Episode 51 -
Choosing the best senior living option for your mom or dad can feel overwhelming. Many of us expect the answer will be obvious – if our Mother is suffering from Dementia, for instance, the time will come when she needs to engage in Memory Care. Or, if our Dad has been diagnosed with Parkinson’s, we know he might need assisted living or maybe he prefers home care instead?
The truth is, though, that the right choice isn’t usually in front of our eyes. More often than not, it’s the little things – like that time Dad complained about the single stair in his shower, or the time Mom forgot to feed the dog – that indicate it’s time to look into care options.
In those less obvious cases, choosing between so many different types of care might feel daunting. What’s the difference between assisted living and a nursing home? Are there ways my parent can continue to live independently? Do I have to hire a full-time caregiver? Does my mom really need that extra help?
In today’s episode, we’ll break down the options for you – so that this new and treacherous landscape can transform into something simple and comprehensible. When you understand your options, you can make a much more informed decision – without worrying that you might be missing something. We’ll discuss assisted living, nursing homes, memory care, home care, and even whether moving Mom or Dad in with you is an ideal option. We’ll also talk about independent living – and ways to stretch that period out for your parents, while still giving them the help they need.
Before we get into all that, though, let’s get into the signs that it might be time for more help in the first place.
You can begin by analyzing your parents’ overall physical health. If your parent is in great physical shape, then their options might be a lot more open. If you notice changes or problems in their health, though, you don’t want to wait to consult a doctor and start planning your next steps. Physical health is nothing to mess around with and must be a priority.
If you can visit with your parent, take the time on your next trip to absorb their behavior and look for any signs of health changes. Observe details like weight, sleep patterns, and possible injuries.
Has your mom lost a surprising amount of weight lately? If she looks thinner than usual, this could indicate that she’s been forgetting to eat. It could also be a sign of something more serious – like cancer, dementia, or depression. If you notice dramatic weight changes, you shouldn’t wait to get your parent to a doctor. When the reason for the weight loss is determined, not only can your mother begin treatment – but together, you can decide the best care option. If this is an early sign of dementia, for instance, you can think about Memory Care. If it’s a medical condition like cancer, your doctor will help you find the most suitable care.
If your parent’s weight is about the same – that’s a great sign. It’s possible that your mother can continue to live independently. Still, there are other – equally important - factors to consider. Once you’ve analyzed your parents’ weight, find out how they’ve been sleeping.
Have you noticed that your dad has been falling asleep at the couch more often, or taking a long time to get out of bed morning? In a non-confrontational, conversational manner, ask him if he’s had any trouble sleeping lately. Has he missed early morning appointments or been consistently late due to sleeping in? This could be a sign that he’s struggling to fall asleep at night. Has he been taking “naps” during the day that tend to last for hours? Does he seem lethargic or is he alert? Changes in sleep patterns are a sign that physical health might be declining. Dad could be losing sleep because of new aches or pains in his body, or because he is just generally slowing down.
If you notice that your mom or dad’s sleep is being affected, be sure to take them to the doctor. Once you understand why this is happening, and treatment begins, you can start looking into the best options for care.
Finally, try to notice if there are any signs of injury on your parent’s body. Your parent might not always tell you when he’s suffered a fall – so you’ll need to look out for these signs yourself. If you notice new bruises, possible limping, or broken skin – this is a sign that your parent has been facing mobility struggles. Now, depending on the severity of these struggles, you might not need to jump to assisted living or a nursing home. Depending on your finances, there are plenty of options to making the home a safer place for your loved one. However, if the falls are a sign of something bigger – like Parkinson’s disease – you will have to look into more serious care.
Of course, not everyone can observe their parents’ physical health. Maybe you live out of town or you aren’t able to see your loved one in person due to the COVID-19 pandemic. If this is the case, ask yourself if there is anyone who is able to stop by Mom’s house for you and report back. Do you have a sibling in town or a family friend? Try to find a neutral party who will report their findings in an honest way. If your sibling is adamantly against long-term care, for example, he might not be the best person to ask – because he’ll go out of his way to only look for signs that help his cause.
You can also ask your parent about their health on the phone. Just keep in mind that they might not be entirely honest with you – or they might not even know the answers. If your dad has suffered weight loss, for example, he probably hasn’t noticed. Still, it’s worth speaking directly to your parents so that they have a chance to voice their own concerns about their health.
Once you’ve analyzed your parents’ physical health, it’s time to address their mental health. Mental health is equally important to consider when it comes to knowing if it’s time for extra help. If your parent is suffering from memory loss, depression, anxiety, or anything else concerning – you’ll want to get them help right away.
Signs of faltering mental health might not be as obvious, but there are certain signs you can look for. Have you noticed if your parents’ house is being neglected, for example? If your mother or father is no longer caring for their home – this could indicate that they are no longer managing their lives well. Look for dirty dishes, messy floors, cluttered corners – anything that indicates that domestic needs are being forgotten. If your parent is not able to keep up with housework, it’s safe to assume he’s struggling to keep up with his own care. Not to mention, no one wants their parent to be living in filth. It might be time to enlist extra help around the house.
Does your parent seem confused? Has mom been leaving the oven on or has dad forgotten to put groceries away? Did you find the TV remote in a kitchen cabinet? Is your mom calling her cat by the wrong name? Sure a simple mistake might happen from time to time and not be cause for alarm, but if you’re noticing frequent signs of confusion, it’s a sign that something more serious might be happening. If this is the case, it’s time to take your parent to a doctor and discuss care options.
Finally, take note of your parents’ physical appearance. If it looks like they are failing to shower, brush their teeth, or keep up with basic grooming, this might mean they are suffering from depression or that a change in their health has impacted their ability to care for themselves. When your parent is unable to care for themselves, it’s time to enlist extra help. Bring your parent to the doctor for further assessment.
Once you have assessed the situation and determined that your mom or dad does need help, it’s time to decide the best type of care for them. Remember to include your parent in this conversation – after all, this is their life, and they should have a say in any major changes they are facing whenever possible. To learn more about how to begin this conversation with your mom or dad, check out our episode “When is it Time to Move?”
If you know that your parent needs some extra help, but believe she still has a great bill of health overall, you might want to make some simple adjustments to her independent living style. This can be the best option for many families – especially when the parent is hesitant to make a more drastic move. Independent living adjustments can also act as a transitionary period to get your parent used to accepting more help.
There are many instances in which independent living is still the best option. If your mom is physically and mentally healthy, for example, but she is struggling to move around the house, consider hiring an occupational therapist or speak with her doctor to see if she qualifies for home health care – that would provide an occupational therapist through her Medicare.
Occupational therapists will evaluate the home and recommend safety changes – like installing grab bars or chairlifts for the stairs. They will also help your parent to improve their physical strength and balance, by teaching them new exercises and techniques. According to AARP, “studies show that visits from an OT help older people stay in their homes longer.” If your relatively healthy parent is adamantly against moving into a facility, an OT just might be the perfect answer for both of you.
In addition to installing grab bars and other safety measures, you can also look into purchasing assistive technology. There are a number of products available meant to help with your parent’s at-home safety. AARP reports that, “SimplyHome offers monitoring equipment such as motion sensors and GPS watches, and QuietCare has a motion-sensor system that can learn a person’s daily patterns and send alerts when there is a significant change.”
If your parent is resisting help, but you can’t be around to track their health and keep up with their living situation, assistive technology might provide just the help you need – temporarily, at least.
You can also enroll in your mom or dad into an Adult Day Care program. If you don’t want your parent to be alone or unsupervised throughout the day, this could be a good solution. Adult Day Care programs provide meals, activities, and companionship – so if your mom is forgetting to eat or your dad is staring at the TV all day, this could be extremely helpful. It can also provide your parents with a new community of friends who can relate to them – which is especially important if they are living alone and don’t spend much time socializing.
The most popular of these services is the Program of All-Inclusive Care for the Elderly or, PACE. If your loved one qualifies for Medicaid, this service is completely free. Otherwise, it’s about $3,000 a month.
If your mom or dad seems perfectly healthy, but they are suffering from loneliness, service programs like Senior Corps could be a great help. Senior Corps sends volunteers to visit with the elderly right in their own home – and the volunteers are 55 and up, to ensure that your mom or dad will feel comfortable.
There are also support networks known as “Villages” available in certain areas around the country. These are nonprofit networks that are intended to help seniors stay at home and get the care they need. Villages volunteers will help your parent with everyday tasks. Your parent will also qualify for discounted services – including everything from household maintenance to at-home nursing care. Villages cost around $300 to $500 a month.
Finally, if your parent wants to stay home but has major health problems that require constant medical care, you can look into hiring a registered nurse. Whether you need a registered nurse for 24-hour healthcare, or only in certain durations, this is something to consider if your parent’s health is failing, but they are adamantly against leaving their home.
While independent living is a wonderful option for many seniors, it is not always possible. If your parent has been diagnosed with a chronic illness, is feeling depressed, has severe mobility struggles, or is simply not in a place to care for their home at all anymore – it might be time to consider other options.
Now, that doesn’t necessarily mean your parent needs to leave their beloved home. In fact, the most common type of care option is Home Care. It’s the largest and fastest growing sector of long term care out there – and it’s easy to understand why.
With home care, your Mom or Dad doesn’t need to make the move to assisted living or a nursing home – which means that in addition to saving on the stress and transitionary position that moving comes with, you’ll also be saving quite a bit financially.
Chances are, your loved one isn’t ready to leave their home – and might not ever be. Home care allows them to stay where they are most comfortable, without making many adjustments. They’ll be able to eat what they love, engage in household activities that they are familiar with, and feel safe in their own familiar surroundings.
If your parent is suffering from dementia, home care is often the best option. It’s highly recommended that a person with dementia remains within familiar surroundings – in order to reduce stress and strengthen memory. Depending on the degree of the disease, you might need to consider memory care – but often, dementia patients are able to stay at home for the remainder of their lives.
Home care also allows you to be in control of when your parent receives help. If your mother needs help maintaining her home or cooking her meals, for example, you can schedule assistance for just a few hours each day. This is a great alternative to paying for a full-time lease with assisted living, especially when your mom or dad may require more hands-on care and assistance.
Finally, home care is customized to your loved one. That makes it pretty indispensable. Your loved one will be the number one priority to his caregivers and his care will be fully customized to fit his individual needs. Unfortunately, that’s not as possible at move-in facilities, just because the staff has so many residents to keep track of. With all the focus on your Mom or Dad, you’ll never have to worry that their individual needs are not being met to their liking.
Home care can provide your loved one with everything they need, up to needing a licensed registered nurse (if you are looking for 24-hour nurse care, we’ll dig into that later on).
Of course, if you and your loved one decide that leaving the home is the right option for them, there are plenty of live-in facilities to consider.
Assisted living is a fantastic option for any person who needs extra help, but is still able to function on their own to a significant degree. The reason a person might choose assisted living over home care is if they are interested in residing in a community of other seniors – where they can build friendships and connections. Assisted living also provides a safe place to live with regular visits from nurses, as well as a nice community and daily activities.
Assisted living doesn’t strip your parent of her independence – it just provides a space in which daily living is easier. Not to mention, the community of other seniors establishes a foundation for friendships and companionship that simply would not be available to your mom or dad at home.
Many seniors report that assisted living communities feel like college again – because they are surrounded by new friends and have so much to do. From community theatre to art classes to book clubs, the activities really are endless. Plus, if you are not able to be with your parent most of the time, you can rest assured that your parent is being well taken care of in an assisted living community.
Depending on the facility and the state – as well as the insurance, assisted living costs can vary greatly. On average, though, the cost can range fairly significantly from $2000 to $4000 up to $8000 to $10,000 a month depending on the facility and the amenities that are offered. If you believe that this is the best option for your parent, look into long-term care insurance or the living benefits of your parents’ life insurance.
Now, if your parent is unable to live independently at all, a skilled nursing facility might be the best option. At a skilled nursing facility, your parent will receive round-the-clock care for everything from their illness to their daily needs. Much of their care will be monitored by doctors and they will receive physical, speech, and occupational therapy to help strengthen their minds and bodies.
If your parent is unable to feed, bathe, dress, or move on her own – this is likely the best option. These facilities don’t have to be permanent residences, though. If your parent has suffered a bad fall or is recovering from surgery, they may need to stay here temporarily while they recover.
Much like assisted living facilities, the cost of skilled nursing facilities depends on the state and the location itself. A private room in a nursing home can be quite costly – averaging about $7000 a month. If your parent is a veteran, though, they might qualify for discounted care. Otherwise, again, look into insurance options – either from Medicare, long-term care insurance, or life insurance and Medicaid.
If your parent is suffering from Alzheimer’s or Dementia, Memory Care living might be their only option. Memory Care provides specialized care for patients suffering memory problems. Specific routines are structured to decrease stress, and staff is trained to deal with the unique difficulties that coincide with Alzheimer’s and Dementia.
There are more frequent check-ins than at Assisted Living Facilities and everything from meal to basic care is highly organized, so there are never any breaks from routine or surprises.
Daily activities are meant to improve cognitive function – so that residents are mentally engaged and strengthening their memory. There are different activities offered depending on the stage of your parents’ disease.
According to registered nurse and memory care consultant Megan Carnarius, “in regular assisted living, residents are expected to manage their own time; menus and mealtimes are posted, but staff is not checking in on them. In memory care, the staff ensures residents are getting to meals, coming to activities, and moving onto the next thing.”
At the same time, these facilities also offer heightened security – so that patients with a tendency to wander cannot leave the premises or risk getting lost. Elevators need codes, doors are alarmed, and in some instances, patients wear tracking bracelets.
If your parent has recently suffered a stroke and is suffering from temporary cognitive and memory problems as a result, Memory Care is probably not the best option. This type of care is intended to be permanent or long-term, not temporary. Instead, you might consider at-home care specialists that are memory specialists or a temporary stay in a skilled nursing facility while your parent recovers.
Memory care costs around $5000 a month on average – but, again, this pricing varies depending on the state and the level of care. Unfortunately, insurance does not always cover the cost of this type of intensive care. According to elder law attorney Richard Newman, “most families that utilize memory care have to pay out of their own pockets.” Long-term care insurance is an exception, though – so, if it’s not too late, be sure to look into purchasing a plan if you haven’t already.
After assessing the different options for long-term care, you might have decided that you want your parent to move in with you. If this is something you are considering, it’s essential that you analyze the situation closely and ask yourself some serious questions before you take that leap. Having a parent move in might not be as cost-efficient as you are hoping or might entail a great deal more work than you’re anticipating.
You also need to make sure this is in the best interest of your parent. Have your parent analyze the situation just as much as you do, because oftentimes, she may simply not want to move in with her adult child. This could make her feel a loss of dignity or she may simply want her space.
Before you move your parent home with you, ask yourself these questions:
- Will I need to quit work to care for my loved one?
- Can I afford to implement the proper safety measures – like grab rails – into my home?
- Can I afford the extra expense of another household member?
- Do I have a good relationship with my parent – or do we fight a lot? Is there any unresolved issues between us?
- How will this move affect the rest of my family members?
- How will I establish boundaries?
- Do I have the resources to provide my loved one with the care they need? Do I want to take on this responsibility?
At the same time, have your parent answer these questions for themselves:
- Do I feel comfortable living in my child’s space and respecting their household rules?
- Do I feel comfortable confronting my child if they are doing something I do not like?
- Do I have unresolved issues with my child?
- Will I still be able to participate in activities I love?
- Do I need to help pay for my care in their house?
- Will this move make me feel less independent?
After both parties have answered these questions, if you determine that moving in together is still the best fit, make sure to implement the necessary safety measures and set up local community resources to help your parent feel at home in the community. These might include church memberships, classes, and counseling services. Then, make sure you speak with your parent openly and honestly about how they can continue to feel independent when living with you.
Finding the best care solution for your parent is never easy. There are so many factors to consider – from your parents’ abilities and desires, to cost of care. Once you have carefully assessed all of your options, however, you should be in a better place to make the best decision for you and your parent. Just be sure to include them in the conversation, too, since this decision will be impacting the rest of their lives.
With the right care, you and your parent can set your worries aside and focus on what’s most important: spending time together and reclaiming happiness.
We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.
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