{"id":7571,"date":"2024-03-06T09:14:37","date_gmt":"2024-03-06T14:14:37","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=7571"},"modified":"2024-03-06T09:14:54","modified_gmt":"2024-03-06T14:14:54","slug":"when-is-it-time-to-move-to-senior-housing","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2024\/03\/when-is-it-time-to-move-to-senior-housing\/","title":{"rendered":"When Is It Time to Move to Senior Housing? \u00a0"},"content":{"rendered":"

Even after a diagnosis of vascular dementia, Laura Brancato\u2019s father was able to stay in his own home for years. But as his condition worsened, that started to become problematic. <\/span><\/p>\n

Her father started to wander out of the house. His sleep became disrupted, keeping his wife up at night and leaving her constantly sleep deprived. His medications frequently needed adjustments, which meant Brancato\u2014who has young children and a 70-hour-a-week career as an elder law attorney\u2014had to drive him to the doctor\u2019s office. Part-time caregivers were hard to find and unreliable, especially once the COVID-19 pandemic began.<\/span><\/p>\n

Finally, Brancato\u2019s family decided to move her father into a memory care community in 2020. He was safer there but unhappy. Visits were limited, because of the pandemic, and her father didn\u2019t understand. <\/span><\/p>\n

\u201cHe thought we had abandoned him,\u201d she said. <\/span><\/p>\n

The decision to move into senior living is one that many older adults and their families will wrestle with, sooner or later. On average, someone turning 65 today has almost a 70 percent chance of needing some type of long term care in their remaining years, and 37 percent will require residential care in an assisted living or skilled nursing facility, according to LongTermCare.gov.  <\/span><\/p>\n

Determining the best time to make the move often creates conflicts. Siblings may fight over the best course of action. Older adults may resist making a move, even when their adult children feel it\u2019s clearly time.  <\/span><\/p>\n

\u201cThe older person is saying, \u2018Why? I\u2019m perfectly fine. I can take care of myself,\u2019\u201d according to Dianne Savastano, a patient advocate and founder of HealthAssist in Manchester, MA. <\/span><\/p>\n

Aging in Place<\/b><\/p>\n

Most older adults want to remain in their own homes as long as possible. Realistically, however, some will reach the point when that\u2019s no longer safe or comfortable. A person living with dementia may wander and get lost, or leave the stove on and start a fire. Mobility issues may pose a high risk for a fall or make it impossible to handle basic daily chores like cooking, cleaning, dressing or bathing.  <\/span><\/p>\n

When counseling older adults and their families grappling with this question, Kimberly Knight focuses on activities of daily living (ADLs). <\/span><\/p>\n

\u201cIt\u2019s all about ADLs,\u201d said Knight, director of caregiver-support programs at the Senior Source in Dallas. \u201cConsider whether the older adult is still able to navigate the home and care for themselves safely.\u201d <\/span><\/p>\n

She asks questions: Can the person get up out of bed, toilet and dress themselves in the morning? Are they able to stand long enough to prepare meals? Do they remember to take their medications on schedule? <\/span><\/p>\n

Knight also urges family members to look for signs the older adult isn\u2019t coping. Are they losing weight? Is there spoiled food in the refrigerator, or no food at all? Are bills and mail piling up? Is the home cluttered? Is the person skipping basic grooming tasks? If a spouse or other older adult is the caregiver, is that person showing signs of fatigue or burnout? <\/span>
\n<\/span>
\n<\/span>Not all of these signs automatically mean it\u2019s time to make a move, but they all do usually mean that the older adult needs more help. <\/span><\/p>\n

Older people without family support need to plan ahead for the care they\u2019ll need someday<\/b><\/p><\/blockquote>\n

For those who want to stay in their own homes, the first strategy is to explore options to make staying there safer and more manageable. A life-alert device, for example, could ensure that an older adult can get help quickly in the event of a fall. A part-time, paid caregiver might be able to help with meals, shopping, getting dressed or other ADLs.  <\/span><\/p>\n

Another key factor in the timing decision is the availability\u2014or lack of availability\u2014of family support, according to Jenny Munro, a gerontologist. She advises older adults and their families every day on the question of \u201cWhen is it time?\u201d as response team manager at Home Instead, an in-home caregiving agency.<\/span><\/p>\n

She sees this with her own father, who\u2019s now 98. He wants to remain in the house where he has lived for more than 60 years. His cognitive condition is still excellent, but he\u2019s frail and weak.<\/span><\/p>\n

Family support is plentiful: Munro is one of nine adult children. After her mother died a few years ago, all stepped in to handle some aspect of his care. A brother who is a banker, for example, is handling his finances. Four of the siblings live nearby, and used to take turns staying with him, a week at a time. That worked until her father began experiencing incontinence. Now, three, full-time, care professionals provide round-the-clock care, and the siblings visit often.<\/span><\/p>\n

\u201cIt\u2019s very expensive,\u201d Munro said. \u201cThankfully, he saved and invested and has the ability to pay for that.\u201d <\/span><\/p>\n

Family support may not be an option, especially for solo agers and older adults without children or spouses. They must plan to handle their care needs on their own.<\/span><\/p>\n

Solo agers especially may want to hire a professional to help with caregiving decisions.<\/b><\/p><\/blockquote>\n

Like Munro, Carol Marak pitched in, along with her two sisters, to care for her mother, who had several chronic health issues, and her father, who had Alzheimer\u2019s. The couple lived in a rural area and needed help with rides to the doctor, cooking, cleaning and managing their finances. <\/span><\/p>\n

The experience was an eye-opener for Marak, 72, who was divorced, childless and had little savings.  <\/span><\/p>\n

\u201cIt scared the heck out of me,\u201d she said. \u201cIt took all three of us to take care of Mom and Dad. Who\u2019s going to do that for me?\u201d  <\/span><\/p>\n

After her parents passed away, Marak began focusing on improving her health and adjusting her lifestyle. She moved from her suburban home to a high-rise apartment building in Dallas that functions as an informal retirement community. Many of the residents are older and support each other. She can walk to errands or catch a bus. <\/span><\/p>\n

She also wrote a book, <\/span>Solo and Smart: The Roadmap for a Supportive and Secure Future<\/span><\/i> (2022). And she\u2019s making plans for when she\u2019s no longer able to care for herself on her own. <\/span><\/p>\n

To do that, Marak urges solo agers to hire a professional who can help weigh caregiving decisions, such as an aging-life-care professional or geriatric care manager. Solo agers may want to undergo a cognitive function evaluation before signs of memory loss occur. The test can serve as a baseline and can be repeated regularly as part of their routine health care, to provide objective information on the older person\u2019s cognitive status in the future. <\/span><\/p>\n

\u201cYou need to have your team of professionals who are looking out for you and who will take notice if you\u2019re starting to decline,\u201d said Marak. <\/span><\/p>\n

An Iterative Process<\/b><\/p>\n

Don\u2019t be surprised if the decision to make a move turns into a series of decisions stretching over several years, Savastano advises. <\/span><\/p>\n

\u201cI call it \u2018iterative decision-making,\u2019\u201d she said. \u201cYou’re constantly adjusting to the older adult\u2019s level of abilities and what they need help with.\u201d <\/span><\/p>\n

She worked for 13 years as an advocate for a client named Rosalie, guiding her through knee replacement surgery and then a move into an independent living apartment in a continuing care retirement community (CCRC).  <\/span><\/p>\n

Rosalie loved her apartment and made new friends. The move was such a success that, even though the CCRC offered sections for higher levels of care, \u201cRosalie made it truly clear to both me and her children, over and over again, that she intended to live there through the end of her life,\u201d Savastano said.  <\/span><\/p>\n

Those who delay moving until they\u2019re in poor health may be turned away by some senior living facilities.<\/b><\/p><\/blockquote>\n

When Rosalie\u2019s cognitive abilities began to decline, the staff wanted to move her into the community\u2019s memory care unit. Savastano negotiated for a way to honor Rosalie\u2019s wishes. <\/span><\/p>\n

\u201cWe gradually increased the use of private, in-home assistance, ultimately involving 24\/7 care in her home, which thankfully she was able to afford,\u201d Savastano said. <\/span><\/p>\n

Savastano cautions that while older adults may wish to stay at home as long as possible, later isn\u2019t always better than sooner. An older adult\u2019s condition can decline to the point that their options become limited to skilled nursing or long term care. <\/span><\/p>\n

\u201cIf you wait too long, you may not have as many choices,\u201d she said. Some assisted living or memory care communities, for example, may accept an older adult with dementia, knowing their condition will decline. Most will make accommodations to allow a longtime resident to stay until the end of life. But the same community likely won\u2019t accept someone in that later stage as a new resident. <\/span><\/p>\n

Sooner, Rather than Later<\/b><\/p>\n

A \u201csooner, rather than later\u201d strategy worked well for Larry and Marilyn Comstock, both in their 80s.<\/span><\/p>\n

After visiting eight communities, the Comstocks moved into an independent living apartment in 2018. Even though both were\u2014and still are\u2014healthy, active and cognitively sharp, and even though it meant leaving behind their beloved home and many treasured possessions, they felt it was time. They chose Highland Springs Senior Living in Dallas, which has on-site medical care and offers assisted living, memory care and long term care, should their needs change. <\/span><\/p>\n

\u201cIt was the hardest decision we\u2019ve ever made,\u201d Marilyn Comstock said. \u201cBut we didn\u2019t want our children to have the burden of finding someplace for us to move. We wanted to make the decision ourselves.\u201d <\/span><\/p>\n

A few months later, the couple felt affirmed in their decision when Marilyn fell and broke her hip. Thanks to the community\u2019s alert system, she was able to get help in minutes. Marilyn recovered, and today they\u2019re both thriving, serving on resident committees and socializing with the many new friends they\u2019ve made.<\/span><\/p>\n

\u201cWe\u2019re glad we moved when we did, because we still have the ability to enjoy the facilities and the people here,\u201d said Marilyn Comstock. <\/span><\/p>\n

When the Older Adult Resists<\/b><\/p>\n

The decision to move into senior living becomes more complicated when family members think it\u2019s time for a move\u2014but the older adult is unwilling. If cognitive decline is present, family members may question whether the older adult is capable of making the right decision. <\/span><\/p>\n

\u201cIt\u2019s a tricky situation when the older adult is resistant to a move,\u201d said Hannah De George, elder advocate at St. John’s Senior Services in Rochester, NY.  <\/span><\/p>\n

De George recently sat in on a family meeting with some close friends. The adult children all agreed it was time for their parents to move into assisted living; the parents were unwilling. <\/span><\/p>\n

\u201cThey felt ganged up on,\u201d said De George. \u201cNo one wants to be told, \u2018You can\u2019t live in your own home anymore.\u2019\u201d <\/span><\/p>\n

Family members can\u2019t force an older adult to move, unless the person has been declared unable to make their own decisions and placed under guardianship by a court order. But that doesn\u2019t mean families should immediately accept \u201cno\u201d as the answer if it\u2019s clear the older adult needs more help. <\/span><\/p>\n

\u201cWhen it\u2019s safety versus autonomy, you have to err on the side of safety,\u201d Knight said. <\/span><\/p>\n

Savastano sometimes coaches adult children on different strategies for making their case with a parent resisting a move. <\/span>
\n<\/span>
\n<\/span>\u201cBut in reality, sometimes you end up waiting until a crisis occurs,\u201d she said. <\/span><\/p>\n

Family Conflict<\/b><\/p>\n

The decision to move an older adult into senior living often sparks conflicts among the adult children. <\/span><\/p>\n

\u201cThis is an issue that can break up families and cause siblings to stop talking to each other for years,\u201d said Knight. <\/span><\/p>\n

An adult child living out of state might think the parent is fine living alone at home, whereas a nearby sibling, who visits every day, may be convinced that\u2019s not an option. <\/span><\/p>\n

One adult child may want to move the parent sooner, rather than later, and sell the aging parent\u2019s home or dip into their nest egg to provide the best available care. A sibling who\u2019s counting on inheriting that money may disagree. Feelings of guilt, sibling rivalry or other emotional baggage add to the morass. <\/span><\/p>\n

Older adults can help ward off conflicts by communicating their wishes in advance, before a crisis hits, and having the legal documentation in place for a trusted person to handle the financial aspects of paying for senior living, should they become unable to do so. <\/span><\/p>\n

If it\u2019s too late for that option, experts advise bringing in a third party\u2014a geriatric care manager or physician, for example\u2014who can weigh in with a neutral opinion on the need for residential care.<\/span><\/p>\n

A Good Decision<\/b><\/p>\n

Laura Brancato\u2019s father was initially unhappy after moving into memory care. But the regularity of the community\u2019s daily schedule\u2014important for people with dementia\u2014made him feel comfortable. Medical staff on site adjusted his medications quickly when needed, avoiding the need for frequent trips to the doctor. Soon, her father embraced the place as home.<\/span><\/p>\n

He stayed there until his death in December 2023. Looking back, Brancato\u2019s family feels they made the right move at the right time. <\/span><\/p>\n

\u201cHe forgot he had ever lived anywhere else,\u201d Brancato said. \u201cInstead of bringing him home for celebrations, we started bringing the family to him. He really was thriving in that environment.\u201d <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Even after a diagnosis of vascular dementia, Laura Brancato\u2019s father was able to stay in his own home for years. <\/span><\/p>\n

Read more When Is It Time to Move to Senior Housing? \u00a0<\/span> ›<\/span><\/a><\/div>\n

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