For many older adults, the first and best option for living out their golden years is to remain in their own homes for as long as possible. But for some, there comes a time when…
For many older adults, the first and best option for living out their golden years is to remain in their own homes for as long as possible. But for some, there comes a time when this strategy becomes unmanageable and it’s time to transition into an assisted living community. Moving is always difficult and it can be made especially more so by all the complex emotions and logistical challenges that often accompany a move made later in life. But there are some ways to make transitioning into an assisted living facility a little easier.
Dr. Susann Varano, a geriatrician at Maplewood Senior Living, a Westport, Connecticut–based senior living residence company, says one of the key components to making a smooth transition to an assisted living community is to start searching for the right place as early as possible. Ideally, you should be planning for and considering your options for months, even years, before you actually need to make the move. She likens the ideal transition to how we plan for college.
“Some people start a college fund when the child is born, and they start thinking about college when they’re in middle school — they consider which high school to go to that will lead to a good college and ultimately lead to a good law school or medical school.” She asks why Americans seem so reluctant to give the same sort of care and attention to what probably should be viewed as an equally important life transition. “These are the final years of your life. Why shouldn’t they be the quality you deserve? You worked hard for your money, and this is your money. Give it the respect that it deserves and don’t be so afraid that just because you’re looking (at moving) means you’re going to go.”
She says many people are superstitious about making a will or talking about their end-of-life plans, thinking that it will somehow hasten their death. “You’re going to die either way. We all are. I don’t know anyone who’s going to live forever, so why not be prepared? Why not have a sense of comfort?” It’s a powerful question and one that should get most middle-aged adults at least thinking about their preferences for later in life.
Dr. Tanya Gure, section chief of geriatrics and associate clinical professor in internal medicine at the Ohio State University Wexner Medical Center, agrees that getting an early start on the transition is important to smoothing the way forward. “I generally encourage families to think about this with a longer view and a longer-term plan. It tends to be more stressful when these discussions come up and there’s an imminent question of moving.”
She says if families can keep a connection to the community in which the senior who needs assistance lives, that can help ease the transition, too. “It’s so common in our society for older adults to live separately from their children in a different state or region,” and finding a way to support that senior from afar so he or she can remain in the community he or she has lived in for years is an attractive option for many, but one that offers some logistical challenges for the adult children managing the situation. Moving the senior to be closer to the family is another option, but that can be hard, too, as it may mean the senior has to give up regular in-person contact with friends and companions, which are known to be helpful for cognitive and emotional well-being. This all means that “the assisted living move is (often) the beginning of the discussion about dependency,” Gure says, noting that the fewer moves you have to make later in life, the better, as each one causes disruptions that can be detrimental to a senior’s overall health.
If it’s possible for your loved one to remain in their own community and keep seeing his or her own doctors, that too can make for a smoother transition. “That’s a nice way to keep continuity for patients,” Gure says. However, this option may not be available everywhere, as some facilities have their own doctors on staff that residents see. So be sure to ask whether your loved one can keep his or her own doctors when moving into an assisted living facility.
It’s also smart to know what to expect in terms of medical support when transitioning to a new assisted living facility, Gure says. “It’s often better to err on the side of having more services in place rather than less at that transitional point,” she says. That way, if there is an issue, the services are lined up and ready. As the senior gets settled in the new environment, you may have the option for de-escalating the level of services used. But you should ask about the availability and flexibility of services before moving a loved one into an assisted living community.
If your loved one is experiencing cognitive decline or has been diagnosed with Alzheimer’s disease or another form of dementia, you may want to spend some extra time with them when they first move in to help them get familiar with their new surroundings, says Megan Carnarius, a registered nurse, founder of Memory Care Consulting and author of “A Deeper Perspective on Alzheimer’s and Other Dementias: Practical Tools with Spiritual Insights.” The nature of these conditions is such that it’s hard to make new memories, and moving to a new home can be disorienting, frustrating and downright scary depending on the stage of cognitive decline. “It takes a bit longer for people to get the layout of a place, and so it would be my suggestion to families moving someone into assisted or independent living to spend the first three or four days staying with them and walking with them everywhere,” she says. This means walking to and from the dining room, the mail room, activities and wherever housekeeping and other services are located to help them get oriented with the new routine and where to go when they need something.
She says this physical act of walking the new routes over and over again is important “because people have somatic memory even if they don’t have cognitive memory.” With Alzheimer’s and dementia, “there’s no place for the new information to land. But if you go with your body and move through space, and the person is getting used to the idea that the bathroom is over here when I get out of bed, people in earlier stages can make that adjustment. If they can’t make that adjustment they should not be there. They need to be in an environment that’s more structured and supportive.”
Lastly, whether cognitive decline is part of the equation or not, the more familiar a senior is with a community, the easier that transition will be. Carnarius notes that “a lot of assisted living facilities will have adult day programs that families can attend and introduce the loved one” to other residents and staff. “Going to events or outings or just going and visiting” can be a good way to get comfortable with the new community. “Then, when it’s time to make a transition into a living situation, the person is so much calmer and more ready. They’ve been with other people [at the facility] and have socialized. Starting early with connecting the person socially to other people” is important for preventing feelings of isolation after a move, she says.
Varano adds that many assisted living communities offer lectures and other events that are open to the public, and attending these can be a great way to get a sense of how that community operates and whether it seems like a caring and welcoming place. Attending events regularly can be especially helpful if you’ve started your search early — seeing a facility on multiple occasions over time can help you determine whether it’s still going strong or if something has changed.
The whole idea is to feel as comfortable as possible when it comes time for you or your loved one to move in. Familiarity breeds comfort in this sense; the better you know the community before you move in, the easier your transition will be. “You’ll feel so good when it’s your time. It’s like you’re home already. You’ll have been there so many times and you’ll know all the people, you’ll slide right in. It’s beautiful. There’s no shock to the system, it just feels right,” Varano says.