Last Updated: April 4, 2013
By Jeannette Franks, PhD
Moving seniors is never as simple as we'd like. You may think
your job is done once the move date for your loved one is set. But
your involvement will only continue, as she or he transitions to a
new home and adjusts to the new surroundings. Whether nearby or at
a distance, you are still one of the primary caregivers, regardless
of the living arrangement. I'd like to offer some suggestions and
guidelines that can significantly smooth the transition and promote
harmonious living in a retirement or long-term care community.
Planning the Move and Setting up the New Environment
Most parents benefit more when you provide the actual physical
assistance in packing and unpacking rather than your dos and don'ts
about what to take and what to leave. Creating a new home can be a
highly personal and potentially emotional process, and ensuring
choices rather than issuing mandates about possessions is one
method that may foster a better sense of identity and comfort for
mom or dad in the new location.
It may be helpful to encourage a meaningful farewell from
whatever place mom or dad is leaving. Whether it is the family home
of many decades or a hasty move from assisted living to a higher
level of care, your parent has established relationships with
people and some sense of continuity of place in the familiar
My friend Elaine M.1, a Seattle grief counselor in
practice for many years, created her own ceremony when she moved.
She held a dinner party in her house with family and a few close
friends, and then they visited each room by candlelight,
remembering special events, commenting on the changes over time,
and saying goodbye. For her, this helped start a better beginning
in the new community.
Establishing a Familiar Environment
When in doubt about what to take, it may be good to err on the
side of hanging on to "stuff" a bit longer, even if space is tight,
as it often is in a new setting. Possessions can be discarded
later, after thoughtful contemplation. Don't rush these decisions
when moving seniors, especially if they seem difficult. I remember
one retired university professor, Henry L., who ruthlessly culled
his books, donating many valuable volumes to a library. He later
lamented his decision and mourned his missing books. Even though he
knew he may never have opened some of them again, they were
long-time companions and he missed them profoundly.
When moving seniors, establishing a familiar environment, rather
than buying the perfect new couch or carpet, can ease the
adjustment. When my father moved to assisted living, I helped him
arrange his bedroom so that when he awoke, his gaze met the same
bookshelves, books, souvenirs, and family photos he had first seen
when he awakened in the family home of 20 years. The living room
was set up with the same old recliner, TV, pictures, and ornaments.
He felt immediately at home, and it especially helped keep him
oriented in the difficult process of mid-stage Alzheimer's.
Working with Staff
Often, what's your job, what's their job, and what's somewhere
in between is unclear. You and your parent may have carefully
reviewed a lengthy contractual document full of legalese, yet are
uncertain as to the difference between a nurse, an aide, and a
resident assistant, for example. Most of you who are moving seniors
are dealing with a retirement
community or long-term care community for the first time and it
is not intuitively obvious what a social worker does or what the
duties of an activities director are.
Primary Point Person
Ask your initial contact, often a marketing director, who your
primary liaison person will be. I've visited almost 300 different
retirement and long-term care communities, and personnel in all of
them vary considerably, depending on number of employees and number
of residents, style of elder care services, budget, and
You probably don't want to stop the first person you see in the
hall to take care of a housekeeping issue or to fix a leaky faucet.
Find out who the main "point person" is. In many communities, the
general manager or second in command to the top administrator will
be that person. He or she can explain to you who to talk to in
various circumstances. It might even be helpful to ask for an
organization chart and even job descriptions, if available.
Conversely, it is important that the office staff knows who the
primary "point person" within your family is. You want to be clear
about whom to contact in case of emergency and who would be the
backup to that family member, in case the primary family contact
cannot be reached or lives at a distance.
In some communities, elder care services such as obtaining
emergency medications are handled by staff. In other situations
this may be up to a family member. Assisted living
can be defined quite differently from state to state, and sometimes
quite differently within the same city.
Try not to get a reputation for being "the difficult daughter"
if you can possibly help it. I remember my dear friend Mary who was
working hard to help her mother settle in comfortably to an
assisted living community. The third day there she complained to
one of the housekeeping staff that some soiled linens had not yet
been removed from the bathroom. However, many communities provide
fresh linens only on a weekly basis. Find out what the norm is for
their elder care services.
Ask staff what you can do to help them do their jobs well. For
example, taking my father out to lunch on the day they cleaned his
room helped housekeeping to discharge their duties more quickly and
efficiently. Then, if an unexpected mess occurred on a different
day, they would have more time and good will to deal with it.
In a nursing
home with round-the-clock staff, elder care services are not
usually provided 24/7. The people on graveyard shift are there for
emergencies and for routine care that must be provided in the
middle of the night-for example, repositioning a resident in bed to
prevent or to help heal bed sores. It's usually unrealistic to
expect staff to provide room service if mom wants a midnight snack.
Find out what can be expected and what is considered above and
beyond the call of duty.
Some residents in long-term care communities might benefit from
an advocate, especially if you live at a distance and cannot be
there on a regular basis. The national long-term care ombudsman
program provides trained volunteers in every county who visit every
facility on a regular basis (see http://www.ltcombudsman.org).
Your family member might desire a paid companion who has the
time and motivation to make certain that your mom or dad has the
best possible quality of life. I was visiting my mother-in-law once
in a Florida nursing home with exceptionally high standards of
care. But during my visit I heard a woman, undoubtedly with one of
the dementias, calling out, "Help me-please help me!" I went in and
held her hand, asking how I could help. She immediately became
calmer and soon fell peacefully asleep. This was a busy skilled
care facility and the staff simply did not have the time to just
sit and hold someone's hand. I did.
Get to know the staff who work directly with a family
member-often the CNAs (certified nursing assistants), aides, and
resident assistants or caregivers-and learn their names and what
they do, both officially and unofficially. Thank them for a job
well done at every opportunity. Written thank you notes are
especially appreciated. When someone does an excellent job, I have
sent that staff person a letter and a copy to their supervisor and
sometimes nominated them for a caregiver award. The local
Alzheimer's Associations, State Pioneer Networks (see http://www.pioneernetwork.org/)
and organizations such as the associations for homes for the aging
(see http://www.aahsa.org/) for
your state usually have recognition events, which are important
because they help to improve care for everyone.
senior housing communities forbid or discourage tipping for
their elder care services. Usually there is a scholarship or
Christmas fund to which you can contribute. I have also bought
holiday or birthday gifts for the people I felt were doing the
Every family is as different as a fingerprint and what works
well for one might not work well in yours. But planning ahead when
moving elderly parents and seniors and understanding the
environment will always help families enjoy the community and
maintain happy family ties.
Jeannette Franks, PhD, is a passionate
gerontologist who teaches at University of Washington and Bastyr
University; she is the author of a book on assisted living and
1 All names in this article have been changed to