Deciding where a parent should live

Question:

What do you do when you and your siblings disagree if Mom should live in an assisted living facility?  

Answer:

One of the toughest things to balance is an older person’s independence with his or her ability to safely live alone. The best way to make decisions about senior safety is to focus the question – “What are we trying to fix” – rather than starting with the solution – “assisted living facility vs. remaining at home.”

The first step is to make a list of what your Mom needs. You should do this together and consider the following questions: Does she need help with shopping? Paying the bills? Transportation? Cleaning? Getting around the house? Making lunch and dinner? Taking her pills? Is it difficult for her to see? You will also want to go through your Mom’s house and identify any safety hazards, especially with regard to lighting, stairs, hallways, the kitchen and bathroom as a part of this process. Creating an objective list that all of you can focus on allows you to explore a wide array of options rather than getting caught up in an “either/or” scenario. It also allows all of you to gain a better perspective on how each of you – including your Mom – perceives her needs.

Next, review your mother’s medical needs and health conditions. Ask her primary care physician to identify any special senior safety needs she may have. It can also be very helpful to get a geriatric assessment, in which a whole team of physicians, nurses and social workers conduct a holistic assessment of your mother’s medical, physical, social and mental health needs. You could then share your list of perceived needs with this team so they can help you determine how well your Mom can function living alone.

Once all of you have done your homework regarding her needs, secured her medical and mental health assessment and reviewed the physical state of her living quarters, then you’re in a good position to sit down as a team and review all of your information and decide if an assisted living facility is warranted.

Try making two columns on a sheet of paper. On the left hand side list all of her needs that you can agree upon. (If you can’t agree on a certain need, then skip over it and work on the ones you all do agree on.) On the right hand side of the paper, brainstorm how each need can be met. For example, say your Mom has difficulty taking a shower and one of your siblings thinks this means she belongs in assisted living. To solve this particular problem, you could:

• Buy a shower chair

• Install a long hand-held shower head

• Place railings in the shower

• Sign up for a personal alert service that would allow her to press a button and have someone arrive to help her if she did fall.

Keep going through the list, staying focused on her needs. For ideas on services to help you meet some of your mother’s needs, call your local Area Agency on Aging at 1.800.677.1116 and they may even send someone out to assess your mother’s needs. If you need some professional help to accurately assess her needs, you might want to hire a Geriatric Care Manager, found in the Yellow Pages under home health or social services. You could also call the National Association of Geriatric Care Managers at 1.520.881.8008 or visit their website at caremanager.org to locate someone near your Mom.

At the end of the day, you may discover that your Mom requires so many services that an assisted living facility may make sense for her. On the other hand, you may find that the solutions you’ve all come up with have alleviated the concerns of those of you who didn’t think your mother could continue living alone. The important thing is to not get caught up in an “all or nothing” debate. There are quite a few options and professional people available who can help you assess your mother’s needs so that all of you can rally around her and do what’s best for her well-being.