Questions to ask during a senior living tour

Before you go

• Visit more than one. Three is a reasonable number. Without comparison you have no reference point, and the first community always seems either wonderful or alarming.
• Book the tour, then visit again unannounced. Ask whether you may drop in a second time. A community confident in its operation will say yes.
• Go at an awkward hour. Mid-afternoon, during a meal, or early evening tells you far more than ten o’clock on a Tuesday morning. Late afternoon matters especially for memory care.
• Bring someone. Two people notice roughly twice as much and remember different things.
• Take notes on paper. By the third community they blur together entirely.
• Bring your parent if it is appropriate. Their reaction to a place is information, and being included changes how the whole decision lands.

Staffing and turnover

Staffing is the strongest predictor of care quality and the thing brochures say least about.

• What is the caregiver-to-resident ratio during the day? In the evening? Overnight? At weekends?
• How many caregivers are on duty right now, and how many residents live here?
• Is a nurse on site, and during which hours? Who covers overnight?
• What has caregiver turnover been over the past year?
• How long have the executive director and care director been in the role?
• Are caregivers assigned consistently to the same residents?
• How do you cover call-outs: agency staff, or your own people on overtime?
• What training do caregivers receive before they start, and annually after?

What a good answer sounds like: specific numbers, offered without hesitation, including the overnight ratio. What should concern you: deflection to how caring the team is, an inability to give overnight figures, or visible discomfort at the turnover question.

Care and health

• How is the initial care assessment conducted, and by whom?
• How often is care reassessed, and how are families notified of a change?
• How is medication managed, stored and administered? Who is authorized to do it?
• What happens if my parent falls? Walk me through it.
• How do you communicate with families about incidents and changes?
• Can my parent keep their own doctors, and do any visiting providers come on site?
• Which hospital do you transfer residents to?
• What conditions or behaviors would mean you could no longer care for my parent?
• How many residents have you asked to leave in the past year, and why?
• What is your Texas license type, and may I see your most recent state inspection?
• What is your hurricane and evacuation plan?

That last question is not optional on the Gulf Coast. Ask where residents go, how medications and records travel, and how families are kept informed.

Money

Covered in depth in our costs guide, but the essentials on the day:

• What is the all-in monthly cost for someone with my parent’s needs?
• What is not included, and what do residents commonly get billed for?
• Is there a community fee, and is any of it refundable?
• What have rate increases been over the past three years?
• What notice is required to move out?
• What happens if my parent outlives their savings?
• May I take a blank residency agreement home to read?

Daily life

• May we join residents for a meal today?
• What happens if my parent does not like the food, or needs a special diet?
• Can they eat in their apartment if they want to?
• What does the activity calendar look like, and how many people typically attend?
• What happens for a resident who does not want to join in?
• What are visiting hours, and can family stay for a meal?
• Can residents bring their own furniture? A pet?
• What transportation is provided, how far does it go, and what notice is needed?
• How do you handle a resident who is unhappy or wants to go home?
• Is there a resident or family council?

Eat the meal if you possibly can. Food quality and the atmosphere of the dining room shape daily life more than any amenity on the tour route.

If you are touring memory care

• What specific dementia training do caregivers complete, how many hours, and how often is it refreshed?
• What is the overnight staffing ratio?
• How are exits secured, and what happens when an alarm sounds?
• Can residents access a secured outdoor area independently?
• How do you handle sundowning, agitation and resistance to personal care?
• What is your approach to a resident who becomes physically resistant during care?
• How are activities adapted for different stages?
• May I visit in the late afternoon to see how that part of the day goes?

Ask that final question at every memory care community. Late afternoon is the hardest part of the day, and how a community handles it tells you almost everything.

What to observe, not ask

Some of the most useful information is not in any answer.

• Are residents up, dressed and engaged? Or parked in a corridor in front of a television?
• Do staff greet residents by name? Do residents seem relaxed with them?
• Does anyone appear rushed? Watch how staff move.
• How long do call lights stay on? Notice one, then notice how long it takes.
• How does it smell? A brief odor in one spot is ordinary. A persistent smell throughout the building is not.
• How loud is it? Constant alarms, shouting or blaring televisions wear on people.
• Are the residents like your parent? Similar age, similar level of ability, similar interests.
• Talk to residents and families if you can. Ask what they wish they had known before moving in. That question gets remarkably candid answers.
• Notice what you are not shown. If the tour skips a wing or a dining room, ask to see it.

After the tour

• Write it up the same day, before the next visit blurs it.
• Score each community on the same criteria rather than relying on general impressions. Memory rewards whichever place you saw last.
• Read the residency agreement properly, at home, without anyone waiting. Consider having an attorney review it. These are binding contracts with real financial consequences.
• Go back a second time, at a different hour, before deciding.
• Check the state inspection record for anything you were told.
• Notice the sales pressure. A limited-time incentive or a warning that a room will not last is a sales technique. Sometimes it is even true, but it is not a reason to skip the contract.

Finally: trust a persistent bad feeling. Families who ignored an instinct because a place looked impressive tend to regret it. The building is the least important thing you are choosing.