With life expectancies growing, many of us face conversations we never thought we’d have. One of these is talking to a loved one about assisted living.
This is a conversation few people look forward to having. But waiting to have it could be dangerous for your loved one. And planning for it makes having “the talk” much easier once the time comes.
So, How Likely Is This Conversation?
First, let’s look at how likely it is you’ll have to have this conversation.
Life expectancy statistics can be confusing. While the average lifespan in America is 78.6 years, the CDC breaks life expectation down in numerous ways. Current age, race, and sex are the biggest determinants.
For example, if you make it to age 80, you’ve probably got another eight to 10 years left. And if you’re a woman, you’ll probably live around 5 years longer than your male counterparts (that gap used to be closer to 8 years).
In other words, chances are good that you’ll need to have the talk with a loved one.
Signs it May Be Time for Assisted Living
Of course, age isn’t the only indicator that someone needs assisted living. There are healthy folks in their 90s who are still going strong and living independently.
The U.S. Department of Health and Human Services (HHS) describes six activities of daily living (ADLs), also known as personal care needs. These include:
- Getting into or out of bed or chairs (called transferring)
- Incontinence care (ability to change colostomy bag or catheters)
- Using the toilet
If your loved one can still perform most (i.e. four or more) of these functions without assistance, they probably don’t need assisted living.
HHS also describes the instrumental activities of daily living (IADLs) as indicators that it may be time for assisted living or long-term care. Answer these questions:
Is your loved one’s home usually messy or odorous?
Are they still good at handling money? Are bills paid on time?
Can they prepare their own meals? How about cleaning up afterward?
Are they able to shop for personal needs, such as groceries and clothing items?
Do they remember to take their medication? Are there pills left over, or do they need refills too often?
Are they capable of communicating via telephone or other devices?
Can they respond to emergency alerts, such as a smoke alarm?
Are their pets well cared for?
As with the ADLs, if you can answer “Yes” to most of these questions, your loved one is probably still okay to live alone.
Is Your Loved One Truly Independent Now?
This question can be a bit more difficult to answer. That’s because we often don’t consider how much assistance our loved one actually receives.
If you were able to answer “Yes” to the ADL and IADL questions only because your loved one receives regular assistance from family and friends, then they aren’t truly independent.
That doesn’t mean that going over to mow Mom’s lawn once a week, or hiring a cleaning service to help keep the house clean, indicates she can no longer care for herself – particularly if she easily handles the other tasks.
But many well-meaning people enable their loved one’s current living situation. Running them to the grocery store, delivering meals, paying the bills, trips to the doctor. If you and that friendly neighbor disappeared tomorrow, would Mom still be okay at home alone?
What About Caregivers?
If your loved one has a caregiver – or if you are that person – they may also show signs that it’s time for your loved one to enter assisted living.
Caregivers often begin to experience levels of stress that A Place for Mom likens to PTSD. Often, this is due to caring for someone who has dementia. But it also happens when your loved one’s needs simply require greater levels of care than the caregiver is equipped to handle.
Hyper-vigilance, avoidance, and anxiety are common signs of caregiver burnout. Caregivers may also feel isolated, angry, or resentful, all of which often lead to feelings of guilt.
Preparing for the Talk
It helps to prepare for the talk, particularly if your loved one has received a diagnosis like dementia. Spend some time researching the condition, talking to other caregivers, and investigating your options.
It’s also helpful to talk to any other caregivers in your loved one’s life, including that friendly neighbor down the street. This helps ensure everyone understands the reasoning behind the decision, which makes it easier for you. This is particularly true if your loved one is resistant at first. Your job is easier when there are other parties helping to build excitement and support for the idea.
You should also visit some of the communities that interest you. This gives you a much better idea of what you’re proposing.
Finally, it’s usually best if there is a series of conversations leading up to the final “it’s time” talk. This is especially true in the event your loved one has a condition that often leads to long-term care, such as Alzheimer’s disease.
Having the Talk
Remember to put on your empathy hat before having this conversation. Assisted living has changed dramatically, but your loved one’s only experience of it may be when their own parent or grandparent needed such care.
Discuss your concerns and share your observations. Talk about the different types of care. Describe the communities you discovered during your research. And, of course, schedule a visit with your loved one. Most assisted living communities welcome visits, particularly during lunchtime. This lets your loved one experience the social aspect of the facility and meet other residents. This type of experience goes a long way toward addressing their fears.
For more tips, watch Having the Conversation, offered by A Place for Mom.
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