As revealed in first part of this article about paying for your retirement, costs for assisted living are increasing. The 2009 national median monthly rate for an assisted living apartment is nearly $3,000. In addition, over the past five years, the cost of assisted living has risen nearly 5% each year. Clearly, paying for your retirement will require planning and resources. In this second installment, details regarding Veterans Administration benefits, Medicare, and Medicaid will be provided.

Veterans Administration Aid and Attendance Benefits
The VA covers assisted living care for veterans and their spouses. Veterans who have served at least 90 days on active duty and at least one day during wartime may qualify for this benefit, commonly referred to as “Aid and Attendance.” This program, run by the Veterans Administration, may pay a maximum benefit of $1,949/month for married veterans and $1,644 per month for single veterans. The surviving spouse of a qualified veteran may receive up to $1,065/month. The income limit for pension benefits is $19,736 per year for a veteran with no dependents; however, this limit can be offset by the cost of out-of-pocket expenses incurred by the veteran including the cost of assisted living care. The communities of Retirement Unlimited, Inc. have more information about this benefit including a DVD that takes you step by step through the paper work, which you may borrow from the Communities.

Medicare
Medicare is a health insurance program, sponsored by the government, for people age 65 or older, for people under the age of 65 who have certain disabilities, and for people of all ages with End-Stage Renal Disease. Medicare does not provide a comprehensive long-term care component and generally does not cover retirement and assisted living costs. However, Medicare may pay for services such as rehabilitation therapies contracted through an agency and provided to the person at the assisted living or retirement community.

Medicare has two parts. The first is Part A or Hospital Insurance. This is the part that most people do not have to pay for to receive coverage. The second part of Medicare is called Part B or Medical Insurance. Most people do pay for coverage under this part of Medicare. Part A provides limited nursing home coverage. If a participant has a three-day qualifying hospital event, Medicare Part A will fully cover the first 20 days of nursing home care. From the 21st through the 100th day, Medicare pays only part of the cost of the stay. The insured must pay a daily co-insurance or co-pay amount which changes yearly. If you choose to participate and pay for Medicare Part B insurance, it will cover a portion of the services received from your doctor. If you have used up your 100 days of Medicare Part A eligibility, Medicare Part B will cover a portion of the services that you receive while in a nursing home. Under Part B, you pay an annual premium and a deductible and then Medicare will pay 80% of the reasonable charges for covered services in a nursing home. For more detailed information on Medicare eligibility, you can go to www.medicare.gov.

Medicaid
Medicaid is available only to people with limited incomes who meet certain eligibility requirements. Medicaid does not pay money to you. Instead, it sends payments directly to your health care providers. Usually a person will be eligible for Medicaid when savings falls below $2,000, although this amount varies by state. Some things are not counted against this savings limit including the value of your home, a necessary car, clothing, household goods or a burial plot. Since Medicaid is a state-run program, different states have different specific eligibility requirements. For example, the Commonwealth of Virginia has an online Medicaid application through the Department of Social Services. If you are a Virginia resident, you can access this application and apply online by going to www.easyacces.virginia.gov . You will be asked to verify financial resources including checking and savings accounts, stocks, property, and insurance. Be aware, however, that it takes between 45 and 90 days in Virginia to process the application to qualify for assistance. You will also need to show  proof of identity, such as a driver’s license, your citizenship papers, and/or social security number. The state will then match your information against federal, state and local records including the Virginia Employment Commission, Department of Motor Vehicles, the IRS, U.S. Citizenship and Immigration Services and the Social Security Administration.

People who meet all Medicaid eligibility requirements except income may be placed on what is referred to as “spend down.” If your income is higher than the limit, but less than your medical expenses, you may be eligible for Medicaid for a limited period of time.

Some assisted living facilities do accept Medicaid payment for a person’s stay. When visiting a facility, you should ask about the availability of Medicaid waivers. If the facility is a participating Medicaid provider, then they must accept the amount that Medicaid reimburses for your stay. In this situation, you would not be billed an additional amount for your stay.

Navigating the financial waters of paying for your retirement can be daunting. However, with information, resources, and a little due diligence, you can have the retirement that you want.

In a 2009 Cost of Care Survey released in April by Genworth Financial, Inc. of Richmond, Virginia, the national median monthly rate for an assisted living apartment was $2,825. This rate can fluctuate dramatically depending on whether the retirement or assisted living community is located in an urban or a suburban or rural area. Additionally, the cost for assisted living has been rising an average of 4.7% annually over the past five years. As these figures demonstrate, paying for your retirement will require some preparation and planning. In the first part of this article about paying for retirement, we’ll provide information about private payment sources, real estate options, and long-term care insurance.

Private Payment – For the most part, the assisted living industry is a private pay business. To pay for retirement in these communities, you would be using funds from your own resources including pensions, retirement accounts, savings accounts, annuities, or investment accounts. You might also use the proceeds from the sale of real estate or private property.

Real Estate Equity Options – The real estate market has been hit hardest by the downturn in the economy. If you were planning to use the monies from the sale of your house or other property to fund your retirement, you may be delaying the sale to await the inevitable upturn in the market. However, when you need the services provided in a retirement or assisted living community, the need is immediate, and you may not be able to wait for the sale of your property. In this case, you do have a few options that you can discuss with a real estate professional or a financial advisor. You may consider a home equity loan, reverse mortgage or a bridge loan. With a home equity loan, you can borrow against the equity you’ve accrued over the years. A reverse mortgage is available to homeowners 60 years or older. It allows you to convert some of the equity in your home into cash. A bridge loan can be obtained if you are awaiting the sale of your house, but need immediate funds for assisted living or retirement costs. A bridge loan is an interest only loan that can help pay these costs until your house sells. Any loan comes with both risks and benefits. It is extremely important that you speak with a professional that you trust before entering into any of these types of loans. You can also check with your state’s Commissioner of Revenue to find out if you might be eligible for any type of tax credit with respect to real estate or property.

Long-Term Care Insurance – According to the American Health Care Association and the National Center for Assisted Living, long-term care insurance can “protect personal assets and inheritance for the family and provide for financial security.” The insurance policy premiums are based on age, health, length of deductible period, amount paid, and duration of the benefits. The premiums can increase with additional options such as higher daily benefits, inflation protection, and non-forfeiture benefits. According to the Health Insurance Association of America, the annual low option premium for long term care insurance for a person aged 50 is about $850; at age 65, the policy would cost $1,800 and at age 79, it would rise to approximately $5,500. Of course, these costs vary by insurance providers. So, it is imperative to speak with a financial advisor or contact your state insurance commissioner’s office for a list of insurance companies who can sell long-term care insurance in your state. In Virginia, the commissioner’s office is located in Richmond. The phone number is (804) 371-9694. Also, if you live in Virginia, you may deduct long-term care health insurance premiums from your state taxes. This deduction can be taken provided that these premiums have not been deducted for Federal taxes. Please consult a tax advisor for full details.

In the next part of Paying For Your Retirement, we’ll discuss the government benefits that may be used toward the cost of assisted living. These benefits include: Veterans Administration Aid and Attendance, Medicare, and Medicaid.

Making good nutritional choices is one of the best things you can do to improve your health. The foods that you eat, according to the article, “Dietary Guidelines for Chronic Disease Prevention,” by J. Shikany, may delay or prevent chronic diseases in later life and may potentially provide years of health, productivity and high functioning. What a bonus! Make good nutritional choices now and reap the benefits for a long time. To do this, you need to know what nutrients are essential and how to incorporate them into your diet. At Retirement & Assisted Living Communities of Retirement Unlimited, Inc., we provide a healthy variety of foods in our dining menu or you can use this information to prepare your own meals in the apartment kitchens in some of our retirement & assisted living communities.

Eating a diet rich in vitamins, minerals, and nutrients may help reduce your risk for stroke, coronary artery disease, type 2 diabetes, and certain cancers. The essentials to look for include: calcium, fiber, iron, potassium, and vitamins A, C, and E. When combined, these nutrients can give you the benefits for healthy aging. Let’s take a look at each of these nutrients and what foods to find them. We’ll also give you a simple recipe for enjoying some of the nutrients.

•    Calcium is essential for bones and teeth as well as the function of muscles, nerves, and glands. Dairy products, of course, are good sources of this nutrient, but so are foods such as collard greens, soy beans, and sardines
•    Fiber comes in two forms: soluble and insoluble. Soluble fiber helps your cholesterol and insoluble fiber is essential for a healthy digestive tract. Good sources of fiber include beans, artichokes, pears, and wheat germ.
•    Iron provides red blood cells with what they need and helps your cells function in top form. Look for iron not only in red meat, but in lentils, lima beans.
•    Potassium helps your kidneys function in a healthy manner and regulates fluid retention. You can find potassium in bananas, potatoes, and dark leafy greens such as spinach.
•    Vitamins A, C, and E help your skin, keep fatty acids from oxidizing, keep teeth and gums healthy, aid in iron absorption and can protect against infections. You can find vitamin A in orange vegetables and fruits like sweet potatoes, carrots, mango, cantaloupe, and apricots. Vitamin E is abundant in dark leafy greens, red bell pepper, and papaya. And, of course, Vitamin C is found in all citrus fruits as well as red peppers and mangoes.

Here is a simple snack that you can prepare that is rich in many of the nutrients that we’ve described. This recipe was taken from the June 2009 issue of Cooking Light. Substitute any flavor of reduced fat yogurt in this recipe. For more healthy recipes for healthy aging, you can check out Cooking Light at www.cookinglight.com.

Blueberry-Orange Parfaits (makes 4 servings)
This snack comes together in a few minutes, if you purchase orange sections from the refrigerated part of the produce section. To make ahead, prepare parfaits and refrigerate, covered, for up to four hours; sprinkle with wheat germ just before serving. The oranges provide fiber, vitamin C, and potassium; yogurt provides protein, calcium, and potassium; blueberries provide fiber and vitamin C; and the wheat germ gives you protein, fiber, vitamin, and zinc.

1 ½ Tablespoons turbinado sugar
½ teaspoon grated orange rind
2 – 7 ounce containers reduced-fat plain Greek style yogurt
2 cups fresh blueberries
2 cups orange sections (about 2 large)
¼ cup wheat germ
Combine the first 3 ingredients in a small bowl, stirring until blended. Spoon ¼ cup blueberries into each of 4 tall glasses. Spoon about 2 ½ tablespoons of yogurt mixture over the blueberries in each glass. Add ¼ cup orange to each serving. Repeat layers with remaining blueberries, yogurt mixture, and oranges. Sprinkle 1 tablespoon wheat germ over each serving; serve immediately

If you prefer someone else to do your cooking for you, then explore our website and see what our communities have to offer. Contact the community closest to you by phone or e-mail or stop by for a visit. Take a tour, stay for a meal, and see what healthy choices Retirement Unlimited Inc. has to offer.

During the process of normal or “healthy” aging, there are natural changes that take place if one is free of any disease. Dr. Adam Gazzaley, MD of the University of California Memory and Aging Center has stated that some changes in the ability to think are considered a normal part of the aging process. Dementia, on the other hand, is not a normal outcome of aging. Being able to recognize the difference between normal aging and dementia in you or a loved one can assist you in determining when additional help or evaluation is needed. When the time comes for the help you need, turn to the retirement and assisted living communities of Retirement Unlimited, Inc for the right care at the right time.

Normal Aging
In normal aging, you can expect a number of skills and abilities to be intact or only slightly different. You will continue to be independent in what are considered daily activities, such as bathing, dressing, driving, and working. You may notice memory loss, but you will be able to give details about those incidents of forgetfulness; and you will be more concerned about this type of memory loss than your close family members. Despite these occasional lapses of forgetfulness, your memory for recent events and conversations will not be a problem. You may notice occasional difficulty with finding the right word that you want to use, but your vocabulary will remain rich. Also, a part of the aging process will be the annoying problem of getting lost in a familiar place. You may have to give yourself a few moments to remember your way (but you WILL remember). As you age, you may still be able to operate your common household appliances, even if you may be unwilling to learn how to use new devices.

Dementia
Now, contrast the abilities and skills of normal aging stated above with what you can expect with dementia. A person with dementia depends on others for those daily activities that will keep them independent. He or she will not be able to recall incidents of memory loss and may only complain about memory problems if specifically asked. These occasions of memory loss will become more of a concern for close family members than for the person. In addition, there may be a noticeable decline in memory for recent events or the ability to maintain a conversation. A person with dementia has considerable difficulty finding and using the right word. The person may use close substitutions for the word he/she wants or may use a description instead of the actual word. The ability to find the right word continues to decline in dementia. The person may lose his/her way in what was very familiar territory and sometimes may take hours to find their way back. Also, a person who has even early dementia will not be able to use common appliances and will be unable to learn how to operate even simple new devices.

Factors to Consider in Normal Aging vs. Dementia
Dr. Adam Gazzaley identifies a number of risk factors for decline that can lead to dementia. He also points to additional factors that can contribute to healthy aging. The risk factors are:
•    High blood pressure, diabetes, poor nutrition and social isolation
•    Heart disease
•    Family history of dementia
•    Stress and depression which negatively affect the healthy aging process
The important factors that will promote healthy aging include:
•    Don’t smoke and limit alcohol consumption
•    Maintain physical activity through exercise that promotes flexibility, strength, and mood
•    Keep up with routine medical care to maintain good health
•    Keep your heart healthy; as the doctor says “What’s good for the heart is good for the brain!”
•    Maintain your social contacts with friends and associates
Retirement and assisted living communities can provide healthy meals, fitness and wellness programs, and social opportunities for seniors.

Some information in this article was adapted from the “Normal Aging” article by Dr. Gazzaley’s. For more research on the normal aging brain, visit http://memory.ucsf.edu/Education/Topics/normalaging.html.

Caregiving is one of the most important, time consuming, rewarding jobs that anyone can do. It is not easy and takes courage, strength, and compassion. You might now be the “parent” for one of your own parents. Or you may be taking care of a spouse. You might be providing part-time care or giving care around-the-clock. All of this caregiving can cause enough stress and frustration to interfere with your own health and well-being. The only way to really care for another person is to take care of you –but how? First, it is important to recognize the signs and symptoms of stress and frustration. Then, you can learn to manage these conditions. The retirement and assisted living communities of Retirement Unlimited, Inc. can help ease the burden of caregiving, even on a short-term basis.

The American Health Assistance Foundation (www.ahaf.org) and the Family Caregiver Alliance (www.caregiver.org) have identified some of the warning signs of stress and frustration. Stress can manifest itself in the following ways:

•    Anxiety or excessive worrying
•    Feelings of hopelessness or powerlessness
•    Anger at inappropriate times
•    Difficulty concentrating
•    Feeling chronically exhausting
•    Difficulty sleeping or sleeping too much

Frustration usually arises from a caregiver trying to change something that is not within his or her power to change. The person that you are caring for may need help due to a medical condition or dementia. Normal daily activities such as dressing, bathing, eating, or taking medications, are more difficult. Over time, these difficulties can result in extreme frustration that may result in unintended physical or verbal aggression toward a loved one or can cause other physical problems for you such as:

•    Headaches, shortness of breath, or stomach cramps
•    Compulsive eating
•    Increased smoking or drinking
•    Lack of patience

Stress and frustration can cause many problems for caregivers, but the good news is that you can take steps to manage these conditions and take care of yourself. Some excellent suggestions from both organizations referenced above can be found in detail on their websites. Here is just a sampling of ideas that you can use:

•    Meditate – Just 10-20 minutes of time can make a world of difference. You can learn meditation techniques from books, CDs, or tapes; or you can just take some quiet time to reflect
•    Exercise – Many studies have shown that any physical activity can reduce stress and promote health. Get outside for a few minutes to walk!
•    Keep a journal – Writing down your thoughts and feelings about the events of the day can help to relieve anxiety and allow you to reflect on the positive aspects of caregiving
•    Make a plan to take time off to be with family or go on vacation
•    Ask for help! Asking for help is not a sign of failure and it allows the people in your life who probably want to help you do so.

I’m sure at this point, you are probably thinking: Ask WHO for help? Make a plan to take a vacation?? I can’t take a vacation; I have to care for my mother/father/spouse!! You can take a deep breath because some retirement and assisted living communities, like those at Retirement Unlimited, Inc. can also provide the help you might need, even on a short term basis (like a two-week vacation!). Explore one of the communities on our website to find a wealth of information about the services that we can provide. Contact a community in person, by phone, or by e-mail and watch your stress and frustration begin to subside. We can help you care for a loved one. All you need to do is ask.

The choices we make as older adults have a direct impact on how well we age and how we feel about aging. Research has shown that lifestyle choices are as significant as genetics and can have an impact on our quality of life regardless of when those choices are initiated [1]. In other words, it really isn’t too late to do something positive for your health and your life! One important lifestyle choice that is showing the most positive outcome for older adults is physical activity [1].

Any adequate physical activity, even if begun in later years, contributes to high physical and cognitive functioning and overall health [2-6]. Research has demonstrated that physical activity contributes to muscle function and tone, flexibility, cardiovascular health, and positive mood and cognition. If those weren’t reasons enough to get you moving, physical activity has also been found to prevent falls and improve brain function even after brain injury [2,4,5]. Physical activity coupled with resistance exercise training has been found to promote muscle functioning in elders through increasing strength, improving flexibility, and preventing muscle loss [7,8]. Now, we’re not talking Arnold Schwarzenegger or even Jack LaLaine bodies, but we are talking about a healthy body that allows you a more independent lifestyle for a longer period of time. Physical activity is the core lifestyle choice and may be the primary factor for promoting optimal aging[1].

Now, that we’ve hopefully piqued your interest, you may be wondering just how to jump into this physical lifestyle choice. Well, have we got good news for you! The American Academy of Family Physicians has stated that it is safe for most adults older than 65 years to exercise. Even people with chronic illnesses like heart disease, high blood pressure, diabetes, and arthritis, can safely exercise. If you have any doubt at all about starting any physical activity, talk with your doctor. Walking, swimming, and bicycling are excellent cardiovascular activities; so is mowing your lawn or planting flowers in your garden. Housework can qualify as exercise, but not channel surfing (as fun as that might sound). The addition of resistance or strength training will increase the benefits of your physical activity. We can pass along to you some easy exercises that you can do at home. These exercises were taken from “Exercise for the Elderly” and more information can be found at www.aafp.org. Each exercise should be done 8 to 10 times for two sets. Remember not to hold your breath and stop immediately if you feel pain:

Wall Push-ups – Stand with your feet slightly apart facing a wall. Extend your arms and place hands flat against the wall; slowly lower your upper body to the wall; push your body away from the wall to return to the starting position. This exercise works your arms and chest muscles.

Bicep Curl – Holding a weight (try soup cans or full spray bottles) in each hand, place your arms at your sides with your palms facing up. Bend your arms at the elbows, lifting the weights to your shoulders and then slowly lower them to your sides. This exercise works the large muscle in your arms.

Chair Squats – Begin by sitting in a chair (it is more challenging to sit in a side chair instead of an armchair). With your feet slightly apart and flat on the floor, place your hands on your hips; lean slightly forward and stand up slowly; hold that position a moment, and slowly return to sitting

These exercises are just a suggestion for a starting point. Do any physical activity that you enjoy and get out there and optimize your life! The retirement and assisted living communities at Retirement Unlimited, Inc. provide a variety of opportunities for residents to be physically active. Contact any one of our communities in person, by phone, or by e-mail for more information.

With the many options out there for your retirement, it can be confusing knowing what choice to make. Many senior housing communities have assisted living options. Some nursing homes have an “assisted living wing.” Some assisted living communities offer independent living. It’s enough to make you want to build a raft and spend your retirement on a small deserted island! We want to provide you with some helpful definitions to navigate through these choices. We can also recommend some deserted islands and really good sunscreen, if you choose that option as well.

Independent Living
When do you want “Independent Living?” You are making this choice usually because you want to and are able to live without any help, but you no longer want (or need) the burden of maintaining your current home. You would prefer to live with other people of the same age and similar interests. You may desire social activities or interesting day trips. You might want to cook some meals, but you also may want the option of dining out without having to drive anywhere. You definitely want someone else to mow the lawn, shovel the snow, weed the garden and water the grass (or at least you don’t want to do so much of it any more)

Where can you find “Independent Living?” One option is found in the retirement housing subdivisions. These can be sprawling campuses with many amenities. With this option, you can buy or rent an apartment/condo/or small “cottage” Many times, these communities require total independence with regard to your health. However, you can also find the option of “independent” living within an assisted living community. In these communities, while you live independently, you also have the option of adding health services as you need them.

Assisted Living
When do you want “Assisted Living?” You make this choice when medical, memory, or aging issues reduce your ability to safely stay in your own home. You may still want the personal privacy and autonomy, but you may need a little assistance. And, honestly, you may also be tired of cleaning, cooking, laundry, and home repairs. Many assisted living communities offer services for personal care. They also may provide housekeeping, laundry, transportation, dining options, and 24 hour supervision. In addition, these communities may have other amenities such as exercise rooms, outdoor gardens, libraries, chapels, or internet access. Assisted living communities frequently base their costs by offering levels of care based on the amount of assistance that you need. Some assisted living communities will allow you to “age in place” meaning that you can remain there even as your health deteriorates. Sometimes, you may find a nursing home that has a dedicated area for assisted living. You should consider this option based on your medical needs, but also on your privacy and autonomy wants.

Nursing Home
When do you want a “Nursing Home?” You make this choice when your health needs require skilled medical professionals (like doctors and nurses) providing services and care on a daily basis. The emphasis in a nursing home is on medical care. Frequently, nursing homes also provide rehabilitation services, allowing for a short term or a long-term stay.

Other Options
There is a really lovely chain of islands throughout the Caribbean that are uninhabited. Choose one with a good coastline and lots of trees for shelter. For long term retirement, we strongly recommend a UVA/UVB full spectrum sunscreen in an SPF 30 or higher. Just a thought: learn to fish and gather before you go. Oh, and bring LOTS of your favorite beverage.

The Internet can be a wonderful source of information when you are looking to retire and find the place best suited to your needs. It can also be an overwhelming source of information that may or may not be useful. Listed below are some of the best and most comprehensive Internet resources to assist you:

Senior Navigator -  This site will help you locate senior housing of all types based on factors such as geographic area, type of living arrangement, specific requirements or amenities. www.seniornavigator.com

Assisted Living Facilities Checklist – This document provides a list of comprehensive questions to ask and consider when touring an assisted living community. www.carepathways.com/checklist-al.cfm

Planning Ahead: A Consumer’s Guide to Assisted Living Facilities – This guide is a comparative checklist designed for consumers and prospective residents. www.longtermcareliving.com/planning_ahead/assisted/assisted8.htm

Assisted Living Cost Calculator – This excellent resource provides help in estimating the monthly cost of all types of retirement and assisted living. www.longtermcareliving.com/planning_ahead/assisted/assisted7.htm

This economic environment makes us even more mindful of the cost of living and our monthly expenses. When you or your parents begin to need additional care, it is tempting to try to save costs by doing the care yourself or hiring services to come into your parents’ home to provide the care. The current conventional wisdom seems to be that it is less expensive to stay at home for as long as possible than it is to move to a Retirement or Assisted Living Community. But, conventional wisdom like that could deplete your emotional AND financial resources faster than you can say, “Curse you, Wall Street!”

It is more prudent to determine the REAL cost of being cared for at home and compare those costs to moving into a Retirement or Assisted Living Community. The first step is to make an objective assessment of the real costs of living at home. Make a list of ALL of your or your parents’ monthly expenses and calculate the total cost. Some expenses are listed below. You may need to add or subtract others based on your personal situation:

•    MORTGAGE/RENT
•    ELECTRIC
•    GAS
•    TELEPHONE/CABLE
•    WATER/SEWER
•    TRASH/RECYCLING
•    MEALS/GROCERIES
•    MAINTENANCE/REPAIRS
•    LAUNDRY
•    AUTOMOTIVE UPKEEP and REPAIRS
•    IN-HOME SERVICES (NURSE AIDES, COMPANIONS, OTHER)
•    TAXES and/or INSURANCE PREMIUMS

When you add up the total you may be very surprised. On average, actual monthly expenses can range from $3,000 to $5,000! If you compare that amount to the rental expense in a Retirement or Assisted Living Community (especially a Retirement Unlimited, Inc. community that includes utilities, telephone, cable TV, maintenance, laundry, housekeeping, scheduled transportation and meals in the monthly rent), you may find that the difference between staying home and living in a community is much less than you think. Combine this difference with the added benefits of increased socialization and amenities that many Communities provide, and you or your parents could very well flourish in this environment more than at home!

So, I ask you again, Is Staying At Home REALLY Less Expensive Than Retirement/Assisted Living?

Adapted from the publication, Choosing An Assisted Living Facility: Considerations for Making the Right Decision, by the Consumer Consortium on Assisted Living. Visit the website for more information at www.ccal.org.

1.    Identify the facilities in your area and plan to visit as many as you can. Use search engines on the internet to identify facilities. Visit the facility’s website and take a virtual tour to narrow your choices. Remember that the closer the facility to your home, the more likely you are to make frequent visits. Be sure to tour the facility and ask the questions that are most important for your physical, financial and lifestyle needs.

2.    Choose your top 2 or 3 choices and return to those facilities to ask more questions. It is important while at those facilities to talk with staff and residents. Ask how long staff and management have worked at the facility.  Ask residents about their experiences living at the facility. If possible, have a meal. Compare the answers to your questions from the different facilities that you visit.

3.    Ask to review the Resident Agreement (facility contract). This document should provide information about services, rates, additional fees, facility and resident responsibilities, admission and discharge criteria, and conditions of termination of the contract.

4.    Review the licensing or certification inspection reports and contact the Long Term Care Ombudsman for complaints about the facility. These reports may be available online. Complaints alone do not indicate the quality of the community. It is important to ask how the complaints were resolved or corrected.

5.    Make an unannounced visit to the facility. You can learn a lot about a community by visiting during meals, in the evenings or on weekends. For resident safety and privacy reasons, you may not be able to tour the community at these times unless accompanied by a staff member. However, observations in the lobby or common areas can be invaluable in your decision.

Use these tips to choose the community that best fits your needs.