An assisted living facility can be an ideal middle-ground between completely independent living and a nursing home. Most of these facilities allow for some personalized care, while also allowing residents to maintain their autonomy.

Hardly available a decade ago, assisted living facilities have grown tremendously in numbers and popularity because they offer services in a more residential and less restricted environment than a nursing home or long term care facility. Retaining one's independence is, after all, everyone's goal.

Services vary widely and choosing an appropriate assisted living facility can be a daunting task.

What is an assisted living facility? If you are considering a move to an assisted living facility, what are some of the questions you should be asking? What are the important considerations?

Residents typically have their-own room or apartment, two or three meals per day and assistance with personal care, laundry, transportation and very limited medical supervision.

Some facilities also arrange for residents to participate in elder community services such as adult day care and recreation.

Facilities should include: special safety features such as grab bars in the bathroom for the toilet and shower, doors should open with handles instead of knobs, wheelchair ramps, health and exercise programs, housekeeping and laundry, common areas for socializing, nurse or medical clinic in the building, and organized social programs available to residents.

Costs vary widely, depending on location, services available, etc., and residents (and/or their families) generally pay the cost for assisted living. Some health insurers or long term care insurance may pick up part of the cost, but under very specific conditions.

If you are considering Asisted living for yourself or a family member, do your homework. Be sure that the facilities you are considering are fully licensed by the state to meet various fire and safety codes. Most facilities and their staff must satisfy special training requirements, and some states require a nurse on duty or on call at all times.

You will find that assisted living facilities vary greatly in terms of accommodations and costs. Call ahead to schedule appointments and, if possible, stay for a meal and take the time to observe and speak with residents. In addition, consider these critical points:

• Do you like the location and appearance of the facility?
• Does the staff greet you warmly? Do they call the residents by name?
• Do residents socialize with each other? Do they appear content? Are many residents dining alone?
• Is the community well-designed for residents' needs? Does it have important safety features ...Is it well lit? Is it well-ventilated? Check for fire alarms, sprinkler systems and emergency doors, which are all required by law. Also check for 24-hour security and emergency call systems that are accessible and can easily be used by residents.
• Is the food nutritious, appetizing and plentiful? Can it be prepared according to individual dietary needs, such as sugar, fat and sodium restrictions?
• Do residents have a choice of eating in dining rooms or in their own units? If a resident is sick, can food be delivered to the room? If so, is there an extra charge?
• Does the facility meet local and state licensing requirements?
• What public transportation, taxi service, shops and places of worship are nearby? Does the facility offer transportation to and from doctors' offices, pharmacies and stores?
• What types of units are available? How much does each cost? Where might your unit be located in relationship to common areas and dining rooms?
• What exactly are the costs? What do monthly fees cover'? Read the contract.
• If you move in, is the level of services reviewed and adjusted periodically by a professional? If additional assistance is needed, who supplies those services and at what cost?
• What professionals are on staff full time? What are their qualifications and availability? What are the hiring and screening practices of the facility?

Moving into an assisted living facility is no small matter. Ask questions, review the attitudes and answers of those being questioned. Does the facility offer the services that are currently needed or may be needed in the future? Is it affordable?

Consider the reputation of the facility, its history, ownership, staffing and services. Finally, double-check with the state licensing board and long term care office. Be sure that what you've been told agrees with state records. Call Consumer Protection and/or the Better Business Bureau to see if any complaints have been filed.

If an older individual does not require 24-hour a day care, yet is not totally able to take care of him/herself, an assisted living facility might be appropriate to help manage daily needs.

Keep in mind that none of us likes change. This is a time when many things are changing dramatically for older individuals. If you are dealing with just a short-term situation, and you know that skilled nursing care will be needed soon, consider what other options might be available and affordable in the interim. It's difficult enough to leave your home and possessions once, let alone again a few months later. Consult a professional to determine what options are available.