Gary Girolimon and Jill Parenteau, siblings in New Hampshire, were providing care and support for their 82-year-old brother, Ron, who had Alzheimer’s disease, until signs suggested they needed more help.
“I would have loved to have kept him in his house,” says Parenteau, who serves as power of attorney for Ron. “But many of the home care providers were not showing up. We’d get a call an hour before someone was supposed to come that they weren’t coming.”
The high turnover rate in aides and their limited English language skills added to the difficulty of managing Ron’s care at home.
The tipping point, however, was when he started wandering, according to the siblings: “That’s when we said, ‘We can’t rely on people coming to watch him.'”
Girolimon and Parenteau knew it was time to find an affordable, local assisted living situation that would be able to support Ron as his dementia progressed.
It’s not always easy to know when it’s time to move from independent living to assisted living, and the criteria varies from person to person. Ahead, we explore what assisted living means and signs that it might be time for a loved one to make the move.
When Is It Time for Assisted Living?
To determine the right timing for a move to assisted living, it helps to understand the difference between independent living and assisted living.
Independent living is “designed for older adults who are generally able to live independently but want the convenience and social opportunities of a community setting,” explains Tina R. Sadarangani, a board-certified primary care nurse practitioner and assistant professor at NYU who specializes in the care of older adults.
They are often built as stand-alone homes in a neighborhood and are usually limited to people age 55 or older. They tend to offer social events, exercise classes, group travel options and other activities that foster mental and physical engagement and enhance quality of life as people age.
Assisted living, on the other hand, is designed for older adults who need help with daily activities, such as bathing, dressing, medication management and meal preparation, but who do not require the intensive medical care provided in a nursing home, Sadarangani says.
Residents typically live in a private apartment or a shared room, and meals are usually served in a communal dining room where residents can socialize. The communities tend to offer additional amenities, such as social events, fitness activities and more, depending on their location and the clientele they serve.
[READ: Who Qualifies for Assisted Living: Eligibility Requirements]
Signs It Might Be Time for Assisted Living
Family members, caregivers or friends are often the first to spot warning signs that independent living may not be the optimal situation. Signs that it may be time to move include:
— Worsening medical conditions, with an increased number of falls and overall increased frailty
— Difficulty managing domestic finances or other money problems
— Difficulty keeping the house clean or maintaining personal hygiene
— Depression or social isolation
Sample scenarios
The following scenarios help illustrate when it may be time to consider moving a loved one to a place where they can get upgraded care.
— Recently lost a spouse: A senior who has recently lost the spouse who was primarily responsible for the housework, meals and shopping will likely have to consider moving. Between struggling to cook or clean and dealing with grief and loneliness, assisted living might be a helpful option.
— Developing multiple medical problems: When seniors develops multiple or serious medical problems, such as Parkinson’s disease, or when a chronic disease progresses, they start to need more day-to-day help.
— Signs of memory loss: For many seniors, the time to move comes along with signs of memory loss or reduced cognitive facility, especially if there’s a diagnosis of Alzheimer’s disease or another form of dementia. In this case, you may want to consider a memory care facility, which offers specialized therapies and support for people who have dementia or are experiencing cognitive decline.
— Caregiver burnout: When the primary caregiver experiences caregiver burnout, an assisted living facility may provide respite. It gives the caregiver a better quality of life and provides the senior with more sustainable care and support. Parenteau says before her brother moved to an assisted living facility, she found it exhausting to be on-call all the time in case something went wrong. Assisted living is able to meet her brother’s needs better than she could.
— Difficult-to-manage behaviors: When a loved one is no longer safe at home, it’s time to consider moving to a more secure environment. For Parenteau and Girolimon, placing their brother into full-time care was a logical response to his frequent wanderings. They were concerned he could get lost or hurt, even with the help of home health care aides.
[READ: How to Choose the Right Senior Living Facility: A Checklist]
The Benefits of Assisted Living
Assisted living communities offer a wide range of benefits to seniors.
Greater ease with completing tasks
Most assisted living communities offer amenities such as communal dining options, laundry services and a salon or barbershop. This makes life easier and safer for many seniors, as they won’t have to risk driving off-site for errands or routine self-care services.
Opportunities for socializing
Assisted living communities offer various activities and events, including games, arts and crafts, music sessions, gardening, outings and more, that foster community and prevent isolation and loneliness, which are otherwise detrimental to health.
Improved fitness and mobility
Staying fit improves your ability to maintain independence and mobility for longer, and most assisted living facilities ensure their residents have access to fitness classes and other means of exercising for better health.
Reduced health care costs
While assisted living communities can be expensive, moving into one may actually save you money in the long run if it means you won’t need as much health care.
“Moving into assisted living earlier can offset higher costs associated with hospitalizations, one-to-one care or the decline that occurs when one doesn’t optimize their health,” says Angela Stewart, vice president of clinical services with Touchmark, a Beaverton, Oregon-based senior living company with communities for 55-and-older adults across the country.
Improved quality of life
These benefits often have a greater impact if a senior moves in earlier rather than later. When done right, a move to assisted living can be a powerful experience for the whole family that opens new possibilities.
“Moving to a community that meets your social, mental and physical needs may not only improve your quality of life, but it might even improve your health,” says Dr. Deena Goldwater, a cardiologist and geriatrician who serves as vice president of care delivery at Welcome Health, a Southern California-based primary care practice specializing in aging.
For Parenteau’s brother Ron, the social interaction has proven to be a big benefit. Despite the high cost of the facility, Parenteau believes it was the right move.
“If he gets really bad, we may look for something different,” she says. “But I think right now he’s happy there.”
[READ: Does Medicaid Pay for Assisted Living? What You Need to Know]
How to Find an Assisted Living Facility and Plan a Move
There are many assisted living facilities, and it’s not always clear how they differ from one another, which makes finding the right assisted living facility for your loved one a challenge.
Here are a few tips to help make it simpler:
— Start your search early. Waiting until a loved one urgently needs more care adds to the stress of finding a good place for them. Instead, start early and learn which options are available in your community.
— Consider future care needs. Some communities offer tiered care options, so your senior would need to move only once and still access all the care they will need in the future. That can be an attractive option for many people, as chronic health conditions progress over time.
— Put yourself in their shoes. Tour each community you’re considering, and ask lots of questions of staff and residents. Try the food and attend events to learn what it’s really like to be a resident there.
— Get all the details about fees and services. Before signing a contract, be sure to read all the fine print and understand what your financial responsibilities would be. Consider whether the facility is affordable for you and your loved one.
— Check for local resources. Assisted living can be very expensive. Medicare doesn’t cover it, but there may be other ways to defray the costs. Speak with an elder care expert in your area to learn about any local assistance programs that may be available to your family member.
How to Ease the Transition to Assisted Living
Moving is never easy, but some seniors may resist the move to assisted living specifically because they see it as a loss of independence
and agency. But it doesn’t have to be, and being ready to address your loved one’s concerns head on can help allay their fears and make the transition easier.
Prepare for difficult emotions
“Moving to a senior living community is a significant life change, and having the time to adjust to the idea, tour facilities and even meet current residents can make the process smoother and less stressful,” says Esther Cromwell, founder and CEO of Avendelle Assisted Living in Raleigh, North Carolina.
When having these conversations, keep in mind:
— You don’t have to do it all at once. You can make small inroads before you sit down for a big conversation about the need for upgraded care.
— Try to do most, if not all, of this communication in person. This way, you can pick up on body language and other nonverbal clues about how your loved one is really feeling and respond accordingly.
— Listen carefully to the answers. Really listen to what your loved one is saying, and aim to ask open-ended questions that allow them to bring up any issues or concerns.
Talk about senior care options
Some tips for approaching your loved one about moving into assisted living:
— Start with a general discussion of what their life is like at home. Ask about safety issues or challenges they might be having and if these can be easily remedied, such as by installing extra handrails around the bathtub. What can you address in the short term until a decision about future care is made?
— Ask what kinds of help your loved one might want. They may be struggling in silence with housekeeping, laundry, running errands or other chores and hoping you’ll offer assistance.
— Ask if your loved one feels lonely. One of the biggest upsides to moving to assisted living is the increase in social stimulation. Community dining and activities can be a big help if a senior is feeling lonely.
— Be empathetic. Try to understand how difficult these conversations can be and approach them with sensitivity and kindness.
Some families find that speaking with an expert about senior care options can be beneficial as well. These experts can help families decide the right time to move:
— Your loved one’s doctor
— Financial advisor
— Attorney
— Social worker
— Family counselor
— Local senior care nonprofit organizations
Do your homework
Before you start the conversation, write down your own concerns and the points you want to get across to your loved one. Then follow these steps:
1. Research options for a good fit, so you have some suggestions at the ready as the conversation evolves.
2. Visit each place you’re considering. As mentioned, it’s important that you experience what it would be like to live there. Meet the residents and the staff to gauge how comfortable and welcoming the place is.
3. Talk to the staff during those visits and get a sense of how they care for people, their training and background and whether you can see your loved one thriving in that environment.
4. Discuss your loved one’s preferences in the context of this new information and see if there’s a match.
Explore Top-Rated Assisted Living Facilities with U.S. News
You can begin your search for the best assisted living facilities
in your area today by exploring U.S. News’ comprehensive online database. The listing relies on data collected in 2024 during a survey of more than 3,500 senior living communities nationwide.
The survey, which gathered more than 400,000 responses from residents and family members, asked about satisfaction with aspects of the community, such as safety, caregiving, management, staff, food and dining and activities. These ratings recognize communities that excel at providing highly satisfactory services and making residents feel safe and well cared for.
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When Is It Time to Move From Independent to Assisted Living? originally appeared on usnews.com
Update 12/20/24: This story was previously published at an earlier date and has been updated with new information.
