It’s inevitable: as we and our parents get older, new challenges and situations arise. Our physical and financial health may falter, we may lose a partner, and we may need a little more help navigating our day-to-day lives. In the later years, a change in living arrangement or social situation may be in order. There are a range of possibilities to consider when making any change, especially one that concerns your future welfare or that of your family members.
Of course, the goal as we get older is to stay in our homes and be independent as long as we possibly can; however, in time, many of us will begin to experience difficulty with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) through the natural aging process and no fault of our own. Inability to manage ADLs can indicate that help is needed. For example, having difficulty with walking, eating, dressing, toileting, bathing and moving around in the home tends to forecast a need for assistance in the near future and a potential change in residence. Trouble with IADLs such as transportation, handling finances, shopping, cleaning, and managing medications can signal a need for an in-home caregiver or the permanent involvement of a family member to assist with daily life.
Besides experiencing difficulty with daily living, more serious signs can show that a person or persons are not capable of getting along without constant attention from a healthcare professional or family member.
Signs an individual may need 24/7 support:
The individual: Experiences frequent falls causing injury, Neglects personal hygiene or lives in extremely dirty surroundings, Is rapidly losing weight, Is getting lost in familiar locations, Is forgetting how to do simple tasks, missing bill payments, or forgetting (or mixing up) their medications.
If someone you love is having trouble with ADLs, IADLs, or exhibiting any of the signs above, a change in living arrangements may be needed for a better (and safer) future. Luckily, various options are available for seniors according to their level of health and financial stability.
1) Aging in Place
For the vast majority of seniors, the goal is to age while remaining in the comfort of their own home. Even for people beginning to struggle with ADLs, the home is still a viable option with small, inexpensive modifications. For a multi-level home, the bedroom may be moved to the main floor to help with mobility; bathroom modifications can be easily made (safety bars installed, new shower area, etc.), ramps installed and more. For those who may need a little more help, personal care workers are available to be on-site for certain hours of the day. Before moving a family member out of the home that they have lived in for years, ask yourself if modifications could be made to make daily life easier.
2) Independent Living & Age-Restricted Communities
For seniors who are relatively healthy but feel distant from social interaction, independent living and age-restricted communities can offer a much-needed boost to their self-esteem and quality of life. Retirement and age-restricted communities have advantages that a typical home and neighborhood may not.
Housing is usually designed for seniors who may struggle with ADLs.
They relieve the stress of daily chores such as home maintenance and housekeeping.
They facilitate new friendships with persons of their same age and interests.
Often communities will offer on-site activities such as ballroom dancing, a movie theater, golf course, etc.
3) Assisted Living
This option is for seniors who do need help with some ADLs and IADLs but can still handle most daily tasks; full-time supervision is not yet required. Residents of these facilities generally live in their own room/apartments with private bathrooms and share common areas with other senior couples or singles. The majority of ADLs such as cooking and cleaning are handled by staff, allowing residents to socialize and enjoy their free time. For many, assisted living acts as a bridge from aging in place to nursing home care. Assisted living facilities (and nursing homes) are often specialized to cater to specific needs. Memory Care Facilities are created for seniors who suffer from dementia or are showing early signs of the disease. These facilities usually incorporate a larger staff with security features in place to keep residents from wandering away from the home. Some assisted living facilities are focused on temporary respite care for seniors recovering from surgery, serious illness or injury. Respite care provides 24-hour help, covering all of the person’s needs until such time as they are deemed healthy for release.
4) Continuing Care Retirement Community (CCRC)
These facilities combine independent living with assisted and nursing home care. A CCRC is for seniors who want to live in a single location for the rest of their lives without worry about their future care needs. When a senior moves in, they live independently, meeting new friends and partaking in daily activities. As the person ages and begins needing assistance with ADLs and more, they move to another part of the community where they receive the care they need. As their health deteriorates, they move again to a nursing facility on campus. CCRCs are commonly the most expensive senior housing option with entry fees greater than $300,000 and monthly fees also charged. If you feel that a CCRC is the best fit for you or family members, start the process early, as there are considerable wait lists depending upon location and amenities.
5) Nursing Home/Skilled Nursing Facility
This is the option for adults who need 24-hour care, they are dealing with debilitating physical and mental illness and are completely unable to care for themselves. In this facility, a licensed physician generally takes the lead and supervises each resident’s care with a nurse and/or health care professional constantly on-hand for assistance. Nursing homes can specialize in specific types of care such as respite care and memory care and are constantly monitored by state agencies in order to ensure they are providing proper care. The cost of a nursing home can be highly dependent upon the level of services needed. Some provide the option of hospice care for those adults at the end of life. The goal of hospice care is to provide seniors with support and dignity in their final days.
5 Steps for Making the Best Choice
When problems begin to arise for ourselves or family members and a decision must be made, there are steps that should be taken to ensure a positive outcome for all involved.
- Do your research. Don’t trust yourself or family members to just any facility or community; make sure the facility is reputable. Ask questions of both the supervisors and current residents. Getting the best care should be your top priority.
- Set daily life expectations. What do you enjoy? What do your parents enjoy? Does the facility offer activities and amenities that meet the needs of its residents? Is the food up to standard? Are the staff? Once you have a list of what you require of a care facility, start checking the boxes.
- Talk to a doctor. Include your doctors in conversations about the mental and physical needs for everyday life. Can the facility accommodate those needs? What does the doctor think? What have they heard about the facility?
- Talk to a financial planner. Here comes the scary question: what can you or your family members afford? What are your options? Is subsidized housing available?
- Visit potential communities and facilities. Like picking the best college, you have to visit each facility. Do the residents seem happy? Are furniture and appliances up to date? Is the facility clean? Is the community welcoming? Do your parents or other family members seem to respond to the environment?
Finding and choosing a housing option or care facility for yourself or a family member is an extremely important process and should never be undertaken hastily. We should all want the best for ourselves and those we love. We all deserve a happy and care-free future as we reach our later years. Good Luck!