Tips for Touring Assisted Living Communities

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Convincing elders to move from the comfort of the home they've known for many years and downsize into an assisted living situation can be one of the toughest hurdles for families to accomplish. Moving is an emotional decision. The best way is to start the conversation sooner than later, while your loved ones are still in good health. Getting them used to the idea beforehand will make it easier when the time comes. Its never an easy discussion, and usually its met with resistance from the elder. But if you haven't discussed it nor made plans for the transition, doing your homework and understanding the option can make the discussion go more smoothly.

Finding the Right Assisted Living Facility

Visit Personally

Finding the very best care for your loved one will help you deal with the situation. Although the internet is a great way to gather a short-list of assisted living facilities in the geographic area you're interested in, there's no substitue for visiting the facilites. Get a feeling for the accommodations, the common areas, the condition of the residents, the dining room and the staff. Once you have the talk with parents, taking them to visit the facilities may ease their anxiety and decrease resistance.

Look into Multi-Level Care Facilities

Be sure to consider the benefits of a multi-level facility, or a CCRC, which allows for additional services as your loved ones' health declines. This prevents the turmoil of having to move them again as more help is needed. Many seniors start out with their own private apartment and then progress through stages of assisted living and eventually to skilled nursing and dementia care if needed, all within the same facility. They may be able to bathe, dress, and take their own medications properly now, but as they need more help, it's a blessing to know that services can be added. Many times the friends they have made along the way progress along with them, providing the comfort of familiar faces.

References are a Must

The best way to check out a location is to talk to numerous families who already have a loved one living there. Drop in on weekends when many families visit and ask if they are happy with the accommodations, food, service, activities, cleanliness, reliability, personnel, etc. If they had it to do again, would they move their loved one there? What have they learned from the experience? What do they wish they had known when they were beginning the process? Also, ask the administrators if there are any liens or lawsuits filed against the facility. Ask to review their licensing and certification reports. If they will not put in writing that there are no legal problems--keep looking! Also, be sure to check with your local Area Agency on Aging and the long-term care ombudsman who monitors the area.

Taste Test

Be sure to check out the kitchen for cleanliness and eat a meal yourself. You may be surprised. Many people have the pre-conceived notion of caferia-style dining with bland food and limited choices. Not so in today's assisted living communities. The facilities have realized the appeal of delicous food choices, served in a restaurant setting. The community should be staffed with registered dieticians to accommodate residents with a variety of dietary modifications, from low sugar to no salt-added diets.

See the Accommodations

Again, the notion of a "nursing home" setting of years past as an institution where elders are locked away is simply untrue. Today's facilities offer condo-style living, ranging from studios to two or even three bedroom apartments. Where your parent will live plays a key role in their long-term happiness.

Activities are Important

Adult children are often filled with guilt about moving their parents out of their own home, that is, until they see them flourishing in a new environment and participating in activities they haven't enjoyed for years. Speak with the activity director to make sure that there are numerous activity options. Does the facility offer field trips, games, crafts, singing, dancing, gardening, cooking, bingo, exercising, movies, interaction with animals, etc.? Be sure to monitor the Director regularly to make sure that the activities are being offered.

Build Relationships

Once you have picked out a short-list of places, ask the administrators for their help convincing your loved one to move, as they are very familiar with this problem and deal with it daily. Ask an administrator to call your loved one and develop a relationship over the phone. He or she may be able to drop by (while you just happen to be there) to talk to your parents and invite them for a get-together. The assisted living staff should establish a relationship, too. A few days later, take your parents out to lunch and then casually stop by the facility to say hello to that lovely person who was so kind to drop by to visit them. Seeing a familiar face is usually very helpful. Remember, any kind of change can be very scary for an elder. Take things slow, planting the idea calm and steady, making their safety your goal.

Create Need

Another idea is to have a social worker ask for your loved one's "help" with the other seniors at the center. Or tell them that they need help with something there. Could they, for example, go over to help out with the bingo, crafts, or singing classes? Perhaps they can help prepare lunch for the elders there. Tell your loved one that they are "needed" there to help and entertain the other seniors. Giving them a "job" to do will help them become comfortable with being there. They will make friends, which can then ease the transition to eventually moving there.

Safety First

Keep in mind that your elder's safety is the most important thing. If you know that they cannot remain in their own home safely, don't let your emotions override what you know needs to be done. Don't wait for a broken hip, a car accident, medicine overdose, stroke, or that crisis call before you step in. Recognize that when you were a child, your parents would have done everything possible to keep you safe. Now, as hard as it is, you have to be the "parent," and you must make the best decisions for their safety. Talk with them about moving. Ask their doctors and healthcare professionals to help you with encouraging them to move--for their safety.

Reach for Support

Realize that since the beginning of time, everyone who has ever been lucky enough to have their parents reach old age has experienced the pain of watching their once-competent loved ones decline and pass away. We all know it is a sad part of life, but even with all that's been written, there are no words that can prepare us for the sorrow. Reach out for help from family and friends and get into a support group right away--don't even think you can do it alone!

Jacqueline Marcell is a former television executive who was so compelled by caring for her elderly parents (both with early Alzheimer's not diagnosed for over a year) she wrote "Elder Rage." She is also an international speaker on elder care and host of the popular Internet radio program "Coping With Caregiving."

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17 Comments

I have learned in my own practice in this area that two other ingredients are essential:
1. Better to explore the senior's needs, hopes, wishes, strengths, and limits with a neutral and, along the way, include the children. Reaching an agreement is superior to "convincing," which more often than not fails to achieve the goal of renewed life and calmness.
2. "Right-sizing" better describes the realities and goals than "down-sizing." Indeed, much of our lives, including careers, partnerships, and residencies, is about finding the right fit given our needs, hopes, wishes, strengths, and limits.
Rabbi Scott B. S., PhD
Respect for your mother and her needs cannot come at the price of disrepsect for your own needs and limits. Your mother's always being difficult does not give her license to be difficult now, certainly not at your own financial and mental peril. If she is competent, which may not be the case, then she will have to arrange to get what she wants without you. Otherwise, she will have to respect what you can and cannot do. That you cannot do everything you wish maybe a cause for regret and sadness, but not a cause for guilt. Within these parameters you can still care for her while caring for yourself.
Rabbi Scott B. S., PhD
I have a similar situation to CAC, who posted on 9/18/09...
My elderly mother of 88 years is very independent, stubborn, and has lived alone for 3 years since my father passed away. She
has been diagnosed as having "mild cognitive impairment" --- the gentle way of calling it Dymentia. She is in a stage where she believes that people are coming into her house and hiding her belongings, including her medication, car and house keys, and her wallet. Her forgetfulness has caused her to misplace items around the house, yet she blames mysterious people who creep in after midnight. She wobbles when she walks, and has fallen at least half a dozen times. She has placed a metal tray in the microwave oven. But she insists that she is the only one living at the house, thus SHE must take care of it. And so, she won't move away. All this risky and rather dangerous behavior has prompted my sister and I to research the assisted living places with memory care wings. What really troubles us is HOW we can convince mom to leave her house. Because she really doesn't understand her dangerous behavior, she absolutely won't be convinced that she must move to safer surroundings. We are open for suggestions on how to accomplish this, even if we have to fabricate a "story" that convinces mom to leave her house.