Moving aging parents or other loved ones into a senior living facility is a major event in anyone’s life. Deciding when to make the move, sifting through all the options and even knowing where to begin can be overwhelming.
Here, we’ll unpack everything you need to know to search for — and find — the best type of senior living facility for your loved one’s needs.
[READ: Long-Term Care Facilities: Types and Costs]
Finding the Best Senior Living Facility for You Takes Time: Start Early
The best way to ensure a smooth transition, experts say, is to start the process early, before a health crisis forces action. Starting your search early ensures a more deliberate, thoughtful approach, allowing time to make well-informed decisions and avoid the emotional pressure of a rushed, last-minute choice. From financial planning to getting to the top of a waitlist at the right facility, an early start puts you in the best possible position.
If the process feels daunting, a geriatric care manager, often a nurse, social worker or elder care expert, can provide experienced guidance for choosing the right care facility and can act as a neutral party to ease family conflicts.
[READ: How to Manage Your Emotions After Moving a Loved One Into Senior Living]
Our 13-Step Checklist to Finding the Best Senior Living Options
This 13-step senior living checklist can help you break down the process of finding a senior living community into manageable pieces and ensure you’re not leaving anything to chance:
1. Consider all of your different senior living options
There is a wide range of senior living options available, with the main difference between these choices being the level of care provided. You have options such as:
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2. Ask about your loved one’s preferences
Everyone wants to feel like their living situation is within their control, so it’s important to involve your loved one in the decision-making process. Here are some topics to cover when having an initial conversation about senior living:
— Amenities. Are there certain amenities, such as an on-site gym, indoor pool, pet services or in-room dining, that would make them more comfortable?
— Community size. Would they prefer a smaller community where, as the saying goes, everybody knows your name, or a larger community?
— Cultural or religious requirements. Are there any cultural or religious traditions that are important for them to maintain in their new community?
— Dietary preferences. Are there any dietary needs or preferences that your loved one feels strongly about?
— Location. Are they interested in staying close to family, friends and their current doctors?
— Social preferences. Are they looking for a more socially engaging community to combat loneliness, or do they prefer a quieter environment?
Carefully considering their preferences when looking for the right facility can help make the move more welcoming and less stressful.
[READ: The Benefits of Intergenerational Activities for Senior Living Residents and Children]
3. Talk about care needs
When you begin the process of choosing a senior living community, one of the first and most important steps is evaluating current and future care needs. Slightly overestimating your current support needs can help ensure the community will continue to meet them over a longer period of time, reducing the chance of an early move.
Virtually all senior living communities also have an intake meeting to look at the prospective resident’s health and care needs before admission to ensure they are the right fit.
Have a frank conversation with your family member’s doctors to understand their health situation and what they see on the horizon. If there are memory issues, but they haven’t progressed yet to an official dementia diagnosis, you should consider facilities that have a memory care unit for when the need arises. If chronic health conditions are part of the picture, talk with the doctor about how well they’re managed now and whether they’re likely to change in the near future.
There is no crystal ball for health issues, but making your best educated guess about what the future may bring, and choosing a facility that can adjust as needs change, can provide greater peace of mind, continuity of care and a smoother experience for both seniors and their families.
4. Determine your loved one’s finances
Another key step in choosing a senior living community is taking a close look at finances to understand what options are realistically affordable. This includes reviewing income sources such as Social Security, pensions, savings and investments, as well as factoring in ongoing expenses and potential future care costs. Because different types of senior living vary widely in price, and costs increase as care needs grow, having a clear financial picture upfront can help families narrow choices, plan ahead and avoid difficult decisions later if a community becomes unaffordable over time.
Fees depend on a range of factors, including the location of the community and the services and amenities provided. What you’ll pay can also vary between levels of care. For instance, according to CareScout’s Cost of Care Survey, the median monthly cost of an assisted living community is $6,200, but a private room in a nursing home facility is $10,798 per month.
Long-term care insurance may help cover some costs, but there may be limitations.
“Check your schedule of benefits,” advises Nancy Avitabile, owner of Urban Eldercare, a geriatric care management practice in New York City. “Be very clear on what is and is not covered.”
[SEE: Financial Planning Timeline by Year: A Step-by-Step Guide to Affording Senior Living]
5. Dig deeper into costs
often include more than just the base rent or care fees. There may be additional expenses for services like medical care, activities, transportation, meals and medication management. There may even be a one-time buy-in fee that secures your loved one’s place in the community.
Without understanding the full scope of costs before making a commitment to a facility, families may face some unpleasant surprises when the bill comes due.
Make sure you fully understand what you’re getting for your money and any hidden costs that might crop up later. And find out how the facility charges, such as monthly rent, a la carte or a tiered payment system.
Ask for a copy of the contract in advance and review it with an attorney to be sure you fully understand all your rights and obligations.
Some questions to ask:
— What services are included in the monthly rental fee?
— How often do rates typically increase, and by how much?
— Are there move-in fees, community fees or deposits to account for?
— Are deposits refundable and under what circumstances?
— How much do amenities cost, how many are included and how are they billed?
— What happens if the resident is hospitalized?
— What triggers a move to a higher level of support, and how are those costs calculated?
Confirm with whom you will be communicating, suggests Tina R. Sadarangani, a board-certified primary care nurse practitioner and assistant professor at New York University who specializes in the care of older adults. Also ask specifically which ADLs are included and which will cost extra, she notes, as not all senior living communities offer the same ADLs as part of their standard contract.
[READ Tools to Support Activities of Daily Living: Helping Seniors Stay Independent]
6. Research facilities that match your preferences, needs and budget
Depending on the geographic area, there can be dozens of options.
The following sources of information to find senior living facilities in your region may be helpful:
— U.S. News. You can search for top-rated senior living facilities across the country.
— Area Agency on Aging. These agencies are designated by the state to address the needs and concerns of older people. They can tell you if your state has a searchable database of assisted living facilities. To find your nearest aging agency, use the federal government’s Eldercare Locator or call 1-800-677-1116.
— Word of mouth. Relatives, friends, neighbors and your loved one’s doctors can be good sources of information. U.S. News also offers details of services and patient and family reviews to help you find the best choice for your loved one.
Make a list of pros and cons, keeping in mind your senior’s preferences and budget, and confirm a facility has the right blend of services, amenities and level of care that they need.
7. Tour your favorite communities
The only real way to get a sense of what life is like in a senior living facility is to visit. Find out when you can tour, and plan to see everything that’s on offer.
While there, observe the following environmental factors:
— Is the facility bright, clean and odor-free?
— Are there obvious safety features, such as call buttons and handrails?
— Do residents seem happy and engaged?
— How do staff and residents interact?
— How are the grounds and buildings maintained?
In addition to taking a formal tour and asking a representative of the community all the questions you have, drop by the community when they aren’t expecting you.
“I always recommend going unannounced,” says geriatrician Dr. Susann Varano, medical director of Clinical Research Consulting in New Haven, Connecticut. “You want to see it in real time. You don’t want them prettying up the place for you and having everyone on their best behavior because they know a tour is coming in. Show up at night and on weekends. Show up during meals. See if it’s organized or chaotic.”
8. Find out about staffing ratios and tenure
Many communities struggle to hire enough staff to provide quality care, so ask about the ratio of staff members to residents. You can also ask about the average tenure; long tenure can be a sign that your loved one will receive more consistent care.
Adequate staffing offers many benefits, including fewer medication errors, lower resident mortality and higher satisfaction. However, many facilities face challenges in hiring and retaining staff due to low pay, demanding work and high burnout. This problem is likely to grow as the aging population increases the demand for care and the need for qualified staff.
Stacey Eisenberg, a senior care expert and owner of A Place At Home — North Austin in Round Rock, Texas, recommends also assessing whether the staff and administration seem to actually care “or are they more focused on filling beds?”
“Pay attention to the feeling you get upon entering a facility,” Sadarangani adds. “It will tell you whether it is a safe and appropriate choice.”
9. Ask about health and safety protocols
A senior living facility should prioritize the safety of its residents and be able to demonstrate how they do this. Observe whether the layout of the facility is designed with seniors’ needs in mind, with wide hallways, nonslip flooring and safety equipment, such as handrails and ramps for fall prevention. Residents should have access to emergency call buttons in their rooms and common areas to request assistance quickly when needed.
Major safety concerns for seniors include:
— Emergency protocols. Ask about the facility’s emergency plans for events such as fires, floods, tornadoes or hurricanes, including evacuation procedures, staff training, safety equipment and how families are kept informed.
— Medical emergency response. This includes staff certified in CPR and first aid as well as a protocol for contacting emergency services.
— Falls. According to the Centers for Disease Control and Prevention, falls are a leading cause of fatal and nonfatal injuries among adults 65 and older. To reduce fall risk, many senior living communities offer safety features such as handrails, emergency call buttons and adjustable-height beds that make getting in and out of bed safer.
— Infections. A concern in any communal living situation is the potential for outbreaks of infectious conditions, such as the flu or respiratory syncytial virus. Each facility should be able to answer questions about vaccination rates, hygiene protocols, testing for infectious diseases and outbreak mitigation steps.
— Wandering. Residents with Alzheimer’s disease or other forms of dementia may be at risk of wandering into unsafe areas. Senior living communities can help reduce this risk through monitored entrances and exits, alarm bracelets and regular resident checks.
Other questions to ask:
— What types of events or circumstances will the family be notified about, and how will those notifications be made?
— What happens if a prolonged hospital stay is necessary? How are fees assessed, and will their living space be held for a period of time in case they can return?
— If your loved one needs a higher level of care, how much notice do you need to give? How much notice will you be given if fees or care charges are subsequently increased?
— What is the facility’s frequency tolerance of calling 911 or going to the emergency room? How much can be handled in-house?
10. Learn about activities
Facilities differentiate themselves through amenities and activities. Whether you want a pool, an on-site barber shop or loads of activities that go well beyond bingo, ask what’s available and whether residents are happy with what’s on offer.
“Good activity directors really set the tone of a facility,” says Jennifer Cook-Buman, a housing and care advisor with 1st Choice Advisory Services in Portland, Oregon. “Ask how well attended activities are, which outings are offered and how they’re managed.”
Some activities that may be offered include:
— Art and crafting clubs
— Book clubs
— Cooking classes
— Exercise or wellness classes
— Faith-based groups
— Gardening clubs
Some communities may even plan excursions for their residents. If this is important to your senior, make sure you get a comprehensive list of offerings as well as any costs that may be associated with them. If possible, ask to sit in on any clubs or classes that may be of interest when you’re touring the facility.
11. Understand specialized therapies
Depending on their needs, your senior loved one may require one or more specialized therapies.
Confirm how and where your loved one will receive needed services, whether on campus or off-site and whether transportation is provided. If specialized therapies are required, ask what’s available, how they’re accessed and how they affect costs, since Medicare may cover some services, such as physical therapy, but not all.
Typical specialized therapies that some communities offer include:
— Cardiac and/or respiratory therapy. These therapies help seniors regain cardiovascular function after a heart attack, stroke, pneumonia or other ailment that affects breathing capacity. These therapies can also help with mobility and independence.
— Occupational therapy. Occupational therapy focuses on improving or regaining fine motor movements, which may help seniors perform daily hygiene tasks, such as brushing their teeth. Mobility deficits can be related to illness or injury, with arthritis as a major reason some seniors need this kind of support.
— Mental health therapy. Depression, anxiety and loneliness can all be detrimental. Talk therapy, such as cognitive behavioral therapy, may offer seniors an opportunity to gain peace and a better understanding of life changes and mortality.
— Physical therapy. Physical therapy can help individuals regain mobility and get back to more normal activities. This type of therapy focuses on regaining strength and endurance and can help seniors avoid future falls and accidents.
— Speech-language therapy. Speech-language therapy is especially important for older adults who’ve suffered a stroke. This type of therapy can help seniors regain language skills and may also help those who are having difficulty swallowing or chewing.
12. Taste the food
Food and dining services play a central role in daily life, so it’s important to ensure that the community offers healthy, nutritious and appealing meals for you or your loved one.
Ask whether the community:
— Can cater to specific health-related or cultural dietary restrictions or requests
— Whether family members can join their loved one during mealtimes
— How and where meals are typically served
— Whether food is always available
— Whether there are multiple on-site dining options
13. Talk transportation
If your loved one cannot drive independently anymore but still has places to go, you’ll need alternative transportation options.
Many facilities have transportation services that help seniors get to and from appointments and other places.
Ask what transportation services the facility offers, where they go and whether there is a fee. If trips are limited to certain destinations, ask whether the facility partners with local car services for discounted rides.
Bottom Line
When choosing a senior living facility for your loved one, you’ll find a variety of options, each with different levels of care. It’s important to include your loved one in the selection process and listen to what they want while balancing the practicalities of the choice, such as what is feasible, both financially and medically.
Talking to a financial advisor can help with the cost, and always get a full list of fees before making any decisions. When you visit places, watch how the staff act, talk to the people who live there, make sure the facility is clean and up-to-date and ask about activities, transportation, as well as emergency and safety protocols.
More from U.S. News
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How Much Does Medicare Pay for a Hospital Stay?
7 Signs It’s Time to Move to a Senior Living Facility
How to Choose the Right Senior Living Facility: A Checklist originally appeared on usnews.com
Update 03/18/26: This story was previously published at an earlier date and has been updated with new information.