Things To Know
Is It Time To Move?
Dealing With Your Emotions
Brothers and Sisters: Where Do They Fit In?
It's Time To Talk To Mom Or Dad
A Parent Who Is Slowing Down Physically, Not Mentally
A Parent With Cognitive Impairment
Time To Relocate
After The Move
Is It Time To Move? (Physical and Cognitive Changes)
Moving is a major event at any time in a person's life. However, with age, it becomes even more difficult to adjust to the changes that accompany a move.
How do you know when it's time to approach the subject of moving into an assisted living facility? Is it after your parent has a major medical problem or hospitalization that requires a home health professional? Or, is it when you notice that he or she can no longer go up or down the stairs at home or do simple chores such as washing dishes?
Decreased activity level is the most obvious sign that living at home has become a problem for your parent. As their level of physical mobility decreases, other problems may arise. Personal hygiene may be more difficult to maintain, and the lack of proper nutrition becomes a serious concern. The inability to cook reduces an older adult's choices to prepackaged foods that are not likely to provide all the nutrients required for a healthy, balanced diet. When your parent needs more help with daily activities such as bathing, cleaning and getting around town, it may be time to look at other housing options.
Sometimes the issue is not that your parent has slowed down physically, but that she is beginning to experience forgetfulness and signs of dementia. Early signs of memory loss may become increasingly evident. For example, forgetting to take medication regularly or eat, even when meals are delivered, may suggest that your parent is no longer capable of living alone.
One option to consider is a personal caregiver-either full-time, or in combination with family members. This option has many benefits, but once you find a good reliable caregiver you are still left with the chance that the caregiver may become ill, miss work or seek other employment. Even more stressful is starting the process over again in the event you need to find a new caregiver. If your family chooses to provide care-giving services, you must recognize the dramatic influence it may have on your lives and your relationships.
The next section explores the emotional issues connected to moving your parent to an assisted living facility. Family dynamics can influence many of your decisions and the way you approach the subject with your parent. In the end, this may be one of the toughest things you do, but it can open up a new world for your parent-one that maximizes his dignity and maintains his independence.
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Dealing With Your Emotions
You may not be prepared for the emotional impact moving your parent can have on you. Whether the decision to move your parent is sudden, because of an illness, or is a decision made over time, you may experience many emotions, including guilt, anger, stress and anxiety.
Most adult children suffer from guilt because they do not want to move their parent away from the familiarity of her home. The idea of not being able to take care of the parent who took care of you is upsetting. Balancing all of the other responsibilities in your life-children, a career, a spouse- can leave you feeling overwhelmed by the additional responsibility of caring for a frail parent. Your parent has done a great deal for you, and you want to return that love and kindness. Feeling guilty is a very normal response to this stressful situation.
We don't pretend to have a solution for the feelings you are experiencing, but we know that providing an environment where your parent can flourish with the daily support she needs, with new friends, and social activities that prevent isolation and loneliness, might help alleviate some of the worry. We also understand that older adults often believe that they are a "burden" to their children. In needing to rely on you more, your parent may be experiencing as much guilt and discomfort as you.
You may be able to manage your guilt by recognizing you are not alone. We see many adult children each year who struggle with these decisions. Taking an interest in your parent's life as soon as you notice changes in her physical, mental and emotional health means that you are a responsible and loving adult child.
As strange as it may seem, anger is another strong emotion that many adult children experience, especially if their parent's mental capacity has diminished and she cannot help make the decision or see the need to move. Like guilt, anger is a very natural emotion and a common response to this difficult new reality. At a time in your life when your children are growing up and are, perhaps, off on their own, it is difficult to cope with the idea that you may be "becoming a parent" all over again.
Anxiety about choosing the facility that best meets your and your parent's needs may begin to surface. Obtaining as much information as possible, visiting different facilities alone, and with your parent, and asking for help are crucial to your own health and well being, as well as your parent's.
Guilt, anger and many other emotions are quite normal, and you should let yourself "off the hook" for experiencing these feelings. Making informed choices at this point in your parent's life is vital. Acknowledging your emotions will go a long way toward making responsible choices with a clear
conscience.
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Brothers and Sisters: Where Do They Fit In?
It is important to discuss your parent's situation with your siblings as early as possible. You will all need to depend on each other as you make your decision, and throughout the moving and settling-in process. One good way to divide the workload for researching housing options is to assign tasks according to your areas of expertise. For example, if your sister is a financial whiz, let her focus on gathering your parent's financial information, while you focus on visiting the assisted living facilities that make sense for your family.
If possible, you and your siblings should investigate and visit each facility separately and as a group. Each of you will have different experiences and collectively will be able to pool your impressions during tours of the facility. Your candid discussions about the facility, the staff and your opinions will help you make a choice that works for everyone.
Discussing legal and financial matters are crucial to ensuring your parent is able to live comfortably in her new home. Arranging your parent's important documents, such as Powers of Attorney for healthcare and finance is important at this time. Managing these tasks puts you on the road to the toughest job of all... talking to your parent about moving.
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It's Time To Talk To Mom Or Dad
There is no easy way to talk to your parent about needing more help or moving from his home. At the heart of the matter is the fact that your roles have reversed and you are now taking on a parental role for someone who has done this for you over the years. People of all ages have a difficult time
being "told" what to do. Imagine how much more difficult it must be to take advice, however wise, from your children-your babies just 45 or 50 years ago!
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A Parent Who Is Slowing Down Physically, Not Mentally
Your parent is likely to cling to her home, or car-things she views as symbols of independence-no matter how logically you explain that her arthritis makes descending the basement stairs to do laundry dangerous or that she really can't see well enough to continue to drive.
Acknowledging these changes can help ease the conversation about moving to an assisted living. At the same time, you can let her know that you are concerned as she navigates stairs or drives around the
neighborhood. Point out that at an assisted living facility, she will have the best of both worlds-with her own apartment and furniture without the responsibilities of house maintenance. Talk about the advantages of no longer having to cook and the opportunity to spend time with other people with similar interests. While she may not agree with all of your points, chances are she has already thought of the problems and costs surrounding the continuing use of the car or staying in the house.
In this case, if your parent is not suffering from a memory-related disorder, you have an advantage because she can become part of the decision-making process. She will still have control over many of the decisions, and hearing and valuing her opinion will make the decision a little easier.
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A Parent With Cognitive Impairment
A parent who has early signs of Alzheimer's disease or other related dementia presents an entirely different scenario. In this case, Dad may have no trouble going up and down stairs, but cannot remember to take his heart medication or seems frighteningly more confused and isolated each day. The decision to move him will likely be made by you and your siblings, but you may not be able to use logic to convince him about moving. Many adult children find it useful to ease into such a move with respite care.
Respite care is an option to introduce your parent to life at an assisted living facility by staying for a short visit-from a weekend to a month. During this time, he can get to know the staff and engage in the different programs and amenities offered at the facility. It also gives you a chance to see if the facility lives up to its reputation and meets your parent's growing needs.
After he has had a chance to experience life at the facility, discussing the move should be revisited. It allows your parent the chance to express any concerns he had during her respite stay. Discussing his concerns with the assisted living staff also gives you the opportunity to see how well the staff handles problems. This process can help you decide if the search for an assisted living facility is complete or if you need to keep looking.
Sometimes adult children have an even tougher issue to face: coping with one parent who has Alzheimer's disease and one who does not. Finding a facility that will meet your father's Alzheimer's needs and allow your mother to stay with him can be difficult. You and your family members should visit the facility as a group and individually to ask questions and get a general feel of the facility and its staff to see if it meets both your parents' needs. Taking your parents to visit can be especially helpful as they will be able to see first hand if the facility is a good fit for them.
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Time To Relocate
Once you, your siblings, and your parent decide on an assisted living facility, it is time to prepare for the move.
Because Medicare and Medicaid do not currently cover assisted living services, most facilities require financial and medical information and a fee to reserve your parent's apartment. Having your parent's bank statements, tax returns, powers of attorney, advance directives and other legal documents in place is essential. This is also the time to talk with your parent's primary care physician regarding any medical issues your parent is experiencing. Discussing your parent's move with her primary physician provides an opportunity to facilitate care between the physician and the assisted living facility's staff.
Looking at what your parent has accumulated over the years and deciding what will and will not go to her new home is a difficult task. Based on the layout of your parent's new residence, you will need to decide what is necessary for comfort and what will be sold, donated or divided among siblings.
The first step is to talk to your parent and learn what she cannot part with emotionally. The next step is to actually see what is needed and what your parent will use. From there, decide what will fit in the new space. Allowing your parent to participate in making the decision will reassure her that her treasured items will remain in the family for another generation.
In some cases, using an outside professional, such as a moving coordinator, to decide what is appropriate for your parent's new home is the best decision. Lack of emotional attachment allows an outside professional to see the situation from a different perspective. He or she will not have the
same emotional attachment you or your family members may have and will be able to determine what will work in the assisted living apartment space. They may also be able to elicit what is of true emotional value to your parent, and what can be left behind. Moving coordinators will also be able to locate other professionals who can help with any remaining items in your parent's home. The assisted living facility's marketing coordinator should have a list of names of such professionals to recommend.
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After The Move
Just after the move is likely to be a stressful time for your parent. Visit regularly to let her know she is still an important part of your life. The transition from home to assisted living will be easier for your parent when she sees that you will continue to visit even after she has moved from her home. At this time, it is best to set up a visiting schedule that you can handle. Knowing she can expect to see you every Tuesday will help the transition from home to the assisted living facility a little easier.
Take time to get to know the staff. Working as a team ensures your parent will receive the best possible care. When family members take time to work with staff, changes in health can be communicated effectively. Taking part in some of the activities at your parent's new home not only brightens her day, but also allows you the chance to see how she is adjusting.
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