

Call the facilities. Remember, the person you speak with will most likely be a marketing or sales representative, so be prepared to probe for detailed information.

Here’s a list of questions to get you started.

  • What personal and health care services are included?
  • What additional services are available if health care needs change?
  • Is specialized care available for Alzheimer’s or other conditions?
  • How are written care plans created? Are residents and their families involved?
  • What unit types and sizes are available?
  • Are all rooms private, including bathrooms?
  • Do any units have kitchens or kitchenettes?
  • What personal belongings, like furniture, can residents bring?
  • What are the entrance fees, monthly rent and security deposits?
  • Can I review a sample contract outlining fees, services and policies?
  • Under what circumstances could a resident be asked to move out, and how much notice is given?
  • Is a resident’s space held if they need to be hospitalized?

Make a short list of facilities to tour

“Touring a community is extremely important in the selection process to ensure families and residents get a good idea of what to expect, meet staff and see firsthand what a loved one will be experiencing,” says NCAL’s Bethea.

Take your loved one on tours and encourage them to ask questions. Visit each facility multiple times, including mealtimes. Ask residents about the benefits and drawbacks and what they wished they knew before moving in.

Closely watch how staff interact with residents. Ask about their qualifications and ongoing training and whether staffing levels are sufficient for residents’ needs. Find out how the facility handles suggestions and grievances and if it has resident and family councils that provide feedback.

Also, ask staff if they feel supported by management. When the staff is happy, that trickles down and can help make your loved ones happy, says Vaillancourt.

Here’s what to keep an eye out for during your tour:

  • Cleanliness
  • Emergency generator or backup power
  • Ample common areas such as dens, living rooms
  • A logical, easy-to-navigate floor plan
  • Rooms large enough for your loved one’s needs
  • Handrails and call buttons in rooms and bathrooms
  • Safety locks on doors and windows
  • Security and fire safety systems
  • Well-lit stairs and hallways and clearly marked exits

What should I know before signing an assisted living contract?

Once you’ve narrowed down your options, the final step is crucial: Scrutinize the facility’s contract.

Comparing the costs

The median annual cost of assisted living vs. other types of long-term care:

Assisted living: $70,800

Nursing home, private room: $127,7550

Nursing home, semi-private room: $111,325

Home health aide, full-time: $77,792

Adult day care: $26,000

— Source: Genworth Cost of Care Survey 2024

Join Our Fight for Caregivers

Here’s what you can do to support family caregivers:

Take it home, review it with family and ensure it includes everything promised. Make sure you understand all fees, service levels, policies and what happens if your loved one’s finances change or they require additional care. Get any unclear points clarified in writing before signing. (AARP’s checklist details what to look for in the contract.)

Be aware of arbitration clauses, which require a third party to settle disputes outside the court system. These clauses can limit your legal options. Consult a lawyer for professional feedback. The National Academy of Elder Law Attorneys has a searchable, national database of practitioners who can help.

Do a background check

Licensing and certification requirements for assisted living communities are set and enforced by each state. NCAL provides details on regulations for every state and the District of Columbia, as well as contact information for each state’s regulators, who can guide you on how to find information about a facility.

If your state requires a license, verify that the facility has one and ask to review the most recent licensing report. State licensing agencies may also have online databases to view facility complaints.

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