Last year we had an article here talking about reasons to consider assisted living. It was more about the needs for assisted living and the potential emotions associated with it by the residents.
This time around we’re going to address issues around assisted living centers that most people don’t know, things that may help you decide if it’s the place you want to put your loved one into. After having to go through the process with my own mother I’m sharing some of what I’ve learned.
1. Assisted living organizations don’t take insurance
Assisted living isn’t a senior care center. The idea is for it to be a place for those of a certain age who can pretty much take care of themselves but might need some minor assistance. Many of them might be older, but that doesn’t necessarily mean they’re not pretty healthy.
Because of this, insurance isn’t going to cover any of the bills; at least not those generated by the assisted living center. They will help coordinate visiting nurse services if requested by a physician, which will be covered by those of Medicare age. Otherwise, it’s going to be totally out of pocket at this level.
2. How much money you have to spend monthly
Believe it or not, this is the 2nd most important thing to know, even moreso than what the monthly rates are. Many of these facilities are going to want to set up automatic withdrawal, which means you need to make sure the resident has the funds to last them for a long time. The income level is going to need to be somewhat significant; don’t even think about looking into assisted living if you can’t spend at least $4,000 a month. This isn’t all “fee” though; I’ll be addressing more below.
3. How much monthly rates are
This is actually the 3rd most important thing to know. Assisted living fees are different across the country and even across your own area. I live in the Syracuse NY area and fees run from between $2,300 and $4,800 a month.
As you can imagine, the least expensive fees are probably in large facilities in urban areas, and the most expensive fees will be in very nice settings with a bit more exclusivity. But wait; there’s more.
These facilities will have rooms of different sizes, from studios to 2-bedroom “suites”. Don’t think apartment sizes for these prices; they’re probably less than half the size of a traditional 2-bedroom apartment.
One that I looked at had what they called a studio apartment which was 100 square feet; that’s the size of a small home office. It didn’t include cable or phone, but it did include heat, and since older people are always cold this might not be a bad feature. Meals and activities will be included in the fees, along with some limited travel and transportation to doctor’s appointments or to the store if you request a small refrigerator in the room.
The more you can spend, the nicer a place you can get, but you’re going to want the resident to have enough spending money to enjoy themselves.
4. How nice are the facilities
Once again this is based on location and price, but even pricey assisted living centers might not be all that nice. There was one assisted living facility that was very spacious and well laid out. It had multiple sitting rooms and game rooms, and even an exclusive room where there was a piano and extra large TV for movie night.
The big spaces can be really nice. Other spaces might seem a bit oppressive. Some residents might end up having to share a room, just like in a hospital, and that’s not always a pleasant experience. Also, some facilities aren’t as clean as you’d hope they would be, especially if they have a lot of residents. Unfortunately, most of the people working in these larger places don’t make a lot of money, so it’s hard keeping quality help.
5. What recreational opportunities do they have?
You like to know that your family member will be mentally and physically engaged instead of having to sit around watching TV. Most of these facilities will offer games, dances, sing alongs and movies, but the larger the places are, the less likely they’ll be in making sure everyone participates as often as you’d hope. Smaller facilities have employees that get to know the residents pretty well, and in those cases the residents will be encouraged to participate in these things more often. By the way, this one comes from talking to residents of different facilities and their experiences.
6. What are the meals like?
Some assisted living facilities have almost world class chefs and fancy meals and desserts. Some will have standard comfort food, while others might have sandwiches and one daily special for lunch or dinner. No one will starve, but the food might not be all that flavorful since dietary concerns become the norm.
Also… well, this one’s not quite fair, but it was an observation I had at one facility. There was a large dining room and I was there during lunch. Half the tables had residents who were still in their night clothes or robes, and sitting at tables either ignoring each other or just looking… old. A few tables had great engagement and laughter, but strangely enough those tables were all male. I’m not sure what that says overall but I have to admit that it gave me pause, thinking that my mother might be at a table where no one was talking or showing any life.
7. Are there hidden fees?
This one is the most important thing you have to find out about. Many facilities will offer different levels of care based on tier pricing, in which case you know what’s going on up front. One of the facilities I looked at gave us a price list of extras, and some of them seemed a bit outrageous. Since they determine which extras your family member might need to receive, it’s possible that your monthly bill could end up being as much as 300% higher than the actual monthly rate… being automatically withdrawn without your prior approval. That will eat up savings pretty quickly.
Truthfully, it was this last one that convinced my wife and I to move my mother into the house with us. It’s turned out to be the smartest move, and we can make sure that her money is safe and that she’s well taken care of.
Most people will have to think about assisted living at some point in their life. I hope this has been helpful.