America may be a youth-obsessed society, but demographics show the country is aging rapidly. According to the U.S. Census Bureau, the population of people 85 and older is expected to increase 39.3 percent by the year 2000 and 33.2 between the years 2000 and 2010. Many seniors are living longer lives but are finding they need assistance with daily living, full nursing care, or acute care. Seniors are aging with more net worth in their pockets, a larger number are living alone, and at-home care by family members is often unavailable, factors that make assisted living or nursing care either more attractive or inevitable. A growing market, Seniors are increasingly turning to retirement homes, assisted living residences and nursing homes for housing in their golden years.

More seniors than ever before are living alone, and the majority are women. They are often in the care of their "sandwich" generation children, who may also be caring for schoolers, teen-agers and young adults still at home. With over 50% of the work force occupied by women, many families are not able to continue family-oriented care when a senior begins to need assistance with daily living tasks such as eating, taking medications, bathing or walking. When a senior can no longer perform those kinds of functions without help, it is time to investigate alternative living arrangements, assisted living, nursing homes or acute care.

Assisted living residences are appropriate for seniors who someone who is too frail to live at home but is not yet in need of skilled nursing care. These are facilities that offer a room or apartment, with three meals a day served in a common dining room and a host of services from 24-hour emergency care to transportation to assistance with daily activities.

When shopping for an assisted living residence, the Assisted Living Federation of America suggests considering the following checklist to assure your comfort and satisfaction or that of your loved one. These guidelines can also be used for retirement homes or for nursing homes with the understanding that some considerations may not be applicable. For example retirement homes are for residents who wish to live in a secured, social environment but are able to live without assistance. On the other end of the continuum of care is the nursing home or acute care facility in which residents need continuous medical attention and nursing care.

Atmosphere -

As you arrive at the residence, do you like its location and outward appearance?

As you enter the lobby and tour the residence, is the decor attractive and homelike?

Did you receive a warm greeting from staff welcoming you to the residence?

Does the administrator/staff call residents by name and interact warmly with them as you tour the residence?

Do residents socialize with each other and appear happy and comfortable?

Are you able to talk with residents about how they like the residence and staff?

Do the residents seem to be appropriate house mates for you or your loved one?

Are staff appropriately dressed, personable and outgoing?

Do the staff members treat each other in a professional manner?

Physical Features -

Is the community well-designed for resident's needs?

Is the floor plan easy to follow?

Are doorways, hallways and rooms accommodating to wheelchairs and walkers?

Are elevators available to aid in walking?

Are cupboards and shelves easy to reach?

Are floors of a non-skid material and carpets firm to ease walking?

Does the residence have good natural and artificial lighting?

Is the residence clean, free of odors and appropriately heated/cooled?

Does the residence meet local and/or state licensing requirements?

Needs Assessments, Contracts, Costs and Finances-

Is there a written plan for the care of each resident? Does the residence have a process for assessing a potential resident's need for services and are those needs addressed periodically?

Does this process include the resident, their family and facility staff along with the potential resident's physician?

When may a contract be terminated and what are refund policies?

Are there any government, private or corporate programs available to help cover the cost of services to the resident?

Is a contractual agreement available to include accommodations, personal care, health care and supportive services?

Are additional services available if the resident's needs change? Is there a procedure to pay for additional services like nursing care when the services are needed on a temporary basis?

Are there different costs for various levels or categories of services?

Do billing, payment and credit policies seem fair and reasonable?

May a resident hanle their own finances with staff assistance if able or should a family member of outside party be designated to do so?

Are residents required to purchase renters' insurance for peronal property in their units? Is staff available to meet scheduled and unscheduled needs?

Medication and Health Care-

Does the residence have specific policies regarding storage of medication, assistance with medications, training and supervision of staff and record keeping?

Is self-administration of medication allowed?

Is there a staff person to coordinate home care visits from a nurse, physical therapist, occupational therapist, etc. if needed?

Are staff available to assist residents who experience memory, orientation, or judgement losses?

Does a physician or nurse visit the resident regularly to provide medical checkups?

Does the residence have a clearly stated procedure for responding to a resident's medical emergency?

Services -

Can the residence provide a list of services available?

Is staff available to provide 24-hour assistance with activities of daily living (ADLs) if needed ADLs include: dressing; eating; mobility; hygiene and grooming; bathing, toileting and incontinence; using the telephone; shopping; and laundry.

Does the residence provide housekeeping services in residents' units?

Does the residence provide transportation to doctors' offices, the hairdresser, shopping and other activities desired by residents?

Can residents arrange for transportation on fairly short notice?

Are pharmacy, barber/beautician and/or physical therapy services offered on-site? Individual Unit Features-

Do dining room menus vary from day to day and meal to meal?

Are different sizes and types of units available?

Are units for single and double occupancy available?

Do residents have their own lockable doors?

Is a 24-hour emergency response system accessible from the unit?

Are bathrooms private with handicapped accommodations to accommodate wheelchairs and walkers?

Are residents able to bring their own furnishings for their unit and what may they bring?

Do all units have a telephone and cable TV and how is billing handled?

Is a kitchen area/unit provided with a refrigerator, sink and cooking element?

May residents keep food in their units?

May residents smoke in their units? In public spaces?

Social and Recreational Activities-

Is there evidence of an organized activities program such as a posted daily schedule, events in progress, reading materials, visitors, etc?

Do residents participate in activities outside of the residence in the neighboring community?

Do volunteers, including family members, come into the residence to help with or conduct programs?

Does the residence create a sense of community by requiring residents to particpate in certain activities or perform simple chores for the group as a whole?

Are pets allowed? Who is responsible for their care?

Does the residence have its own pets?

Food Service-

Does the residence provide three nutritionally balanced meals a day, seven days a week?

Are snacks available?

May a resident request special foods?

Are common dining areas available?

May residents eat meals in their units?

May meals be provided at a time a resident would like or are there set times for meals?

With these guidelines in mind, you can choose the appropriate residence in your price range and in the location you wish with confidence. For more information, contact Eldercare locator service at 1-800-677-1116.