Nightly News   |  March 05, 2013

Asking tough questions about residential communities

It’s crucial that all family members are on the same page when choosing an assisted living facility for their loved ones – and when considering end-of-life directives. NBC’s Dr. Nancy Snyderman reports.

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>>> a lot of our viewers speaking up about our story last night about the 911 operator begging for someone to save a dying woman, to no avail, sparked a lot of conversations as well among families across this country, matters of life and death . our report tonight from our chief medical editor, dr. nancy snyderman .

>> reporter: ann and dick field are in good health and enjoying retirement near denver, colorado. but at ages 83 and 85, they are not taking any chances when it comes to detailing exactly what they want for end of life care.

>> we sent every one of the kids a notarized letter saying when we preferred to have them use dnr, if there is no quality of life .

>> reporter: because they are in an independent living facility, they are not required to provide medical directives to the staff. but like a lot of residents here, they have what's called a file of life detailing their medical conditions and instructions in case of emergency. these are all safeguards, experts say, against medical intervention that may be unwelcomed or unnecessary.

>> if you don't have advanced directives in place and you have -- your heart stops beating, for instance, we as innocence and nurses have no choice but to do everything to keep you alive.

>> reporter: senior community living in the united states consistents of three levels, all with different regulations and requirements. independent living is most like your own home, meaning no significant caregiving or medical services are provided. assisted living offers some nursing, personal care and support for daily tasks. residents are required to provide medical directives. and in skilled nursing facilities, there is full-time medical care with staff on hand 'round-the-clock.

>> people really need to find out what services are off odor is they can make a decision on whether or not that's the best place to live.

>> reporter: according to the assisted living federation of america there are important questions to ask before moving into any type of senior communities. what personal care and medical services do they provide? what training and qualifications do the staff have? and under what circumstances would you have to leave, for instance, if your health situation changes or if you need more help? ask the tough questions and read the fine print before you interview anyone. and then have those conversations, the difficult ones, about end of life , the directives and frankly, what everybody wants, brian, while people are young and healthy enough to engage in those conversations.

>> that's how this story resonates. nancy, thank you, as always.