As much as senior living facilities are intended to be a solution to the challenges that many aging seniors face, they’re not perfect. Problems can arise during and after your loved one makes the transition into an assisted living facility or other long-term care community.
Here, we’ll take a look at seven common problems that can crop up and offer some suggestions for how to navigate them.
1. Financial Challenges
Problem: Costs of senior care are constantly increasing, and for seniors with limited savings, it’s possible to outlive your resources.
Reason: Senior living facilities, such as assisted living facilities, can be pricey.
“A lot of people expect that Medicare will help with the costs,” says Bob Rees, chief sales officer with eHealth, Inc., a health insurance broker and online resource provider headquartered in Santa Clara, California.
However, Medicare, the federal health insurance program for those age 65 and older, doesn’t typically cover assisted living services because the care is largely nonmedical. Medicare also doesn’t cover long-term care in a nursing home, though it will cover short-term skilled nursing care.
Medicaid could step in to provide some coverage for assisted living for those who qualify, Rees adds, and it can cover nursing home costs. But that assistance can vary state by state and you usually must spend down all of your assets before Medicaid kicks in.
Solution: Start planning early, and develop a long-term savings plan. Financial tools, like long-term care insurance, can help ensure you set aside enough money to afford the care you’ll need. However, there’s a lot to these policies, so you should find a trusted advisor to help you sort it all out.
[READ: How to Pay for a Nursing Home With No Money.]
2. Concerns About Care Provided
Problem: Facilities with a high rate of staff turnover can make it difficult to build a relationship with your loved one’s caregivers.
Reason: Staffing at senior living facilities, especially nursing homes, has been an ongoing issue only made worse by the COVID-19 pandemic. For instance, 72% of nursing home providers participating in an American Health Care Association survey reported that their staffing levels are lower now than before the pandemic.
A new federal mandate seeks to address this concern by mandating minimum staffing standards — i.e. setting a minimum acceptable ratio of caregivers to residents in federally funded nursing homes — to improve patient safety.
Solution: While not all senior care facilities will be subject to the new rules, it’s worth asking how any facility you’re considering manages staffing challenges while prioritizing patient care. It’s also a good idea to ask about the ratio of caregivers to residents.
In addition, you should speak directly with the caregivers at any facility you’re looking at to get a sense of whether or not they like their work and are happy at that facility.
Once a senior has moved in, keeping an open line of communication with staff is generally the best way to identify small issues before they become much bigger problems.
[READ What Are the Levels of Senior Living?]
3. Medication Mismanagement
Problem: Many older adults take multiple medications per day and may need assistance to get the right dose at the right time. Medication mismanagement, however, can jeopardize this critical piece of the care puzzle.
Reason: Medication mismanagement at senior living facilities can range from a loved one not getting their daily meds as needed to prescriptions of unnecessary medications, such as antipsychotic medications.
Some dementia patients can become agitated and volatile, so nursing homes may misuse these powerful medications, which have a sedative effect. For this reason, antipsychotic medications are sometimes referred to as chemical straightjackets.
Solution: If your loved one suddenly seems out of it, it’s time to talk to the staff and management at the facility.
It’s important to note: Not every use of antipsychotic medication in older adults is improper. In fact, for some seniors who have certain mental health disorders, their use is necessary. But if this is something new, you need to start asking questions.
[READ: Activities of Daily Living for Seniors.]
4. Unhappiness With the Placement
Problem: Some seniors may find that the senior living community they’ve selected doesn’t measure up to their hopes. They may end up feeling unhappy with their choice, depressed or lonely.
Reason: Transferring to a new level of care can be tricky for residents and potentially lead to confusion, restlessness, fatigue and changes in sleeping and eating habits. This situation can be especially challenging for some families to manage because it can be very expensive to move to a new facility if there’s a contract in place.
Solution: Encourage your loved one to get more involved in activities offered at the facility, especially if they’re feeling shy or having trouble making friends. Talking to the staff could shed some light on what’s going on, and they may be able to make some suggestions for your loved one to feel more at ease.
A geriatric care manager can also be a useful resource. These aging life care professionals can make recommendations for how to successfully transition into a new senior living situation and can provide solutions to other challenges that arise along the way.
5. Wandering and Elopement
Problem: Those with dementia tend to feel compelled to walk, says Dr. Alvaro Pascual-Leone, chief medical officer and co-founder of Linus Health, a Boston-based digital cognitive assessment platform.
Wandering and elopement, however, can be dangerous.
Reason: Wandering describes a senior living resident who meanders around and potentially disturbs others, explains Dr. Elizabeth Landsverk, a geriatrician based in the San Francisco area. Provided it’s contained within a safe environment, wandering is not usually dangerous, but it can create conflict for a loved one.
Elopement, on the other hand, means a resident has wandered off the premises into an uncontrolled and potentially dangerous environment. Elopement can also turn deadly. Since 2018, more than 100 seniors — out of 2,000 who wandered — have died, according to a 2023 Washington Post investigation.
Solution: If your loved one begins wandering or elopes from their senior living residence, speak with the staff at the facility right away to find ways to redirect your loved one’s energy and keep them safe.
If an assisted living or nursing home facility is struggling to contain your loved one or is unable to find other ways to channel their restless energy in a safe way, it might be time to move into an area specifically designed for memory care. Memory care facilities tend to have security measures in place to keep residents safe, such as preventing them from accessing doors that lead outside.
6. Conflict With a Staff Member or Another Resident
Problem: Your loved one can’t get along with others.
Reason: Congregate care settings, like nursing homes and assisted living communities, are a place where residents share space and live alongside each other. Naturally, personality conflicts and other issues can arise. Your loved one may also decide they simply don’t like a certain member of staff and may find it challenging to be looked after by that person.
Solution: If the issue is with another resident, ask facility staff if there’s a way to mediate the conflict or keep the two residents out of each other’s orbits as much as possible. If the issue relates to a staff member, ask if another caregiver can be assigned to manage your loved one.
7. Changing Care Needs
Problem: Your loved one started in independent living or assisted living, but they’re quickly losing ground in taking care of themselves.
Reason: For most people, needing more care over time is an inevitable aspect of aging, but it can make residing in some senior living environments untenable.
For example, if your loved one develops dementia and the community they currently live in doesn’t offer memory care services, it may be time to move them into a memory care facility with that support.
This need for more care can also create additional expenses that can be very difficult for some families to afford.
Solution: Just like with handling financial challenges, the best way to ward off these issues is to plan as far in advance as possible and save money specifically to help pay for senior care, says Tyler End, CEO and co-founder at Retirable, a retirement advisory company based in New York City.
“You will need to plan for health changes in retirement, which will generally consume more of your disposable income as you age,” he points out. “With proper financial planning, you can account for the growth of these expenses and be prepared for the unexpected.”
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Common Problems in Senior Living Facilities and How to Handle Them originally appeared on usnews.com
