When it’s Time for Assisted Living: A Caregiver’s Guide to Having the Talk The decision to move into assisted living is rarely an easy one. Elderly parents can be fiercely resistant to giving up their home, and many equate assisted living to being institutionalized. The reality is that assisted living communities often enhance an elderly person’s life, providing assistance with everyday tasks and increased opportunities for socializing, while still allowing seniors a certain level of privacy and independence. Assisted living is not a nursing home—it is a long-term residential-style living option in a setting that offers personal care and assistance with meals, bathing, dressing, transportation, medication management, and other activities of daily living (ADLs). Apartments can be equipped with lifesaving emergency call systems in case of a fall, accident, or other emergency, enabling residents to get help rapidly. Many seniors with shrinking social networks find that assisted living provides more opportunities to socialize (group meals and outings, for example) than they would have otherwise. Social connections are vital to the well-being of seniors, and assisted living is a viable solution.
Signs that It Might Be Time for Assisted Living How do you know when it’s time for your parent or loved one to make the transition to assisted living? You may already feel strongly that your loved one’s abilities have declined to such a degree that they are no longer safe (or happy) living at home alone; however, if you’re still feeling uncertain about whether their limitations are severe enough for a move to assisted living, consider the following signs: Changes in Physical Appearance Your loved one’s appearance has declined—perhaps they look unkempt, their personal hygiene has declined, or their clothing is stained or wrinkled. These are signs that hygiene and personal care have either become too difficult to manage, or that your loved one is becoming forgetful about personal care.
Noticeable weight gain could indicate an illness or condition, such as arthritis or diabetes, is slowing your loved one down, leading to weight gain. It could also be a sign that your loved one is overeating because they are forgetting meals and snacks they’ve already had that day. Noticeable weight loss and looser-fitting clothing could indicate that your loved one is forgetting to eat meals. It could also indicate a health problem, such as cancer, depression, or dementia. Unsafe Driving Behavior If riding in a car with your loved one behind the wheel proves to be a frightening or unnerving experience because they drift from their lane, have slow reaction times, tailgate, or mix up the brake and accelerator pedals, these are signs that it may be time to stop driving. In our society, not being able to drive can make it much more difficult for a person to live on his or her own. Pay attention to whether your loved one’s car has dings and dents, which could indicate careless driving. Also notice how quickly your loved one puts on their seat belt and how they follow basic driving rules—missed steps could be signs of a problem. Social Signs Many elderly people lose touch with friends over time, and when old and dear friends pass away elderly seniors are often left wondering “Am I next?” This can be a lonely and frightening feeling. Notice whether your loved one still gets together with friends for outings and social events, or whether they have become isolated. Does he or she: Keep a calendar of appointments? Go days without leaving the house? Has your loved one abandoned activities or hobbies he or she once loved? Isolation and abandonment of things once enjoyed are signs that being on his or her own may not be the best situation for your loved one. Money Signs How your loved one manages (or mismanages) money can be a sign of cognitive trouble. Here are signs to look for: Unopened personal mail – Few people avoid opening letters from friends and relatives—unopened personal mail is usually a sign of trouble. Letters from banks, insurers, or creditors – Especially those referring to overdue payments. Scattered mail around the house – This indicates that important bills and notices aren’t being managed properly. Unopened bills – Not opening bills or paying them on time is often one of the first signs of dementia.
Signs around the House The following may indicate an inability to perform normal housekeeping duties: Lots of clutters – If your loved one has always been a neat freak, but you’re noticing lots of clutter around the house, this can indicate that they’re having a hard time keeping the house clean and organized. Items on the floor can be a trip hazard. Dirty bathroom(s) and/or kitchen – Bathrooms and kitchens need to be kept clean for both sanitary reasons and safety. Grime in the bathrooms can cause slips and falls, and grease in the kitchen can present a fire hazard. Generally poor housekeeping – Spills that haven’t been cleaned up can indicate that your loved one was not physically able to clean up the mess, or forgot about the spill, which could be a sign of dementia. Animals that seem neglected – Cat litter boxes that are unchanged, dirty water in the fish tank, or a dog in desperate need of grooming could indicate that your loved is having difficulty caring for their pet(s). Kitchen full of ready-made convenience meals – This can indicate that your loved one no longer has the energy or the mental faculties to prepare fresh food. Living on highsodium convenience foods is not healthy. These are just some of the signs that a person is having difficulty with the activities of daily living (ADL) and that a move to assisted living may be the right choice. Having the Conversation Perhaps you’re just coming to realize that your loved one needs the help an assistant living community provides. Maybe you’ve already tried to broach the subject of senior housing several times and have encountered resistance. Whatever your situation, here are some things to expect when talking to loved ones about senior housing, and tips for communicating effectively. Seeing Things through Your Loved One’s Eyes It’s important to realize that staying in their homes represents control for many elderly people. Your parent or loved one may already feel like they’re losing control in other ways—their hearing, mobility, and vision, and their ability to drive—so it’s understandable that giving up their home feels like an additional loss of control.
What to Do if Your Parent/Loved One Is Resistant The importance of being gentle and tactful when broaching the subject of assisted living cannot be overstated. Don’t be surprised if your loved one is resistant to the idea. While their resistance may be frustrating, reacting with anger or frustration or raising your voice is generally counterproductive. If at first your loved resists, have the conversation again another time. Bring it up regularly, and speak in terms of how it affects you—“I’m really concerned about your well-being, mom, and I want you to be safe and happy.” You may find that your loved one slowly comes around to the idea. Allow them the autonomy to make the decision for themselves. If at First You Don’t Succeed … You may have to bring up the subject of assisted living many times. Be persistent, but always be tactful and respectful. Even if your loved one doesn’t make the move as quickly as you think they should, try to make their existing home as safe and comfortable as possible. Remember that as long as your loved one is mentally capable of making decisions, a move to assisted living is ultimately their choice. Dealing with Feelings of Guilt Many children of elderly parents have kids of their own still living at home. Dubbed the “Sandwich Generation,” these individuals often face overwhelming responsibilities (and expense) as they struggle to care for two generations simultaneously. The inability to provide the level of attention and care an elderly parent needs often leads to feelings of guilt. The reality is that one of the most loving things a child can do is ensure their parent gets the help they need.