Towards the end of my dad’s life, he spent time in the hospital, which left him weak and disoriented. I worried about him going back to his independent senior apartment. They didn’t offer assisted living, but I worried that he needed more help than he could get at his complex.
It is a very difficult thing – how to know when your parent needs assisted living. My dad was great some days and not so good other days – so that made it so very hard for us to make that decision.
But – there are certain signs that finally helped us to come to the conclusion that it was time to move.
9 Signs That An Elderly Person Needs Assisted Living
Below are 9 signs that indicate that your senior parent or loved one may be ready for an ALF (Assisted Living Facility) type of housing.
- They need help with dressing, bathing and or cooking
- They are not taking their medications correctly or on time
- They forget to turn off the stove or can’t operate appliances safely
- They have trouble getting up from a seated or laying down position
- They have eaten spoiled or out of date foods, or they forget to eat
- They are not able to properly take care of their finances
- They are showing signs of depression
- They are becoming more isolated at home
- They show signs of a slow recovery from an illness or a worsening chronic health problem
Knowing when it may be time to look into an (ALF) assisted living facility (or other different type of housing option) for your senior parent is not always easy. But if you and your parent(s) have an honest discussion about what they currently can and cannot do for themselves, the decision may end up staring you in the face.
Just in case you aren’t 100% sure what an ALF is…
Type of alternative housing that offers a combination of private “apartment style” living with a variety of supportive services such as meals, assistance with personal care (i.e. bathing, dressing), housekeeping tasks, and social programming. These additional services are often included in the base monthly rental fee. – brooklinema.gov
Below is more information about the list of signs that I listed above that indicate it may be time to consider an assisted living type of housing.
1) Impairment In Activities Of Daily Living (ADLs)
As seniors age, sometimes they can no longer perform the standard activities of daily living (ADLs) we usually take for granted. The Centers for Medicare and Medicaid Services defines these daily activities as “… activities related to personal care. They include bathing or showering, dressing, getting in and out of bed or a chair, walking, using the toilet, and eating.”
For example: many seniors become arthritic as they age. Stiff joints and painful fingers may mean they have trouble getting dressed or undressed. Health issues can also cause this problem.
After my mom was diagnosed with a brain tumor, she became wheelchair-bound. The tumor caused her legs to become mostly immobile. She couldn’t put on pants or transfer to the toilet or bed. My father was in his early nineties and wasn’t strong enough to help her, so we arranged for an aide to come in to help. If Mom had lived alone, it would have clearly been time to move her into assisted living.
2) Not Taking Medicines Correctly Or On Time
Sometimes it seems like the more we age, the more medications we pick up along the way. As a dental hygienist, it’s part of my job to review my patient’s medical histories. I’m often shocked by how many meds people are on.
This can be a huge problem for an elderly person. Poor eyesight, cognitive issues, confusion and and forgetfulness can lead to seniors taking too many pills or forgetting to take their medications entirely.
A lovely woman in my dad’s senior living community was found by the staff sitting on her kitchen floor, staring into space after her worried nephew couldn’t get in touch with her.
She was diabetic and had just been diagnosed with shingles. Although she had taken her medications, one type was in a blister pack that reduced by one pill per day, every day for a week.
She got confused about how to take them and was in pain from the shingles, so she took far more than she should have. The overdose of medications reacted with her blood sugar, sending her into shock. She spent a week in the hospital, recovering.
If she had been in an assisted living facility, it’s likely that a staff member would have been in charge of dispensing her medications. This would have eliminated her confusion over the complicated instructions.
3) Forgetting To Turn Off The Stove Or Can’t Operate Other Appliances
I don’t know about you, but I’m guilty of leaving a stove burner on occasionally and I’m not even in my senior years. Imagine how tough it might be for someone with cognitive issues to remember. And what about the other appliances in the house?
Stove alarms are great for reminding seniors that they’ve left a burner on, but if your parent is consistently having trouble using things like the can opener or microwave, they also may not be eating correctly.
Assisted living facilities (ALFs) assess their residents and put care plans into place while allowing as much independence as possible. In a case of someone with memory issues, the facility should provide meals and food service so your parent doesn’t have to worry about kitchen safety.
And, what about fireplaces, the gas pilot lights on stoves or water heaters, or using the dryer? Even something as mundane as forgetting to remove dryer lint can start a fire. According to FEMA, $35 million a year in properly losses result from fires in dryer lint.
4) Has Trouble Getting Up From A Seated Position
Weak muscles and problems with balance can result in falls. And sometimes these weaknesses can mean that a person can’t get up from a soft couch or bed.
My father was stubbornly independent, but when he began having trouble getting up from the couch at age 97, he got a folding chair to use instead. This worked well until he lost his balance while getting up one night. The chair collapsed under him and he fell, ending up in the ER with a broken finger.
Dad was generally steady on his feet, but this is a good illustration of what can happen when someone has trouble getting up. In an assisted living facility, aides are available for residents who need help getting up from a seated position or transferring to a toilet, bed, or wheelchair.
5) Eating Spoiled Food Or Forgetting To Eat
After my mom passed away, Dad lived by himself for a year. He refused to move out of their house which was forty miles from me, so I called frequently and visited him weekly.
It wasn’t long before he started complaining of occasional diarrhea and an upset stomach. This didn’t happen all the time and a physical revealed no problems. Slowly it dawned on me, however, that I was sometimes seeing the same lunch meat or milk in the refrigerator that had been there on the prior week’s visit. I realized that Dad was occasionally eating out of code food.
Even writing the “opened” date on the container didn’t help. In Dad’s mind, if the expiration date was – for example – two weeks in the future, that was the last date he could use the product. He couldn’t grasp that food begins to spoil once the package has been opened.
When he eventually moved to a senior community that provided all meals, his stomach issues never bothered him again.
6) Your Parent Is Not Paying Their Bills On Time
If you notice that bills are piling up and late notices are starting to come in then it may certainly be time to consider helping your elderly parents with this task. Living in an assisted living facility generally relieves them of having to deal with paying utility bills, insurance bills, etc.
Of course, every individual person and circumstances are different. My father was still able to drive safely for the first year that he lived in an ALF so he still had to make care insurance payments.
7) Your Senior Parent Is Depressed
Sometimes older people who are depressed appear to feel tired, have trouble sleeping, or seem grumpy and irritable. Confusion or attention problems caused by depression can sometimes look like Alzheimer’s disease or other brain disorders. Older adults also may have more medical conditions, such as heart disease, stroke, or cancer, which may cause depressive symptoms. Or they may be taking medications with side effects that contribute to depression. — National Institute on Aging
When my grandmother turned 90, I remember being appalled when she said she was ready to die. As a young person, I couldn’t imagine having that outlook, but then she told me she was lonely. The vast majority of her friends had passed away, as had all of her siblings and cousins.
If your senior parent is living alone, it can make a world of difference in their health and outlook if they go into an assisted living facility. There will be people around them and peers they can reminisce with about “the old days.” Additionally, there will be activities designed to get them out of their rooms and engaged with others.
Keep in mind that the National Institute on Aging says that “for older adults who experience depression for the first time later in life, the depression may be related to changes that occur in the brain and body as a person ages.”
If your parent’s depression requires medication, many assisted living facilities (ALFs) provide medication management and some also offer skilled nursing care.
8) Your Parent Is Becoming More Isolated In Their Home
If you notice that your parent is not going out with friends as much as they used to or if they are not going to church or participating in other activities that they used to do it may be that they are becoming more and more isolated at home. This is especially true if they live alone.
Depression may be playing a part of that or it may be that their friends have moved away, they are unable to do the activities they used to enjoy or that it’s simply just too difficult to get out of the house.
In the study sponsored by the AARP, researchers from the University of Michigan surveyed a group of about 2,000 Americans ages 50 to 80. More than a third of seniors in the poll said they felt a lack of companionship at least some of the time, and 27% said they sometimes or often felt isolated; most of the people who said they lacked companionship also felt isolated, and vice versa. Almost 30% said they socialized with friends, family or neighbors once a week or less. – time.com
Whatever the issue is – if isolation is becoming a problem – moving to an ALF may help them with that. Living in a building with others in your same age group and participating in activities that all can enjoy can help to alleviate those feelings of loneliness.
9) Slow Recovery Or Worsening Chronic Health Problems
Does it seem like it is taking your parent longer to recover from a cold? Does something “minor” turn into something serious? Do they have a health condition such as COPD or congestive heart failure that is getting worse?
These are red flags that your senior loved one needs more help, especially if they need more care than you can give or if you don’t live in the same city they do. Many (not all) assisted living communities offer medication management and on site medical care. Some have physical therapy. This allows your parent to live more independently than they would in a nursing home, while still getting the help they need.
When Does Someone Need Assisted Living?
All these signs that I mentioned above can certainly be definite signals that it’s time to start looking at some alternative housing options for your senior parents.
If an assisted living community is not something that your parent is willing to do then you may want to consider any of the other senior housing options that are available today.
- Granny Pods
- Active adult communities
- Senior villages
- Senior co-housing
- Residential care homes
- Continuing care communities
You can read more about these housing options in our article on Housing Options For Seniors 55 And Older.
But if you and your parent have made the decision to move to an assisted living community, then read on.
What Are The Criteria For Assisted Living?
Assisted living facilities are intended for older adults who require some assistance with their ADL’s (activities of daily living) but can still live alone in an apartment setting. Normally, the type of assistance they require is for bathing, dressing and meals.
Some assisted living organizations will help with medication management, administering insulin, etc. Generally, the amount of health care services that they provide are limited so ALF residents are normally fairly independent – they just need a bit of help with specific tasks.
Do your research and check each ALF that you are considering to find out what they do and do not provide as far as services and care for their residents.
How Long Does The Average Person Stay In Assisted Living?
According to a report by the National Center For Assisted Living, the average length of stay in an ALF is 22 months. That’s just shy of 2 years. This may not seem like a very long time but let me give you my theory as to why this is the case.
I don’t have any statistics on this but my personal experience has taught me that most seniors who do move into an ALF do so when they absolutely have to. So, by the time they “have to” there already is a major decline in their ability to function and care for themselves.
In other words, their health is already in serious decline when they finally do decide to make the move.
Can A Dementia Patient Live In An Assisted Living Facility?
Generally, if your senior parent suffers from any form of dementia – it may be difficult for them to move to (or continue living in) an ALF setting. It does depend greatly on what the ALF provides as far as care and how impeded your parent is by their dementia.
It may be that the ALF you are looking at has what is usually called a Memory Unit which is where residents with cognitive problems reside.
Also, if your parent is able to hire and pay for a private aide to help them while they live in an ALF – that may be a solution is well.
You see, most (if not all) ALF residents live in their own private apartment. For many seniors with dementia, living alone is not an option – it’s simply not safe.
If all they need is some help with bathing and dressing and they can get their meals in the dining room, then it should not be a problem. Speak with the director at the assisted living facilities you are considering to get more information on this issue.
Again, if it’s the beginning stages of dementia, there may not be an issue – but generally – dementia does not get better so it’s important that if you are moving your parent to another type of housing – that it be the kind that they can live in for the remainder of their life.
Here’s a wonderful resource for seniors and families who are dealing with issues related to dementia.
Making The Decision To Move
It’s never an easy decision to move someone out of their home, but sometimes it is what’s best for them. You’ll know they are in the proper place for the care they need by researching and visiting several assisted living communities before choosing one.
Be sure the community has transportation if your parent is no longer driving. Find out what activities the facility offers and what medical support they provide, if any. Are meals included in the monthly fee (also how many meals per day)? Are cleaning and laundry services provided? What “extras” might incur a fee (example: home healthcare visits, onsite physical therapy, etc)?
If your parent is fighting you about a move, try these tips to make the transition easier.
Does social security pay for assisted living? No, Social Security does not pay for someone to live in an assisted living facility. Medicare may cover some qualified healthcare costs for up to 100 days in a skilled nursing facility, however. It may also cover some costs for home health care.
Is there financial assistance for assisted living? As of 2019, Medicaid will pay for some costs associated with assisted living. This benefit is available in 44 states and the District of Columbia. What they cover is different in each state, however. Check with your state’s Medicaid program to find out what the qualifications are and what benefits your elderly parent can receive.