The decision to place a loved one in a long-term care facility can be a difficult one.

It may be obvious they can no longer live on their own, but they don’t quite need the level of care nursing homes provide. Assisted living facilities can be a good in-between option.

But with not-infrequent news reports of deaths or serious injuries occurring at these facilities, how are families expected to know what questions to ask to ensure safety and the proper level of care?

Eilon Caspi, a gerontologist and elder mistreatment researcher who teaches at the University of Minnesota, has some suggestions.

Do your research

Search both a facility and its parent company online, Caspi said. But don’t just look up the name − make sure to include keywords that will show news articles and potential lawsuits.

Including a local news outlet’s name in the search bar can be very helpful. Additionally, using words such as “inspection” can yield important results.

When to tour a facility and what to look for

Touring a facility at both peak and non-peak times is essential, Caspi said.

“It’s a recipe for disaster for people with dementia to have no meaningful engagement in the evening,” Caspi said. “In many places, it’s four o’clock and they’re done, and these are the hours that are critical.”

During tours, keep an eye on the facility’s layout, especially in its dementia units.

Labyrinth-like facilities can be a nightmare for those with dementia. Additionally, staff in dementia wards should be able to have a view of an entire floor at all times, Caspi said.

Ask for staffing ratios and turnover rates

The healthcare field has a workforce crisis, Caspi said. Assisted living facilities are no exception.

Thus, families should ask for the facility’s actual staffing ratios, not their ideal ones. Turnover rates can also be an indicator of workplace environment.

Consistency is key for those with dementia, Caspi said, so having an established caregiver can result in better outcomes.

Inquire about training requirements

The reality of the workforce crisis is that some facilities must hire caregivers with only the minimum required qualifications, Caspi said.

But in those cases – and just as a general practice – the facility should require supplemental training.

Caspi noted that cosmetics technicians in some states need 400 hours of training, which includes hands-on work, before being allowed to provide services.

Yet some assisted living facilities require only 10 or 12 hours of classroom training.

“These are people who are for our elderly – we have to decide where our priorities are,” Caspi said.

Ask the state for inspection reports

Assisted living facilities are not regulated by the federal government, so it’s left up to states to determine the frequency of inspections and facility requirements.

But this also means that families should ask the state’s health department or whatever agency oversees facilities for inspection reports for any centers they’re interested in.

Some states publish their inspection reports online, such as Delaware. But The First State doesn’t always provide the most up-to-date reports or a complete list, so requesting them through Delaware Health and Social Services is important.

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