One question that we often get from our clients is how to know when to place a parent into an assisted living facility or nursing home. Making this decision can be difficult, and disagreements about the best options can cause tension and confusion within the family. However, if you plan ahead and know the physical and mental signs to look out for, knowing when it is time to make the transition can be a much less heartbreaking experience. Below are some of the most important steps that you can take to ensure that you know when to help your parent make the permanent move to an assisted living facility or nursing home – and what to do once the decision has been made.
1. Initiate the discussion before a move becomes necessary.
Moving to a nursing facility is hardly a pleasant thought, but for many seniors it will become a reality. Many children of our clients experience guilt or concern that they may not be acting consistently with their parent’s wishes when they make arrangements for them to move into a long-term care facility. However, if you begin discussing options with your parents while they are still healthy and able to express their wishes, you can eliminate much of this guilt and insecurity. Talk to your parents about what type of facility they expect to move into, what aspects of long-term care are most important to them, and even which specific facilities are the most attractive to them. Initiating the conversation before the situation reaches a crisis point will help you (and your parent) to be capable of making the correct decisions when the time comes to make the move.
2. Be on the lookout for changes in physical capabilities.
People who move to long-term care facilities often do so because they are physically unable to care for themselves. While some people need extensive care, those who move to assisted living facilities may only need help with one or two activities of daily living. If the layout of your parent’s house has made it difficult or dangerous for them to move around easily in the home (for example, they can no longer climb stairs), living in the home may no longer be an ideal situation. It is important to look for evidence that your parent has fallen or stumbled. A typical warning sign that someone needs to move to a long-term care facility is when they have experienced several falls without being able to get up or call for help. Assisted living and nursing facilities have round-the-clock staff on hand to monitor residents.
Another warning sign is when the house begins to appear dirty. Perhaps Mom’s house was always spotless, but lately you’ve been noticing crumbs in the kitchen and dirt on the floor. These could be signs that your parent is no longer able to care for her home in the way that she would like, and it may be time to consider moving her to an assisted living facility.
Further physical signs that it may be time to consider speaking with your parent about moving outside of the home include evidence of frequent sleep disturbances, difficulty dressing or bathing, and difficulty preparing meals.
3. Be on the lookout for changes in mental capabilities.
Has your parent exhibited sudden changes is personality? Is it becoming obvious that she is forgetful or frequently disoriented? Are you concerned that your parent has begun to make poor decisions or has had difficulty making decisions at all? Each of these issues could mean that your parent has dementia. Because diseases causing dementia are usually progressive, their condition usually will not improve and it is important that your parent move into an assisted living facility or nursing home before the dementia worsens. Symptoms such as forgetting to take medication, difficulty operating electronics like the telephone or the stove, and dangerous driving habits can also be signs that it’s time to consider moving to a long-term care facility.
4. Schedule a family meeting.
Once you’ve determined that your parent’s physical and mental symptoms show a need to move out of the home, it’s important that you schedule a family meeting. This allows everyone in the family to share their concerns and to make decisions together about who will be involved in the decisionmaking process and how to proceed with the move. Remember to include your parent’s caregivers in the family meeting – their input can be important in determining what your parent’s needs are.
At the meeting, it is important to have an agenda to help everyone focus on what decisions need to be made. This agenda could include discussions about your parent’s medical status, sharing feelings and opinions about the situation, financial concerns, and how to move forward. If you feel that there may be disagreements between family members, you may want to hold the meeting in a neutral place and have a disinterested third party mediate the meeting.
5. Research long-term care facilities in the area.
If you haven’t already done so, now is the time to research different options for long-term care in the area where your parent will be living. One option is to go to www.snapforseniors.com to research different facilities in your area. Once you find a facility you’re interested in, you can call the facility to take a tour, check references from families of former or current residents, and weigh your financial options.
6. Continue to keep family involved.
Moving to a long-term care facility is a large transition for everyone, not just your parent. It is important that you keep your family informed about what decisions have been made, even if they are not directly involved in the decisionmaking process. If some family members are contributing more time or money to the transition process than others, it is important to acknowledge this effort and attempt to achieve balance within the family if possible.
7. Most importantly, continue to keep your parent involved.
Of course, the person for whom the transition will be the most difficult is your parent. She may be feeling confused or angry at the thought of leaving a home that she may have lived in for a number of years, or she may not understand where she is once she lives in her new home. This is especially true if your parent suffers from dementia. It is important that you allow your parent to express her feelings about her new home and that you listen to her concerns. One way to ease her mind could be to ask her how she feels about the new location at a time when she is calm and there are few distractions. Depending on the situation, it may be helpful to visit the facility with your parent shortly before the move so that she can learn more about it and start to become comfortable there.
