First Things First: Does Your Loved One Need Care and What Are Your Options?

Does your parent or loved one need more care? The following signs may indicate that it’s time to consider assisted living:

• An empty fridge, spoiled food, or weight loss, may mean your parent isn’t eating well because shopping and/or cooking is a challenge.
• Wearing the same clothes or neglecting personal hygiene, which may mean that doing laundry and bathing is difficult.

• Forgetfulness or strange/inappropriate behavior, which may be due to memory loss and confusion.

• Frequent bruises or other injuries from falling.

• Depression is common in seniors who are isolated and alone.

If your parent has one or more of these signs, you may need to have a discussion about his or her living options in the near future. Below is a list of some of the options you may wish to consider:

• A roommate or live-in caregiver in their current home: There is a wide range of senior services available within the comfort of their own home.
• Moving in with a nearby family member or friend.

• Independent living (also known as retirement communities, retirement homes, senior housing, or senior apartments): These communities are designed with seniors in mind, with smaller living spaces that are easier to navigate, and often have group activities and services.
• Assisted living: For those who need assistance with some aspects of daily living, including help with medications. The level of help required may vary, but the staff is available 24 hours a day.
• Skilled care center: The highest level of care for seniors outside a hospital.

Choosing an Older Adult Living and Care Community: Top 10 Considerations

Be sure to visit facilities at different times of the day and participate in a meal and activity during your visit. Get feedback on the facility from several residents and their family members.

1. Staff friendliness and professionalism. Speak with staff at each facility. Staff should be relaxed, friendly, and patient with you and with residents. Ask to speak with the management team and be sure you understand the staffing pattern and goals of the property.
2. Security and safety.  This includes features of the physical property as well as policies and procedures for staff. Be sure that entrances/exits, elevators, bathrooms, and outdoor areas are well maintained with good lighting, locks, grab bars, and other safety features.  Are there stairs or steps that could pose a tripping hazard? Find out about night staff patterns, and how staff responds to emergencies, and ask about medical concerns specific to your parent or loved one. 
3. Resident satisfaction. Observe and speak with residents of each facility and note whether they appear to be happy and interacting with one another. Observe or participate in a group activity if possible.
4. Location. Is the community near you or other family or friends who can visit regularly? Is it near grocery stores, drug stores, and safe public transportation? How will your loved one get around? Are the neighbors friendly?
5. Cleanliness. As you walk through the facility, note whether it seems clean and fresh. Ask how often housekeeping is provided in the rooms. Sample the food, and walk the grounds to be sure they are well maintained and safe.
6. Standard of Care.  Observe residents to see whether they are well-groomed and dressed appropriately. Ask how changes in medical conditions are handled. At what point would a resident be required to move elsewhere for medical care? Ask as many questions as you need to until satisfied that your loved one will be treated with kindness, dignity, and respect.
7. Meals. Inquire about dining options, hours, and procedures. There should be flexibility and the ability to accommodate special circumstances or needs.
8. Activities.  Ask about the variety and frequency of activities (both indoors and outdoors), trips and outings, religious services, and holiday events. Is there a library? Chapel? Gym? Try to participate in a group activity and observe the attendance and interest level of the residents and staff.
9. Cost.  Senior housing can range from $800-$5,000 per month depending on your loved one’s needs. Private insurance may cover some of the costs — check your plan for details. In the U.S., Medicare does not cover housing, but Medicaid may in some cases. Vets may be eligible for ongoing benefits as well. When inquiring about costs, be sure to find out how often costs are expected to increase and how much notice will be provided for such increases. Although it may be difficult or uncomfortable, you will likely need to get a clear picture of your parent’s financial resources in order to determine which options and facilities are within your budget.
10. Management. The management team plays a vital role in the quality and professionalism of a senior housing facility. Be sure to get an introduction to the management team and pay attention to all written and verbal communications you receive from them. Again, ask residents and their family members about their experience with management and do your due diligence before making a decision. Make sure that the facility is licensed and in compliance with local regulations. You can also check the Better Business Bureau for complaints against the facility.

Making the Move: Supporting Your Loved One During the Transition

Even under the best of circumstances, a move to senior housing or assisted living can be stressful and emotional. It is important to be sensitive to your loved one’s feelings as they adjust to their new environment. There may be feelings of grief, loss, confusion, fear, or anger, which should be acknowledged with understanding and patience.

It’s also important to acknowledge your own feelings during this transition and ensure that you have the support you need to process those feelings and make the best of the change.

Some other ways to support your loved one are:

• Call and visit often. Make sure your loved one continues to feel loved and included in family events and outings if possible. Take an interest in their new friends, routines, and daily activities.
• Help decorate or personalize your loved one’s living space. Find out what they are able to take with them to their new home and help them to feel more at home with objects that are meaningful to them, like family photos. Respect their choices and wishes in decorating their new space.
• Make a folder of useful information to help orient your loved one to their new space. Include things like a floor plan of the residence, a map of the neighborhood including grocery stores, post office, etc., a list of dos and don’ts for the facility, instructions for the TV or computer, and important phone numbers.
• Listen to their feedback and address any issues that come up as they adjust to their new living arrangement. Take concerns seriously and talk with them about how you will address the issue(s) together. If the problems are serious and solutions are not forthcoming, be willing to consider choosing a new facility.