When your loved one moves to their new senior living home, you might feel relief in knowing they are safe and cared for. However, you’ll also naturally take a step back from a caregiver role and need to adjust to this feeling of not having as much oversight and control over the day-to-day happenings in your loved one’s life. This step back can leave family members feeling a bit left out, which often leads to worry. 

All these feelings are normal, but it can be empowering to understand the signs that your loved one is receiving quality care in their senior living community. These communities should always work together with the senior, their medical team, and family members to ensure the older adult is supported, safe, and has a high quality of life. Here, we’ll define and go over signs of quality care in senior living.

Defining quality of care in senior living

It can be challenging to define what constitutes good care in a senior living setting, especially when residents have diverse needs. However, there are a few governing bodies and organizations that oversee both assisted living communities and nursing homes, aiming to define quality care.

For assisted living (senior living communities that feature 24-hour caregiver support in a less acute setting), quality care is defined by the National Center for Assisted Living. This organization provides guiding principles that are not state or federal regulations but instead are general indicators that point to quality care, including:

• Having a person-centered care philosophy so that all residents get the interventions and support they need and prefer rather than a one-size-fits-all approach, recognizing that residents all have unique histories, challenges, and preferences.
• Having a quality insurance and performance improvement policy so that key leaders and staff members are reviewing health care trends within their community in order to see if there is a way to reduce accidents, falls, and other emergencies through systemic change.
• Having a well-trained, organized team that provides customized support to each resident.
• Focusing on decreasing hospital readmissions, increasing staff stability, and safely reducing the off-label use of antipsychotic medications. 

For nursing homes (senior living communities that provide 24-hour clinical oversight and care in a more acute environment), the Centers for Medicare and Medicaid Services (CMS) rates communities with a star system to help family members and residents recognize outstanding quality care. A five-star community is the highest rated and includes indicators such as:

• Staffing.
• Falls and follow-up.
• Meeting federal regulations and standards.

Let’s look at how these defining characteristics of quality care can play out in senior living.

Positive signs of quality care in senior living

Regulatory guidance aside, it is important to understand what a senior living community that provides quality care looks and feels like. The next time you visit or check in with your loved one, note that some of these indicators mean that the senior living community is providing quality care, offering appropriate support and assistance, and increasing safety, dignity, and quality of life. It’s important to recognize, though, that all communities and seniors are unique.

A clean and well-maintained environment

While even the best housekeeping team can’t keep up with every small detail at every moment, especially in a busy senior living community, if your loved one’s home is clean and smells good, this is an indicator of quality care. Other environmental considerations include the housekeeping team interacting with residents in a friendly way and shared spaces feeling clean and welcoming.

Comfortable, happy residents

Another indicator of quality care and support is how residents look and interact with the community around them. If your loved one and their neighbors appear clean and well-groomed (not disheveled), this indicates that they are receiving the necessary support with their activities of daily living. Residents should also seem lively and engaged.

Friendly and dignified staff interactions

The foundation of an excellent senior living community is the relationship between residents and team members. If you see residents and staff interacting easily and comfortably, you know that their relationship has been built on trust and dignity. This indicates time spent with one another and is a good sign that the community provides quality care.

Active residents, in groups and independently

Residents in a senior living community should be engaged with one another and with the hobbies or activities they love. Look for residents involved in small and larger group activities, having conversations in shared community spaces, and pursuing independent leisure pursuits, such as reading the newspaper, working on a word puzzle, journaling, or listening to music.

Quick response times 

Caregivers cannot be everywhere all at once, but it is realistic to expect that calls for help via a community call system are answered promptly.

Vibrant and welcoming meal times

A great time to observe staff interactions and resident engagement is during a meal in the dining room. Meal times are important not only for eating delicious and nutritious food but also for connecting with peers.

Regular communication with families

Senior living communities that provide quality care should involve family members in events, activities, visiting hours, and care plan meetings. Support groups and educational sessions are also excellent offerings that can enhance the family atmosphere of a community.

When to raise potential concerns

Now that you are aware of some indicators of quality care in senior living, it can be helpful to recognize some warning signs that may warrant follow-up with community leadership. When possible, note your observations along with the time and date so that when you bring them up to leadership, you have plenty of details they can use to investigate.

Warning signs that could be concerning can include the following:

• Your loved one is isolated or expresses fear or nervousness around certain staff members or other residents.
• Your loved one has poor hygiene, including wearing the same clothes repeatedly, having unbrushed hair, appearing dirty, or having extreme body odor.
• You see bruises or scratches that are unexplained or unreported to you.
• You notice rapid weight loss or weight gain.
• You simply feel that something is “off” with your loved one that cannot be explained.

When approaching senior living community leadership about your concerns, remember to do so with an open mind. You want to work with the team to identify the cause of your observations or concerns and find a solution together.

Communicating with your loved one and the staff

Your loved one is your main source of information about how things are going in their senior living community. You should always listen to their stories and concerns, asking additional questions about topics that concern you. 

In addition to keeping up with community happenings with your loved one, you should also be in regular communication with community staff. This includes being on the email list for the activity newsletter and dining menu. It can also be wise to call the nursing station a few times a month to check in on how they think things are going with your loved one. Share your concerns, and see if you can develop a plan to remedy them.

Attending your loved one’s care plan meetings in person or over the phone can also be an excellent way to hear how your loved one is progressing toward their wellness goals from multiple members of the leadership and care team. If you’re still concerned, you can reach out to the community’s director of nursing or administrator to come up with a plan together.

There’s a balance to trusting your gut while maintaining realistic expectations. You can advocate for your loved one while still supporting the senior living community as they develop a plan to address your concerns. An open line of communication is the key.