Most older adults will need a little extra help at some point later in life. In many cases, that means moving into a senior living residence.
Senior living facilities, which can take a range of forms, are designed for older adults who need assistance with activities of daily living, including doing laundry, driving a car, managing a household, taking medications on time, bathing, toileting and managing finances.
It’s not always clear when it’s time for a loved one to move to a senior living facility, but there are some telltale signs to watch for, according to Stacey Eisenberg, a senior care expert and owner of A Place At Home — North Austin home care and placement in Round Rock, Texas. The signs include:
— Decline in personal hygiene. “When you see that your parents are struggling with maintaining their personal hygiene or have a fear of going in and out of the shower, that is a sign,” she says. So is forgetting to change clothes, wearing pajamas all day or regularly forgetting to brush their hair or teeth.
— Decline in home maintenance. If the home seems dirty or messy, the fridge is mostly empty or is filled with expired foods, that could indicate they’re struggling to cook and feed themselves.
— Decline in cognition or toileting ability. More severe signs include incontinence, frequent urinary tract infections, memory loss or cognitive decline.
Starting the Difficult Conversation About Senior Care
When you start noticing any of these signs, it’s time to talk to your loved one about their options and their plan for the future. Unfortunately, these conversations can be emotional and uncomfortable.
“For someone experiencing physical or cognitive decline, it’s difficult to accept that we can’t do some of the things we used to do and took for granted,” says John Mastronardi, executive director at The Nathaniel Witherell, a short-term rehabilitation and skilled nursing facility in Greenwich, Connecticut.
These conversations, however, are critically important for your loved one’s health and safety. The following suggestions may help smooth the process.
1. Talk to Your Siblings First
If you have siblings, be sure you all agree that it’s time to have the senior care discussion. Settle any differences of opinion among yourselves before you speak to your loved one. Presenting a united front is important before initiating this delicate conversation.
If you can’t agree, consider contacting a social worker or elder care specialist, such as a geriatric care manager, to help you resolve your differences. Sometimes, an outside perspective from someone who’s worked with others dealing with the same issues can help you find the best way forward.
[READ: Identifying the Right Time for Senior Care.]
2. Know the Various Senior Living Options
There are many different senior living options available, so you’ll want to have an understanding of what they are before you approach your loved one. Types of senior living communities include:
— Continuing care retirement communities (CCRC)
To prepare for the conversation, research the senior living options nearby. Search online and gather brochures or other marketing materials from places that look promising to share with your loved one. Give them a chance to consider these options, and ask which ones seem most appealing and worth touring.
[READ What Are the Levels of Senior Living?]
3. Have the Talk Sooner Rather Than Later
Don’t wait for a medical or other emergency to force you to address the issue. It’s much harder to make good decisions in a moment of crisis. Procrastination is not helpful because you never know when an aging loved one may need help.
And when you do start talking about senior care, make sure your loved one knows you’re not blaming them or passing judgment.
“Take an ‘us’ point of view. We are in this together,” advises Maria Hood, former director of admissions at United Hebrew of New Rochelle, a continuing care campus in Westchester County, New York. “‘We are a family. You raised me, now it’s my turn to help you.'”
[READ: When Is It Time to Move From Independent to Assisted Living?]
4. Ask About Your Loved One’s Financial Situation
It’s never easy to talk about money, but it’s important to gain a solid understanding of your loved one’s financial situation when broaching the topic of moving into senior care. How much they’ve saved will have an enormous impact on the next steps you’ll be able to take.
“Home health care, long-term care and related expenses are typically the largest costs people experience — especially toward the end of their life,” says Tyler End, CEO and co-founder of Retirable, a retirement advisory company based in New York City.
Ask how much they’ve put away and whether they have long-term care insurance or other financial assets that can help pay for their preferred senior care option. Don’t be surprised if your loved one’s financial footing is precarious and be prepared to consider how you’ll help them find an affordable senior living option.
“Too many seniors assume Medicare will cover all their long-term care needs if and when the time comes, but unfortunately this just isn’t the case,” explains Whitney Stidom, vice president of sales enablement with eHealth Inc., a health insurance broker and online resource provider headquartered in Santa Clara, California.
Medicare covers medically necessary services, such as hospital stays, doctor visits and certain skilled nursing care, but only for a limited time and under specific conditions. That means that most costs associated with long-term care are not covered by Medicare.
5. Focus on the Positives
Highlight the advantages of a potential move to senior living rather than focusing on the downsides.
“Don’t make the conversation about their limitations,” Mastronardi advises. “That will only remind someone they were once vital and energetic.”
Instead of saying things like, “Mom, you really shouldn’t drive anymore,” or “Dad, you should not be climbing ladders,” present senior living as something that makes their life better. For example, they’ll no longer have to shovel snow or make their own meals when they don’t feel like cooking. There will be opportunities to socialize with other people who are at a similar stage in life.
If they object, be understanding.
“It’s important for people to retain autonomy. They have the right to say no,” Hood says.
6. Ask Your Loved One What Kind of Help They Could Use
One way to approach the conversation that may generate buy-in is to tell your loved one you’ve noticed that they seem to be having a harder time taking care of things and that you want to help.
“Then ask how they see themselves needing help,” Mastronardi says. “Ask: ‘If you had a wish list, what kind of help would be on it?'”
Maybe it’s having groceries delivered or getting reminded to take medications.
“This opens the possibility that it might be helpful to them, and it empowers them to be a partner in their own care, confirming that they still have some independence and control over it, which they do,” Mastronardi says.
Work with your loved one to determine exactly what kind of help they want and which type of setting would best meet their needs.
7. Ask Experts for Help
Recruiting a professional to help you learn what’s out there and how to talk to your loved one can be super helpful.
“When a family member calls me and says, ‘I don’t know anything,’ I say, ‘Of course you don’t. That’s OK. That’s what I’m here for,” Hood says. “This way, you are not doing it alone.”
Among the resources you can tap:
— Local elder care facilities
— National aging organizations, such as the National Council on Aging
— Your loved one’s physicians
— Geriatric care managers
8. Be Prepared for Ongoing Talks
Early on, your loved one may need minimal assistance, and hiring a part-time home health aide might be enough to keep them healthy and safe for a while. But over time, as their needs change, moving to an assisted living community
or nursing home might be prudent.
If your loved one isn’t ready to face the need for more care, don’t push it. Suggest that you revisit the topic another time — say, in a few months — just to check in and see if their needs and desires have changed.
“Approach your loved one with respect, and if the person is not ready, you have to back off,” Hood says. “Chances are, this won’t be one conversation. It will be several over time. And that’s OK.”
A gentle, regular check-in approach offers your loved one time to accept that their situation is changing and that you can help support them in finding a good solution.
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How to Talk to a Loved One About Senior Living originally appeared on usnews.com
Update 12/09/24: This story was previously published at an earlier date and has been updated with new information.
