Moving to Assisted Living Part 3
Twenty five years ago, my mother visited her mother in a skilled nursing facility and came back very depressed. At dinner that night she said; “Promise me that you will never put in in one of “those” facilities…. no matter what! I don’t want to die in a place like that.” How many of you have had similar conversations with a loved one?
At a recent Assisted Living conference I attended, there was a discussion among 500 senior care professionals concerning this point. Most of them had had similar discussions with their parents. The question was, how then does one talk to a loved one about moving into assisted living. After a spirited discussion, the following points came out:
- Most elderly people are confused about the difference between the skilled nursing facility their parents were in and today’s assisted living homes. Twenty five years ago, assisted living was not prevalent as it is today. Aging relatives lived at home alone or with their children until they required skilled nursing, usually toward the end of life. In those days, there was no paradigm for Assisted Living. So when today’s elderly are asked about moving to an assisted living community, they think that they are going to the same skilled nursing facility their parents went to and died. First of all, they need to know that skilled nursing is a higher level of care than assisted living. They are not the same. In skilled nursing, you share a hospital type room. In assisted living you live in an apartment, with care services provided as needed.
- Today’s assisted living is more like living on a cruise ship without the inconvenience of choppy water. You get a nice room, delicious meals and snacks, entertainment and a staff assigned to take care of you! The bonus is that unlike most seniors that live alone, you are physically active and have a variety of friendships and social experiences.
- In some cases, assisted living residents arrive because their physician advises them not to go home from the hospital due to some ailment or injury. In this case, assisted living is often an interim solution until they recover. Frequently, however, after living in a facility for several months, residents prefer the conveniences and programs and decide to stay permanently. The point is: after experiencing the benefits of assisted living, many choose never to go back home. Why deal with household maintenance, gardening, laundry, groceries, cooking and loneliness? Many happy residents have remarked that they regretted taking so long to realize that assisted living is really fun with something interesting happening all the time. They say that they now have a much better quality of life and will live longer as a result.
- The consensus among residents and their families is that it is much better to be straight with a loved one about the necessity of moving to assisted living facility. “Mom you can’t go home. You have had five falls and the last time you nearly broke your hip. Your doctor said you are malnourished and need more social interaction and exercise. Also, despite your best efforts, you are not taking your medications consistently causing you to visit the ER for a life- threatening emergency last month. You need a professional support system that is available to you 24/7, otherwise your life is in jeopardy.”
- Some elderly people will tour an assisted living facility and declare: “ I don’t want to be around old people.” It is as if they think they are still 45! The counter to this is to compare the quality of life they have today with what they will have tomorrow. “Mom, how long can you keep caring for dad? You can hardly get him into the shower now. How will it be in 3 months? You are running yourself ragged, trying to maintain the household you had 30 years ago. It is better to plan ahead and have time to make choices before something suddenly happens and you are forced into a lifestyle change.” People who anticipate and plan for life as an elderly senior have a much better experience than those who pretend that things will somehow remain the same. It is better to be proactive and control where you are going than live inside a pretense.” The reality for most people over 80 is not “if” they will move to assisted living, but “when.” The biggest mistake they make is to put off making the decision and then be forced to move in a short timeframe. Their affairs are in disarray and they have lost control of their circumstances. Family members or friends are then left to sort out their affairs, sometimes with unsatisfying results.
- In some cases, loved ones have mild cognitive impairment or dementia and are not able to make effective decisions for themselves. They will resist any effort to change anything about their life. In these cases, it is almost pointless to present an option of moving to assisted living as they don’t have the capacity to understand their own needs. This is perhaps the most difficult situation families face when considering care options. In the end, the family has to take a stand for their loved one, insisting on placement in a secured dementia unit. Often this has to be done over the objections of the resident and/or their family member. The central theme in this conversation has to be about maintaining the highest quality of life for the resident. Focus on what is best for the resident, not the family members. “Bob cannot live at home any longer. It is no longer safe. He nearly burned down the house when he left the burner on and started a fire. He was found wandering five miles from home in freezing weather. He hasn’t had a shower for a week and hardly changes his cloths. He doesn’t take his medication, which is life threatening. His physician has advised that Bob should go to a facility with a secured dementia unit (SDU). He will have a better quality of life at Oaks of Bensalem. I have toured the facility and it is perfect for him. As his guardian, I am taking him to move in on Thursday. We are encouraged to visit as much as we want.”
The bottom line in having discussions about moving to assisted living is to be authentic. Communicate your stand for the person. Clarify that in checking with their physician, psychologist, clergyman, family members and friends you have concluded that they may have a ”blind spot” about the quality of their life. They may not be able to see what others can see so clearly. In your commitment to and love for them, you want to communicate to them what they cannot see. Times change. Successful aging depends upon the willingness to be flexible and give up attachments that no longer serve them. It is time to consider another season of life and change their lifestyle for that season. Many happy and vital seniors living in assisted living have uncovered the best kept secret: Let go of the “stuff” that keeps you stuck in your old life and you will feel free in a new one.”
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