Living Transitions

When do I move to assisted living or skilled care?

Aging in the home you love is the choice most people make, and it is a great choice if planned carefully. Making certain your home is aging friendly and having the right people to help over time is a key to success. But even the best laid plans don't always work out. Just in case, it is good to think through the scenarios that warrant a move to assisted living or skilled care.

Dementia

The most difficult situation that often requires a move is dementia. Neglect of the home may be an early sign of dementia, especially if a person has historically done a great job in this regard. At the point where family or friends recognize a problem or develop the courage to address it, the person with dementia may be too ill to recognize the severity of the issue and have denial about their disease. They may resist help or refuse to move. What can be done?

Unfortunately, this situation occurs all too often. Family and friends worry as the person with dementia faces danger and neglect. Family fights, increased risk of elder abuse and increased risk of injury may result. Eventually, there may be the added expense of going to court to appoint a legal guardian against the elder's wishes.

To prevent this situation, create written agreements stating that you agree to move to a safer environment if you are diagnosed with dementia. Discuss these agreements with your family periodically. Situations we talk about on a regular basis will more likely become ingrained in our psyche. Familiarity creates confidence and comfort with decisions. If you are ever diagnosed with dementia, hopefully the ingrained conversations will help facilitate a move if needed.

Frailness or ill health

Frailness or ill health can result in a need to move to a safer environment. If your home is aging friendly, you have the right agreements in place for upkeep of your home, and you have a trusted person to care for the finances, it is possible to stay in your home until death. The key here is to plan ahead. If all of the pieces are not perfectly in place, create an agreement with your family as to when you will move to a safer environment.

Need for social interaction

It is important to realize that as you age, staying in your home may not provide the social interaction you need. If engagement with others is important to you, the loss of friends and family without moving to an interactive environment can result in withdrawal, depression, or a condition known as the “dwindles” where you may just gradually wither away. Acknowledge your need for social interaction and include this in agreements with your family members as a trigger for when you will move to a supportive environment.

Perfect practice makes perfect. By outlining your living accommodations as you age, along with triggers for when you will move, your family can use fewer "worry minutes" and you can grow old in the environment that is safe and supportive to you.