Watching a frail older family member begin to fail at home can be alarming. The person who once took care of the family now needs help getting through daily tasks. Finding the appropriate level of senior care can ease minds, knowing both their safety and dignity can be better preserved.
As people age, most wish to remain independent in their own homes.
There are key factors to monitor to help in the decision to move a failing elder to a senior care facility.
Assisted living and long-term care facilities are different levels of care for differing needs.
The conversation to move can be a difficult one but there are tactics that can lead to success.
Is 'aging in place' the best?
As family elders age, they face many challenges related to chronic diseases, pain, and possible cognitive issues. Even as they decline in their ability to remain independent in their home, they often feel most comfortable there.
However, the comfort zone of the familiar can be harmful. Staying in a private home beyond the time that it is safe to do so may accelerate the worsening of their well-being.
Your challenge is getting an accurate picture of exactly what your elder’s deficits are, and which senior care facility is the most appropriate.
The following will guide you in assessing your elder’s current situation so a thorough discussion with your loved one and their primary care provider can begin.
The six Activities of Daily Living
Activities of Daily Living (ADLs) are the basic tasks everyone does daily without thinking about them. However, bathing/grooming, dressing, toileting, transferring, walking, and eating can prove difficult for an older adult. A loss of ability to perform any one or more of these will eventually lead to further deterioration of their overall well-being.
For example, they may have trouble getting into the shower, so they forget to bathe. If they wear the same clothes every day, it may be because they struggle with poor range of motion or untreated pain. Maybe they have hand tremors, making it hard to feed themselves. Forgetfulness can lead to not remembering to eat at all.
The downturns may be subtle at first. Proud elders are known to deflect or even lie when asked how they are functioning on their own. Time spent with them in their home can reveal their actual abilities.
Look for changes such as basic grooming, their ability to get in and out of chairs, shuffling their feet while walking, and weight loss.
The eight Instrumental Activities of Daily Living
Instrumental Activities of Daily Living (IADLs) include the more complex business of life. Functional decline in a senior’s capacity to cook, clean house, take medications appropriately, do laundry, shop, manage finances, use a phone, or drive safely indicates they are no longer able to take care of themselves.
If your aging family member, for example, gets confused or forgetful about their medications, this will have an impact on their health, sometimes quickly. A cluttered home creates obstacles leading to falls. Week’s old food in the refrigerator is a health hazard. Unattended finances can lead to disaster.
The isolation issue
So, while your frail loved one may resist the idea of moving to a care facility, staying home alone can ultimately be deadly. Full-time assistance at a senior care facility is the support they may need, now or in the near future.
Types of personal care facilities
Assisted living (AL) care services may make sense if 24-hour nursing is not yet necessary. These facilities provide all meals, housekeeping services, and engaging activities.
Many ALs offer private apartments that can accommodate furniture and other personal items from a senior's home. This can be comforting for elders to see the things they know and love when moving to a new environment.
If necessary, medication administration via trained caregivers contributes to a safe and timely routine. Take note that ALs rarely have medical professionals on site. However, the round-the-clock, non-skilled care providers routinely check on each resident and are available for emergencies at the push of a button.
These staff members also assist with ADLs, so your elder receives daily help. They promote independence based on each elder’s capabilities. This builds confidence and esteem while safety is preserved.
If your aging elder has dementia and has a history of wandering or is exhibiting harmful behaviors, many ALs have “memory care” units. The higher staffing ratios and locked doors can give concerned family members peace of mind.
Long-term care (LTC) facilities, commonly called nursing homes, are medical service providers. In addition to providing the same services as an AL, medically complex and frail elders can receive the medical care they require as their health declines. Your family doctor will need to be involved in the transfer from home to LTC.
The process of admitting your elder to a LTC facility can take a significant amount of time. Details like personal finances, future costs, and finding the right LTC home for your elder means being proactive now.
It all starts with a conversation with your beloved elder. If you sense, based on their decline in abilities listed above, that your family member needs facility placement but you fear their resistance, here are some helpful tips to move forward.
Tips for discussing this with your elder
Your approach is everything. Find calm moments, using expressions of care and concern. If you are scared for their safety and they won’t budge, expressing your fear, anger, and frustration will only hamper the decision-making process for all involved.
Take facility tours together. The fear of the unknown is reduced and your elder may feel more in control of the choices ahead.
Highlight facility features. Whether it's location, activities, appealing meals, or pleasing décor, focus on the positive that can assure a more supportive daily life.
It takes a village to care for the aging. If your elder is refusing to consider moving to a facility, ask for help from their primary care provider, a trusted family friend, or a clergy member.
Leave it be for a while. If you feel resistance, save the conversation for another day. This is why it is so important to broach this subject early. It may take multiple attempts. If your elder becomes upset or shuts down, drop it for now.
If you cannot sway your senior that a facility is in their best interest, the last resort is to consider legal counsel. Elder care lawyers advise about options, seeking guardianship and social worker support. Contact your Area Agency on Aging for referrals.
Whether the changes of aging creep up slowly or seem to happen overnight, keen observations will serve you well when deciding when the best time is for obtaining senior facility services. You can start planning today and give your elder a chance for more years of dignity and safety.