Recognizing the Signs that it’s Time for Assisted Living – Part 1

 This will be part 1 in a 2 part series on assisted living…
assisted living
Our Family’s Story:  The Signs Were All Around Us

For any family, choosing assisted living for a loved one is understandably a difficult decision.  My mom is actually sharp as a tack, but suffers from degenerative spinal stenosis, foot drop, and has severely limited mobility.  She had been living at an independent living community for over 10 years in South Florida.  With the daily help of an excellent aide in the last few years, she was still just barely able to take care of herself.

Like me, my mom is very stubborn and she refused to use an aide at night due to some bad  prior experiences.  Combine that with a love of snacking in the middle of the night and it actually spells disaster.  Over an 18 month period, she was hospitalized twice for injuries due to a falling, resulting in (3) three month stays at a rehab center.

I went to visit her several times during this trying period.  In one week alone, she fell 4 times, luckily not injuring herself further.  I knew it was time, my brothers knew it was time and even my mom had to admit that it was time. There were more than enough reasons to move to assisted living.  This was a very big deal…

Our Process – Seemed Like the Blind Leading the BlindDoctor Speaking with Elderly Patient

On her own, with no coaxing, she came to the conclusion that she wanted to move to be closer to my eldest brother and I.  We set out to look at the options that we thought would be the best fit for her.  It became an entire family project with everyone involved, but she had the ultimate say in the matter.  In reality, her doctor also suggested it and she valued his opinion.

Given that none of us actually knew very much about assisted living, it was a major learning curve for everyone.  Some places you have to buy into, others are rentals, and still others look like nursing homes.  Ultimately we decided to stick with the national, well respected assisted living brand she was used to from independent living.  She told us in detail what her criteria was and we based our collective decision on that.

A Strong Dose of Reality

Unbeknownst to us, many assisted living facilities also have Alzheimer wings.  Apparently with people living longer, many residents start to show acute signs of dementia when they are on the assisted living side.  Initially, when I toured the facility, it looked like it would fit my mom’s needs.

4 months later when we moved her in, we found that the majority of the residents were deep into dementia.  To put it bluntly, she had very few people she could be friendly with as her issues were strictly physical.  I have come to understand that this situation is more common than we realized.

Luckily, my brother lives 7 minutes away and can run errands and take her out.  I live 200 miles away, so I visit every other weekend.  She has been there about 18 months and she is settling in.  She has a lovely mini apartment, she has made some friends, and even joined a book club.  With some great physical and occupational therapists, her mobility has improved greatly.

Let’s take a look at some of the signs and symptoms that you should look for when making this vitally important decision about assisted living.

Falls and accidents

If your loved one seems to be falling frequently and also hiding his or her bruises, it’s time to explore the option of assisted living. You also need to look carefully at recent accidents, which may be physical or medical. A lot of these accidents happen while your loved one goes wandering, which may occur quite often in the later stages of dementia. All these are important signs that it may be time to move towards assisted living.

Aggressive and agitated behavior

Do look out for symptoms of agitation and aggression in the behavior of your loved one. Such behavior can tend to take a heavy toll on the minds and emotions of other family members and other caregivers. So if that’s happening, it’s time to go for help.

Deteriorating health

Overall, if the health condition of your loved one appears to be deteriorating, it’s time to wake up to the possible need for assisted living. Chronic conditions, in particular, tend to worsen with dementia and other such patients. At times, this deterioration can be quite sudden and steep, which definitely calls for considering assisted living.

Slow pace of recovery

If your parent or other loved one seems to be taking too long to recover from even ordinary illnesses such as a cold or Thank Youthe ‘flu, it’s a sign of trouble. It’s important to check out whether he or she has been taking the necessary medical care during the illness and to what extent. If you find that they’ve been ignoring the illness, it’s all the more reason to move to assisted living.

Problems in managing daily living activities

Technically termed Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), these include the basic skills required for independent living. Bathing, dressing, cooking, eating, shopping, laundry and handling medications are all essential tasks of daily living that a person should be able to manage without assistance. And if that isn’t happening, it may well be time to take recourse to assisted living.

Unexplained weight changes

This is related to the independent management of daily living activities. If your loved one isn’t eating properly or shopping for the much-needed stuff for the kitchen, it’s going to show up some way or the other. Often, it shows up as loss of weight. Your loved one may suddenly be looking thinner and frailer. This may further manifest itself in difficulty in getting out of a chair or in maintaining their body’s balance. These, however, are signs you’re likely to catch only from close quarters. So start looking at your loved closely and carefully for these signs of need for assisted living.

Interestingly, weight gain is also a problem sign since it could mean your loved one is eating too frequently, perhaps out of sheer forgetfulness or diabetic pangs of hunger. Or maybe they simply can’t afford to buy fresh stuff and are dependent on packaged goods that make them prone to unexplained weight gain.

Changes in odor, grooming, and appearance

Changes in appearance are another marked sign that it’s probably time to move to assisted living. Unkempt appearance generally indicates that your loved one isn’t looking after himself/herself too well. Such changes are particularly noticeable in those who are otherwise known to have been always well-maintained.

So if your father, who’s never been anything but clean-shaven, is suddenly seen sporting a beard, check out on what’s happening. He’s probably just forgetting to shave – a good enough sign for you to move him to assisted living. Even body odor tends to change in such circumstances since a lack of personal hygiene can lead to serious transformations.


In Summary

Catching the signs for moving your loved one to assisted living isn’t always easy. So you’d really need to make a lot of effort to look for them. Remember, your parents aren’t going to tell you that they’ve been falling, or not eating, or are no longer able to wash or iron their clothes. You need to look for incidental signs to conclude that this is what’s happening to them.

Is your mom wearing the same dress she wore the last time you went to visit her? Does the house look dirtier and more cluttered than you’ve ever seen it before? Does the medicine cabinet seem filled with expired drugs, which probably means they’ve forgotten to take their medicines? A stack of unpaid bills is another indication that they’re noStill Mom longer able to manage their own lives without help.

And while you’re still contemplating whether you need to provide them with assisted living, take all the possible steps to ensure their total safety. Make sure their home has all the necessary safety gadgets and emergency response systems. Ask their friends to keep a look-out for them (but first check that they do have friends and aren’t living in total isolation).

From my family’s experience, having a medical doctor weigh in with their professional recommendations went a long way towards us making the ultimate decision.  I no longer feel pangs of guilt because I recognize that my mother is where she needs to be.

Thank you for reading and if you would like to share your comments, please do.  Our next post will be Part 2 – How to Evaluate Assisted Living Facilities.


Related Article:  14 Tips for Reducing Stress

2 thoughts on “Recognizing the Signs that it’s Time for Assisted Living – Part 1

  1. Ruth, thank you for this information!
    Ecspecially the part explaining about the negative effects of too many dementia patients in one place, and people of solid mind among them.
    This, I believe, can be a very depraving experience for those with flawless mental capacity, and I believe that more awareness in the settlement and housing planning of mixed care recipients is urgently necessary!
    Thank you for shining more light on this issue, Ruth!

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