Knowing when it’s time to consider moving into an assisted living facility is not easy and recognizing the signs are unique for each individual.
Here are the 9 warning signs that I saw in my dad that told me it was time to move him into an assisted living facility.
9 Signs That It Is Time For Assisted Living
- Needing help with Activities of Daily Living
- Forgetting to take medications
- Leaving the stove on
- Trouble getting up from a seated position
- Eating spoiled food or forgetting to eat
- Forgetting to pay bills
- Showing signs of depression
- Becoming more isolated
- Worsening medical conditions
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. I was concerned that, going forward, he would need more help than he could get at his complex so it was important to begin thinking about assisted living.
Because a decline in health can begin as early as our 50s, according to AARP, it can be difficult to actually know when it may be time for your aging parent to transition into an assisted living facility. In my case, my dad was great some days and not so good on others, which made it tougher for us to make the decision to look into an assisted living facility (ALF) or other types of housing options.
Just in case you aren’t 100% sure what an ALF is, the National Institute on Aging says, “Assisted living is for people who need help with daily care, but not as much help as a nursing home provides.”
Assisted living residents usually live in their own apartments or rooms and share common areas. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and on-site staff; and social and recreational activities. Exact arrangements vary from state to state. – National Institute on Aging
Assisted Living vs. Nursing Home – Which One Is Best?
The decision as to whether an ALF or a nursing home is best for your elderly loved one boils down to the amount of hands on care that is needed.
Generally speaking, the most common reasons seniors are admitted into a nursing home are because of severe cognitive and/or physical decline that requires them to need 24 hour care. A nursing home admission makes sense when private in-home care is unaffordable or if friends or family members are unable to care for them.
Residents in assisted living facilities are usually more independent and do not require as much hands on care as those who live in nursing homes.
But, please know that an ALF resident can also pay for a private aide to come in if they need it.
How Do You Know When It’s Time For Assisted Living?
The signs that a senior loved one needs assisted living include declining medical condition, inability to perform self care, leaving the stove on, depression, isolation, difficulty managing medications and bills, messy environment and poor nutrition.
These 9 signs that I mentioned above are indicators that the time has come to make a change in the living environment that your parent or senior loved one is in currently.
Before making the move, though, keep in mind that assisted living is just one of the housing options available to seniors. Do some research to be sure that an ALF is the best fit for your parent because they might actually need to live in a skilled nursing facility( nursing home) instead.
Now, let’s take a deeper dive into our list of the 9 signs that indicate it may be time to consider an assisted living type of housing.
1) Needing Help With Activities Of Daily Living Tasks
As seniors age, sometimes they can no longer perform the standard activities of daily living (ADLs) that we usually take for granted. These are tasks such as personal hygiene, dressing, grooming, toileting, eating, etc.
The Centers for Medicare and Medicaid Services defines these activities of daily living 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. Other 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 to the bed without help.
My father was in his early nineties at the time 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 or perhaps a nursing home setting.
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 medications people are taking.
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.
To illustrate: a lovely woman in my dad’s senior living community was found sitting on her kitchen floor, staring into space after her worried nephew alerted the staff because he 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 (Day 1 she took 5 pills, Day 2 she took 4 pills, etc).
She got confused about how to take them and was in pain from the shingles, so she took far more of them than she should have. The overdose of medications reacted with her blood sugar, sending her into diabetic 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. Plus, the staff members are supposed to check on residents every two hours, so she would have likely been found and hospitalized much sooner.
3) Forgetting To Turn Off The Stove Or Trouble 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. 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 letting dryer lint build up can start a fire. According to FEMA, $35 million a year in properly losses result from fires in dryer lint.
4) 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 back pain and 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 rising 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 located forty miles from me, so I called him frequently and I 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 examination 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 food past it’s expiration date.
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) Forgetting To Pay Bills
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 certain bills, such as those for utilities, cable, and insurance.
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) Showing Signs Of Depression
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 engage with others.
Keep in mind that the National Institute on Aging also 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) 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 then 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 residents are able to participate in can help to alleviate those feelings of loneliness.
9) Worsening Health Problems Or Slow Recovery From An Illness
There are some health related red flags that you should take notice of to let you know that your senior loved one needs more help than they used to. Especially if they need more care than you can give or if you don’t live in the same city they do.
- Does it seem like it is taking your parent longer to recover from a cold?
- Is their blood pressure or insulin levels constantly abnormal?
- Does something “minor” turn into something serious? (i.e. a cut or scrape becomes infected)
- Do they have a health condition such as COPD or congestive heart failure that is getting worse?
Many (not all) assisted living communities offer medication management and on site medical care. Some have physical therapy or food service.
These type of services allow your parent to live more independently than they would in a nursing home, while still getting the help they need.
Alternative To Nursing Home Or Assisted Living Facilities
All these 9 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.
But 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
- Nursing homes (this is normally for elderly with poor health conditions who require 24 hour care)
You can read more about these housing options in our article on Housing Options For Seniors 55 And Older.