Should Your Loved One Continue Living at Home?


Rebecca and her husband live 500 miles away from her 82-year-old mother, who is exhibiting signs of early Alzheimer's disease and suffers from chronic arthritis. Rebecca worries about her mother's safety, but upon questioning her, the answer is always the same: "Everything is fine. Stop worrying about me."

Then one day, while at work, Rebecca received a phone call from a hospital social worker. Her mother fell down the stairs, broke her hip and was hospitalized. Rebecca's mother insisted it could happen to anyone and that she was perfectly safe at home and able to take care of herself.

"This is a common scenario," says Pamela Braun, MSW, LCSW, CPF, of Geriatric Assessment, Management & Solutions. "When questioned about their situation and needs, an elderly person may hide the truth from family members. Often the adult children find out what is truly going on from a third party such as the hospital or a neighbor."

A peron's home represents familiar comforts, self-sufficiency and privacy. That is why the prospect of moving out, going to live with a relative or transitioning into a senior living facility is one of the most difficult decisions a person must make in their lifetime. Often, rational decisions take a back seat to an emotional choice.

In situations like this, the difficult task of determining whether the elderly person can safely remain at home must be addressed. A care manager is a professional who specializes in assisting older people and their families with long-term care arrangements and conducting a thorough assessment to determine if they are physically and mentally able to continue living safely in their own home.

Braun says allowing an aging parent to remain at home is the "least invasive intervention" and can be successful. "When people move out of their home, it is usually after Plan A (remaining at home) did not work. Trying the least restrictive approach first is advisable, but family members must be realistic about their loved ones' abilities."

Can Your Senior Parent Age in Place?

To determine if an elderly person can safely continue living at home, take a good look at their present housing situation, financial resources, health status and medical needs. Braun says some topics of this assessment should include:

  • Medication
    Are they remembering to take their medications at prescribed doses and times? Are medications expired? Are they spread out in different rooms, with no apparent structure or routine?
  • Meal preparation
    Can they cook for themselves? Are they eating balanced meals? Are they able to safely operate appliances? Do they remember to turn appliances off when finished cooking?
  • Safety
    Is the home equipped with grab bars, emergency response systems and other tools to ensure safety? Do they have difficulty getting around or taking stairs? Do they have a plan in place to contact help in case of an emergency?
  • Personal hygiene
    Can they bathe themselves, groom adequately and launder their clothes and linens? Are they bathing frequently enough?
  • Transportation
    Are they still driving? Should they be driving? Do they have alternate means of transportation?
  • Socialization
    Are they isolated from others most of the time? Do they have friends? How often do they get out of the house? Are they depressed? Are there signs of alcohol abuse?
  • Home management
    Are they paying their bills on time? Are there stacks of papers and unpaid bills laying around? Is the house clean or in general disarray?

Print an Assessment Checklist

Having been involved in many of these assessments, Braun says, "It is a delicate situation. This is a role reversal between adult children and parents, and it typically is not welcomed by the elderly person."

Approaching this touchy subject can be challenging if a loved one is resistant to change, but there are some tips for beginning this discussion that can help.

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I vividly recall my grandmother almost burning the house down by leaving a tea kettle boiling on the stove. But there was no extra money around to provide a live-in caregiver while everyone was at work. She did not seem "ill" enough for a home -- simply becoming more forgetful and suffering the effects of aging. What do you do?
my mother in law's home is dirty, packed with stuff (hoarder), she has rats want let the pest control guy come in, doesn't see the doctors often enough, unable to cook much due to oxygen (when she comes to our home we can't cook on top of the stove either because she can't breathe good. Her memory is bad and she is not able to pump her own gas for her vehicle, she is unable to buy her own groceries, take out her own trash.
I don't think anyone will help or listen until the woman is dead or severely injured. It's almost to the point that no one actually even cares about her. My mother in law thinks I'm her enemy but all I want for her is to live in a clean environment, have good meals, see doctors regularly, and have friends to share with daily. What do I do?