The need for senior care is often evident. If your father just had a stroke, the hospital’s care team may organize his transfer to a senior care facility with specialized rehab. However, the signs aren’t always so conspicuous, so the decision may not be so straightforward.
As time progresses, you might start questioning, “Is mom still safe living all by herself?” In these moments, it becomes crucial to recognize when it’s time to consider moving to a senior care facility.
Levels of Senior Care
Often, a senior care journey begins with more independent levels of care. When it’s time for a senior to move to a higher level of care, like a nursing home, it’s usually because they need medical assistance and extra help with their daily activities.
Entry options for senior care often include:
— Assisted living. Assisted living facilities are for older adults who need help with activities of daily living, like bathing or walking.
— Board and care homes. Board and care homes, or group homes, are smaller abodes that care for 20 or fewer seniors. Skilled nursing care is usually not offered at board and care homes, and it’s similar to an assisted living environment.
— Continuing care retirement communities, or CCRCs. Sometimes known as life plan communities, CCRCs are like a campus for senior care. Depending on the community, they may offer a range of services from independent living quarters to skilled nursing care.
Assisted living is a frequent first choice and a great option for seniors who need some assistance and don’t want to sacrifice the social atmosphere. These communities are secure and staffed with caregivers and medical personnel. According to the American Health Care Association and National Center for Assisted Living, more than 800,000 Americans are members of an assisted living community.
Naturally, many seniors might be apprehensive about the transition to any senior care facility. However, “patients don’t have to worry about much other than enjoying themselves. The gym, games and social activities are all provided for them,” says Dr. Michael Tehrani, a geriatric physician with MedWell Medical in Long Beach, California. “At home, seniors might feel alone without much to do, but when they are in assisted living, they are surrounded by others who share similar interests.”
The Pros of Senior Care Facilities
Michelle Feng, a licensed psychologist and the chief clinical officer of Executive Mental Health in Los Angeles, says that some positives of senior care include:
— Increased socialization and connection. “This increases engagement and combats loneliness. For those that are worried about something happening to them at home, the additional support can lead to decreased anxiety and an increased sense of safety,” Feng explains.
— Safety. Feng warns that “remaining at home can have its drawbacks when living there is no longer safe or has become too difficult to manage. Keeping up the home and seemingly simple things like changing light bulbs and smoke detector batteries can be more stressful, as a fall can result in more severe consequences as we get older.”
Since there are so many factors to consider when choosing a senior care facility, it takes research to find the right timing and the best facility. Consult a moving checklist for assisted living for all the questions you’ll need to ask to ensure you or your loved one choose a facility that will provide a positive experience.
When to Consider Moving to a Senior Care Facility
There are many reasons to consider moving from independent living to assisted living. And according to experts, the sooner the better. Some senior living facilities have years-long waitlists. So planning ahead now can mitigate some of the stress once there’s a pressing medical need.
Sue Johansen, a San Francisco-based executive vice president with A Place for Mom, a senior advisory service, says that deciding on a senior living community earlier can alleviate stress, provide a more stable and structured environment for the senior and preserve the relationship between parent and child that can deteriorate when the child becomes caregiver.
Another key reason to decide early is because the decision process involves the senior. It “allows them to have a say in their future living arrangements and maintain a sense of control over their life,” Johansen adds.
The reasons for a senior to consider transitioning to a senior care facility include:
— Complex health conditions.
— Mental health issues.
— A need to downsize.
— Declining ability for complex tasks.
— Decreased treatment compliance.
— Independent living has become unsafe.
Complex health conditions
The ability to perform basic activities of daily living
becomes a challenge during the aging process. Tasks that usually take a few minutes — like getting dressed, grooming, eating and using the restroom — can take some seniors significantly longer. This can be a cause of stress and also a concern for injury.
Additionally, having a complicated diagnosis that involves a specific diet, therapy or daily maintenance becomes difficult to manage as seniors age. A senior care facility is often the best option when independent care becomes overwhelming.
Mental health issues
As seniors age, they are more susceptible to mental health difficulties. This can be due to a health condition, like Alzheimer’s disease, or personal circumstances, like grief after death of a peer. With Alzheimer’s disease many seniors also experience agitation and social isolation, especially in the later stages.
Feng notes that “research from a 2020 study indicates that losing the ability to perform activities of daily living can negatively impact mental health. In a two-year prospective study with over 2,000 Americans over 65 years of age, researchers found that a loss of independence with eating and bathing was associated with the most decline in mental health status.”
Mental health may improve in a senior care facility as there is more opportunity for social integration and activity.
A need to downsize
Many seniors are living in sizable residences meant for family get-togethers and visiting grandchildren. However, this amount of square footage can become difficult to navigate and maintain with age. A simple task like traversing from the bedroom to the kitchen to get a snack becomes taxing.
Seniors may also have trouble with their home’s upkeep. Keeping surfaces disinfected, cleaning cookware and maintaining pet waste are all essential to supporting good health.
In addition, some seniors struggle with throwing items away; there may be memories attached to items as mundane as old receipts. The practice of hoarding is also not uncommon among seniors. A 2014 study in the American Journal of Geriatric Psychiatry estimates that between 15% and 25% of seniors exhibit some of the characteristics of hoarding disorder, which can be exacerbated by old age and dementia.
Declining ability for complex tasks
Aside from basic care like grooming or using the restroom, seniors also need to perform more advanced self-care tasks, called instrumental activities of daily living. With age, some seniors benefit from having these tasks taken off their plate or having a senior living facility help oversee them.
— Grocery shopping.
— Transportation to and from activities.
— Preparing meals and cleaning up after meals.
— Financial management of bills and assets.
— Communication, such as using a phone and email as needed.
— Managing medications.
When seniors are unable to accomplish these tasks, they may benefit from the additional assistance of a senior care facility to cue or oversee that these activities are completed.
Decreased treatment compliance
Growing older often comes with the diagnosis of one or more chronic diseases, which isn’t easy to process. Chronic conditions also require adherence to a medication and treatment regimen.
If a senior is unwilling or unable to follow their treatment plan, they may need help from a senior care facility.
Independent living has become unsafe
When the risk is greater than the reward of independent living, it’s time to search for an alternative.
Some risks of independent living may be:
— Increased prevalence of falls.
— Wandering in or outside the home and getting lost.
— The cost and effort of home care becoming burdensome.
— Sundowning, or confusion or agitation that occurs in the evening hours.
These risk factors can cause worsening physical and mental decline. In a senior care facility, there will be staff available to ensure that physical safety risks are mitigated.
Making the Best Choice
Ultimately, deciding on the timing and level of senior care for your loved one involves many factors. The physical health, mental health and safety of your loved one all must be taken into consideration. Consult a medical provider for tailored medical advice to help your family make the best decision.
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Update 08/24/23: This story was previously published at an earlier date and has been updated with new information.