Neglected to Death

Protecting yourself and your loved ones

If you are considering an assisted-living facility for yourself or a relative:

• Consult your doctor. If your relative is suffering from the infirmities of aging, make sure they are able to live at an ALF. ALF residents must be able to perform most of their activities of daily living — such as going to the toilet, dressing, and getting around — with only minimal assistance. An elder who is bed-bound, for example, cannot live safely in an ALF.

• Consider a facility that’s close to family and trusted friends. Advocates say ALF residents who are visited regularly by involved and inquisitive family members generally receive better care. Residents who are isolated from family, and who do not have strong-voiced advocates, are more likely to be overlooked.

•  Seek help from a financial advisor. If you do not have long-term care insurance, you won’t want to deplete your savings too quickly, because facilities that accept rent from government insurance programs, such as Medicaid, as their only source of revenue often operate on the thinnest of margins. Look for ways to stretch out your savings so you can live in the home best suited to meet your needs.

If you are choosing among different assisted-living facilities:

• Consult the Long-term Care Ombudsman Council in your community. The councils maintain several resources that are available to the public.

• Review the Agency for Health Care Administration’s website at The results of the agency’s inspections, once every two years, complaint investigations and other resources are available to the public.

• Visit the facilities that interest you at different times of day. A home that seems cool in the evening may be hot at mid-afternoon. Tour the entire facility, not just the lobby. Look inside residents’ rooms. Pay attention to all your senses, especially smell.

• Reach out to the facility’s family or residents’ council. Attend a residents’ council meeting, if you can, and ask lots of questions.

• Check the ALF’s activities calendar, and ask to observe daily activities. Boredom and inactivity are unhealthy for elders, so look for a facility that will keep you or your loved one busy and entertained.

• Visit at mealtime, and not just one meal. Records show ALFs often are faulted for having menus with a variety of healthy, enticing options — and then cooking meals that don’t match the menu. Be sure that the facility you pick is capable of providing a diet that meets your needs, such as offerings for people with diabetes. A Sunday night visit is recommended, because Sunday evening meals often are the most overlooked by facility staff, records show.

• Talk to a lawyer before signing any contracts. If you sign a contract that allows only binding arbitration when something goes terribly wrong — such as a death or disabling injury — you will lose the right to sue, and you could forgo significant damages that you might otherwise be entitled to.

• Ask to see the résumé of the home’s administrator and director of resident services, who may be the only manager on site with a degree or professional experience.

When you move in to an assisted-living facility:


Know and document the names of every caregiver who works with you or your loved one

. Don’t be afraid to ask for names and birth dates, and vet the people who spend the most time with them. Caregivers often are the difference between life and death if your loved one experiences a severe fall or other healthcare emergency.

Check the details of your loved one’s medications at least once monthly. Does the medication match the prescription? Is the dosage accurate? Read the fine print. If your loved one is taking several prescriptions, are there any interactions that may prove lethal? Is your loved one being prescribed medications by a doctor other than your family physician? If so, what do you know about that doctor?

What you should you do if something goes wrong:

•  If your loved one dies at an ALF, and you suspect the death was not natural, request an autopsy by the county medical examiner.

Be sure to document everything. Your observations and impressions may be helpful to authorities who investigate what happened.

You have a right to call or write authorities if you suspect an ALF resident has experienced abuse, neglect or financial exploitation. The state Department of Children & Families investigates all such reports and can be reached at 800-96 ABUSE. The Agency for Health Care Administration also investigates reports of maltreatment, and can be reached at 888-419-3456.

You also can report concerns of improper care to the Long-term Care Ombudsman Council in your area.