Moving can be overwhelming at any stage of life. But it’s exponentially more difficult for older adults with Alzheimer’s disease and other types of dementia, for whom any change in routine or environment can lead to anxiety, frustration and even trauma. It can also be heart-wrenching for caregiving relatives to manage.
As challenging as the transition may be, however, it can yield extensive benefits for your loved one. Living in a memory care center or assisted living community that offers specialized care can mean more security, safety and support for seniors with dementia, especially when their needs have outpaced the care available at home. They’ll also benefit from reduced anxiety, improved social connection and greater longevity.
Since it will likely take time for your loved one to adjust to assisted living, these tips can help ease the transition.
[READ: Everything You Need to Know About Dementia Care in Assisted Living Communities.]
What to Do Before the Move
Alzheimer’s disease and other forms of dementia are chronic, progressive diseases that slowly degrade people’s cognitive function and ability to care for themselves. Although the timeline of disease progression can vary, typically the decline happens gradually over months or years.
It’s during this period that you should start keeping an eye out for signs that it’s time to move your loved one into a specialized care setting.
1. Recognize the signs.
There are several tell-tale signs that can signal it’s time to move a parent with dementia. Common ones to watch out for include:
— Memory loss
— Difficulty managing the home and finances
— Confusion
— Changes in personal hygiene
— Loss of caregiver support
That last item was the triggering factor for Tracy Grilli’s mother. Her cognitive capacity had been declining for a few years, but Grilli’s father continued caring for his wife at home. Grilli, a retired nonprofit administrator who lives in Londonderry, New Hampshire, worried about what her mom would do if something happened to him.
Grilli was at a swim meet when she got word that her father had been hospitalized with an acute kidney infection and her mother was home alone. She raced to the family home in Massachusetts to look after her mom, who had somehow disabled both phones so Grilli couldn’t get through to her remotely.
“I ended up staying with my mother for about a week, and then my sister, Kim, came up from Texas to stay with my mother for another week,” she recalls.
During this fraught period, Grilli’s father remained in the hospital, and the reality of their situation sunk in: It was time to move.
[Read: How to Find the Best Memory Care Facility Near You: A Checklist]
2. Research the options for assisted living with memory care.
When a move becomes inevitable, you’ll need to do some research to find the right place. Grilli’s sister Kim spearheaded the search for an appropriate assisted living facility in Massachusetts. The process she followed is what most people do to find a good assisted living placement:
— Search online, including U.S. News’ Best Assisted Living.
— Read reviews of local facilities.
— Ask friends and local contacts for recommendations.
— Ask your loved one’s health care providers for recommendations.
— Check with the local office of elder affairs to see whether any complaints have been lodged against the facilities you’re considering.
— Visit a few of the best options to meet the staff and other residents to get a sense of where your parent would be living.
Within a matter of days, Kim had developed a short list of possible locations. Their dad was discharged from the hospital on Saturday, and the following Thursday, they moved into the assisted living community, where their parents shared an apartment until Grilli’s mother required more intensive memory-specific care and was moved to the nursing home wing of the facility.
[READ: What’s the Difference Between Memory Care and Nursing Homes?]
3. Visit facilities.
To find the best assisted living or memory care community for your loved one, it’s important to tour the facilities you’re considering in person. During the visit, take a close look at other residents and how staff interact with them. Ask a lot of questions and speak with as many of the staff members as you can to get a feel for who will be looking after your loved one.
Each community is different, but there may be a differentiating factor that makes a particular place more appealing as a future home. For example, one of the key reasons Grilli’s parents moved to the facility they did was that her mother knew women who were already living there.
“They came up and brought my mom down to lunch,” Grilli says. “Starting out with familiar people and my father there helped ease the transition.”
4. Talk to your loved one.
Anxiety is a hallmark symptom of dementia, and change can exacerbate it. But it’s important to keep communication with your loved one open in whatever way works best for them given their current cognitive status.
“Your parent should be at the center of every decision as much as possible,” says Nicole Brackett, director of quality and care delivery with Homewatch CareGivers, a personal care service company headquartered in Greenwood Village, Colorado. “This empowers them and helps ensure that their preferences and comfort are prioritized.”
But be forewarned: Even if they’re involved in the decision-making process, your loved one might not be happy about moving, adds Dr. Elizabeth Landsverk, a San Francisco area-based geriatrician offering an online telemedicine, education and support resource for eldercare professionals, caregivers and families.
“Be prepared for your elderly loved one to show anger and even accuse family members of trying to control them,” she says.
Landsverk notes these behaviors often come with advanced age. Aggression or agitation can also be part of the dementia disease process.
5. Pack strategically.
In an ideal world, you’d have plenty of time to get organized before moving a loved one with dementia into an assisted living community. But often, the transition must happen urgently, as was the situation for Grilli and her parents.
Depending on the size of the facility and the living space your loved one will be moving into, they may need to leave many of their things behind. This type of downsizing can be especially challenging, so be prepared for packing to be time-consuming and emotionally fraught.
Check with the facility in advance to learn what your loved one can bring with them. Will they be able to bring furniture? A pet? Other comforts from home? Or is the space small and already furnished? Getting as much detail as possible upfront can help you select only what your loved one can bring and also prioritize the things they’ll need most in the first few days in their new space.
What to Do When Moving
On move-in day, communicate clearly with your loved one about what’s happening as well as with facility staff to ensure you’ll be able to access the living space when you expect to.
Keep your focus on what’s best for your loved one, and keep them at the center of your efforts. In most cases, they’re moving into a better, safer situation than the one they’re leaving behind. This should be a net-positive endeavor, despite the challenges of executing the move itself.
6. Pick the right time of day.
People with dementia often exhibit a condition called sundowning, which is a worsening of symptoms later in the day. Also called sundowner’s syndrome, this exacerbation of symptoms can lead to increased confusion, aggression or agitation in dementia patients.
Why exactly sundowning happens isn’t fully understood, but increased stress and unfamiliar, confusing or overstimulating environments are thought to aggravate the process.
For this reason, it’s often best to schedule your loved one’s move for early in the day when they’re fresh and better able to react appropriately to cues and directions.
7. Manage your emotions.
Moving is always stressful, and you’re likely to feel even more pressure when moving a loved one into assisted living because of their loss of ability to look after themselves.
Plus, accepting that your loved one needs more care than you can provide can be a difficult pill for some caregivers to swallow. Concerns about how you’ll pay for your loved one’s care adds to the stress.
As difficult as it may feel in the moment, stay as calm, patient and positive as you can. Seeking help from your own support network can help.
For Grilli, her sister’s support throughout the process was invaluable and helped make a difficult period a little easier.
“We were able to tag-team,” Grilli recalls. “I was the one that lived closest, and I had the flexibility to stay with my mother. My sister would come up when she could. She stayed with my father when he was being treated for cancer and drove him to all his radiation treatments.”
8. Anticipate bumps.
As with any move, there will be bumps and hiccups along the way. The key is to anticipate what might go wrong and have backup plans.
9. Build relationships with staff members.
The staff at your loved one’s new home are your pipeline for information on how your loved one is doing and what else they may need. Start off on the right foot by building a relationship with as many staff members as you can as you help your loved one move in.
What to Do After Moving
After your loved one is settled into their new living arrangement, your work as a caregiver continues — as an advocate and champion of their needs. You also play a critical role in helping your parent find purpose and connection in their new home.
10. Encourage your loved one to socialize.
New routines can be jarring for people with dementia, but you can help your loved one settle in and make new friends by actively drawing other residents into your interactions.
For example, stay for a meal time at the home or get involved in an activity session to help your loved one strike up conversations with other residents. Sometimes, having a relative there to help break the ice and offer a guiding hand can smooth the transition.
11. Stay connected.
There are many ways to make the most of a nursing home visit.
“Regular visits help you monitor the quality of care and maintain strong family bonds, reinforcing that the loved one is still closely connected to family,” Brackett says.
If you live too far away to make regular visits, look for other ways to maintain that connection, such a video calls and keeping in touch regularly with both the staff and your loved one.
For example, Grilli notes that she called her father three times a day to check on him and spent every weekend visiting him and her mother. That sort of consistent, ongoing contact helps remind your loved one that you’re still on their team and want to remain involved.
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Moving a Parent With Dementia to Assisted Living: 11 Tips originally appeared on usnews.com