When Home is No Longer An Option: Part II

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Visited an Assisted Living Residence

There is no substitute for a visit to facilities when you need to find an assisted living residence. Check out the following:

The Staff

No matter how lovely an assisted residence looks, the quality of life is determined by the quality of the staff. Ask about staffing ratios and training. Observe the staff at work. Do they seem to be enjoying what they are doing, or do they appear harried and stressed? Watch the interactions between the staff and the residents.


Activities are essential for maintaining skills and giving enjoyment.  Look at the activity calendar. Are the offerings appealing? Are the activities scheduled during your visit actually taking place? How engaged do the residents appear to be?

Be skeptical of a calendar that relies heavily on watching television and passive activities. The schedule should include exercise opportunities, and scheduled trips into the community for those who are able. Attention spans among Alzheimer’s patients is limited; it is okay if the time for each activity seems short.

The Residents

Observe the residents while you are touring.  Are they well groomed? Do they seem engaged with the staff, each other, or an activity? How well do you think your loved one would fit into the resident population?

Family Inclusion

Ask about visiting hours and any restrictions on pets and children.  Look for residences that involve families in activities and care planning. Even if your family will not be able to participate in family focused activities, it is a good sign when a residence seeks to have others observe daily operations.

Find out how the residence communicates with families. The staff should be assessing each resident at regular intervals and whenever there is a significant change in condition. The resident and a family member should be invited to participate in the meeting when the resident is being assessed.


If possible, have a meal. Is the food hot and presented in an appetizing way? Check out the menu for the week to get a sense of the diversity of the food. Some people with dementia can independently eat only if the menu includes finger food or food that does not require the use of a knife. Ask about the availability of alternative meals.

The Interior Spaces

Your family will be spending time in this residence. Are there spaces with sufficient privacy for your visits? Are these places comfortable and pleasant? A good design will include a range of public, semi-public and private spaces to accommodate the needs of all residents and families.

Assess the upkeep of the residence. Are common areas clean? Does the place smell fresh? Are the resident rooms tidy?  ind out if residents may bring favorite furniture for their bedrooms to recreate a sense of home.

Interior design and decoration can either support people with dementia or put additional stresses on their ability to function. Many people with Alzheimer’s have problems with depth perception  They are easily disoriented and tend to wander. They need to be in a secured space for their safety, but the security should not be too obvious. Does the residential design reflect an appreciation of these challenges?

Bright lighting, clear signage, and carpeting and upholstery that do not have busy designs make a space easier to navigate. So do circular pathways that enable someone to walk continuously without coming to a dead end.

Outside Areas

Outdoor gardens or seating areas can de-institutionalize a facility. These spaces must be secured, but enclosed courtyards can feel more like a prison than a garden. This feel can be overcome with comfortable seating areas, fencing with minimal presence and elements such as fountains, bird feeders and flowers.

Being outdoors is a sensory experience, but can be degraded by noise from traffic or continuing machinery, or unpleasant smells from car exhaust or garbage disposal areas. Don’t just look at the outdoor area from a window; spend some time there to see if it provides an affirming connection to the natural world.

Putting It Together

Different residences can blend together, especially when you are looking at several in closely spaced appointments. Take notes about the visit in your car (or at the public transportation stop) before you leave. Visit the ones you like again, preferably at a different time of day. Your work to find the right place takes time, but is well worth it.


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White Oak Cottages  6 Longwood Drive  Westwood  MA  02090  •  Telephone 781.320.1999