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When Is It Time for Assisted Living?

Kara Lewis
By Kara LewisFebruary 2, 2021

More than one million older adults reside in assisted living communities, according to the American Health Care Association and the National Center for Assisted Living. These facilities offer access to 24-hour care for seniors who would benefit from some daily assistance but don’t require skilled nursing or specialized dementia care.

“Assisted living provides a good balance for individuals who need some assistance throughout the day, but who want to remain as independent as possible,” says Barbara Levison, a geriatric care manager and the president of Florida’s Aging Life Care Association chapter.

Is this popular care type the right fit for your senior loved one? Read on to learn key signs it’s time for assisted living.

How to know when it’s time for assisted living: 10 questions to ask yourself

Determining the right kind of care for your senior family member and knowing when to reach out for help can be difficult. According to Levison, both senior well-being and caregiver mental health may be strained by the time many families take these essential steps.


“In my experience, families and caregivers often wait until things are progressing to a breaking point before looking for assisted living options,” says Levison.

Be proactive about recognizing common signs it’s time for assisted living with this checklist.

1. Does your loved one require help with activities of daily living?

Activities of daily living (ADLs), such as bathing, dressing, and mobility, present frequent concerns for seniors. Nearly 9% of adults 75 to 84 need personal care assistance, according to a 2017 report by the Centers for Disease Control and Prevention (CDC). This figure grows to 21% for seniors 85 and older.

Medication management stands out as one of the most common concerns for seniors and caregivers. In a 2020 A Place for Mom survey of more than 1,000 caregivers, 60% were considering a move to assisted living for their senior loved one due to issues with medication management. Errors in medication management can pose real danger for seniors: The CDC estimates 350,000 people are hospitalized each year due to medication mismanagement.

Assisted living communities provide help with medication management, bathing, and other daily tasks, which benefits both seniors and their caregivers. For Linda Lagesse, 78, who served as her husband’s sole caregiver for nearly four years, ADLs motivated her to contact A Place for Mom’s Senior Living Advisors to find assisted living for her husband.

“I bathed him. I dressed him. I tried to help him get exercise,” Lagesse recalls. “I was exhausted. It just got to be a lot.”

2. Do they need more opportunities for socialization?

Alongside these positive relationships with staff, seniors in assisted living also find connections with other residents. These friendships can help prevent senior isolation, as well as increase a senior’s likelihood of participating in enriching activities.

If your senior loved one often seems bored at home, assisted living encourages residents to get involved with activities like fitness classes, happy hours, game nights, and more.

3. Would your loved one benefit from care coordination?

Before his move to assisted living, Lagesse’s husband experienced frequent health issues that continued to land him in the hospital.

“He kept getting sick, which meant that he was not getting the care he needed from me,” Lagesse said.

In addition to the emotional and physical toll of these hospitalizations, her husband’s regular appointments with many doctors and specialists could become overwhelming.

To simplify this process, assisted living communities coordinate care for their residents. Doctors, physical therapists, and other health professionals often provide services at the community. For residents who wish to continue to see their own doctors and care providers, transportation to nearby appointments is provided. Additionally, assisted living staff communicate insights from these appointments with families and caregivers, allowing them to stay informed and involved.

4. Would a maintenance-free lifestyle reduce stress?

Daily chores and home upkeep can raise significant stress for ailing seniors and their caregivers. Assisted living communities remove these responsibilities. In these long-term care facilities, seniors can expect services like:

  • Vacuuming
  • Dusting
  • Bed-making
  • Bathroom cleaning
  • Laundry
  • General apartment maintenance and beautification

5. Does your senior family member lack access to proper nutrition?

Often, seniors may lack the energy or resources to grocery shop. Additionally, cooking can become challenging for loved ones as they age or lack motivation to cook for one. This can have negative effects on senior nutrition. According to a 2020 A Place for Mom interview of 1,000 caregivers, nutrition was one of the top three reasons for considering moving a senior family member to assisted living. When it comes to dining options, assisted living includes:

  • Three chef-prepared meals a day
  • Nutrients and ingredients from every food group
  • Fresh fruit, healthy snacks, and drinks available any time
  • Weekly menus posted in advance
  • The option to select a special meal plan, accounting for diabetic, fortified, low-sodium, high-fiber, kosher, and other diets
  • Dining rooms with opportunities for conversation during meals

6. Can you continue to provide adequate care long-term?

If caring for your aging loved one has proven to be a challenging balance, assisted living can mark an end to this struggle. Taking a proactive approach to finding trained, compassionate care can allow you to maintain your relationship with your senior loved one without the pressures of constant caregiving. One of these pressures to evaluate when considering assisted living is the hidden cost of family caregiving, which can mean lost income for primary caregivers, in addition to home accommodation expenses, like wheelchair ramps, safety locks, and grab bars.

In other words, it’s crucial to be honest and realistic about your timeline and the expectations you’re placing on yourself, experts say.

7. Have friends or family members noticed changes in you or your loved one?

Have friends and family members commented that your loved one’s health may be worsening, or that they may need more mental stimulation? While this isn’t an automatic sign to seek out assisted living, it can present an opportunity to explore your options.

It’s also necessary to consider how caregiving is affecting you. Unfortunately, caregivers are often the last to notice their own burnout and fatigue. In these situations, family members and friends can act as accountability partners in protecting your mental and emotional health.

“One of my friends stayed with my husband so that I get away for a couple of days. When I got home, he met me at the front door, and said, ‘Linda, you cannot continue to do this. This is too much,’” says Lagesse. “That was really the turning point. It was eight days later that my husband ended up back in the hospital. I knew I had to do something. I couldn’t continue to do what I was doing.”

8. Does their physician recommend assisted living?

While the perspective of family and friends can play a pivotal role, some caregivers and seniors might want a medical evaluation. In these scenarios, seeking counsel from your senior loved one’s doctor can give much-needed insight.

For Lagesse, this meant reaching out to her husband’s cardiologist and his primary care physician, both of whom supported her in moving her husband to assisted living.

Just as a doctor’s opinion can comfort a caregiver, it can boost a senior’s confidence and enthusiasm in the decision to move to assisted living. Seniors are more likely than people of other ages to trust their doctors and take medical advice, according to a 2019 survey from Pew Research Center.

9. Is your own mental and physical health suffering?

In addition to all the time you spend caring for your senior loved one, take time to check in with and prioritize yourself. In her 10-minute video about signs it’s time to look for senior living, dementia and elder-care expert Teepa Snow encourages caregivers to ask themselves the following questions:

  • How are you feeling about yourself?
  • How are you feeling about the person you’re supporting?
  • How are you feeling about how your life is going?
  • How are you feeling about the amount of sleep and rest you’re getting?
  • How are you feeling about other aspects of your life that you’re responsible for?
  • Does the person you’re supporting enjoy being with you?

When caregivers have negative answers to these questions on a regular basis, it can signal the need to step away from a full-time caregiving role. When is it time to move a parent to assisted living? While the answer can be highly individual, one central indicator arises when a caregiver is consistently overwhelmed. A 2020 A Place for Mom survey of 1,000 caregivers found that nearly two out of three primary caregivers have arrived at this breaking point: 65% reported sacrificing their own physical and mental health in order to care for a loved one.

In addition to placing an unfair burden on the caregiver, these feelings of stress can harm senior health and jeopardize the relationship between senior and caregiver long-term. Alongside these mental effects of caregiving, the physical health repercussions are shocking: More than half of caregivers have been diagnosed with two or more chronic conditions, according to the 2020 AARP Caregiving in the U.S. survey. Caring for a family member shouldn’t mean neglecting your own health — and persistent health problems may mark strong signs it’s time for assisted living.

10. Is your loved one largely independent?

When considering senior living, Levison urges families and caregivers to educate themselves on the various types of care available and the many differences between these options.

“If your loved one is experiencing cognitive decline and needs constant supervision, then they would need memory care as opposed to an assisted living facility,” says Levison. “Also, if it’s difficult for them to hold a conversation, they would be more comfortable in a memory care facility where residents have similar abilities.”

“If an individual is requiring regular skilled nursing care due to complicated medical issues, it might be time to consider a nursing home as an option.”

Though there are exceptions, assisted living is not generally a good fit for individuals with dementia, stage 3 and 4 wounds, or brittle diabetes. Similarly, seniors who require access to 24/7, on-site nurses would benefit from a more advanced care type.

In general, seniors in assisted living are mostly independent, but may need help with brushing their teeth, taking their medications, showering, or other activities of daily living. Seniors may also choose assisted living for socialization and mental stimulation. To see if your loved one would thrive in an assisted living setting, nurses typically perform a needs assessment.

When is it time to move a parent to assisted living? Next steps for finding care

You’ve answered 10 questions and determined that your loved one may need additional care. Assisted living communities can provide support while preserving your loved one’s independence.

If you’re recognizing signs it’s time for assisted living, talk with a local Senior Living Advisor to learn more about assisted living communities near you.

Sources:

American Health Care Association (AHCA) and National Center for Assisted Living (NCAL). “Facts and Figures.”
https://www.ahcancal.org/Assisted-Living/Facts-and-Figures/Pages/default.aspx

Centers for Disease Control (CDC). “Early Release of Selected Estimates Based on Data From the National Health Interview Survey.”
https://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201712_12.pdf

A Place for Mom. “Caregiver Survey, December 2020”

Pew Research Center. “Findings at a glance: Medical doctors.”
https://www.pewresearch.org/science/2019/08/02/findings-at-a-glance-medical-doctors/

Kara Lewis
Author
Kara Lewis

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