Preparing for Assisted Living

Raise your hand if you’ve ever felt overwhelmed at the mere thought of a loved one going into assisted living. According to American Senior Communities, “around one million Americans live in some type of senior living community, and that number is expected to double by the year 2030.” So, clearly, you are not alone.

It must be remembered that each family caregiving situation, by its very nature, is unique. What might work for me, might not for you and visa-versa; similarly what might overwhelm me might not overwhelm you. There are no “cookie-cutter” answers here. And if any difficulties arise, family caregivers are well advised to discuss them with supportive friends, family, clergy and maybe even a therapist if need be.

A loved one moving into assisted living is a major transition, and not just for the loved one. There are so many things to think about, and a family caregiver can easily feel snowed under.

That’s how I felt when we decided that my parents would go into assisted living after Hurricane Sandy (October, 2012) flooded their home. I felt so ill prepared. In hindsight, when considering assisted living for mom or dad or both of your parents, I can now see that the majority of the issues actually fell into three categories: legal/financial, physical and emotional.

Legal and Financial Considerations                                          

It is my contention that everyone should name a power of attorney. It doesn’t matter if the person is forty or eighty years old, stuff happens and it typically happens when we least expect it.

According to Legal Zoom, the power of attorney (POA) “is a document that allows you to appoint a person or organization to manage your affairs if you become unable to do so. However, all POAs are not created equal.” There are several types of powers of attorney (POAs), they further tell us. There’s the general power of attorney, the special power of attorney, the healthcare power of attorney, and the durable power of attorney.

We had a durable power of attorney for my parents. It’s what worked for my family. To assess what will work for your family, I recommend going to a lawyer, sitting down and discussing the situation with him or her.

While sites like Legal zoom are great, the thought of “doing-it-yourself” makes me nervous. I like the idea of sitting down with an experienced, licensed professional and letting him or her draw up the paperwork for me. To my mind, it’s better to be safe than sorry. Heaven forbid I accidently fill out something wrong.

Additionally, I feel that it’s important to have a will and, if it makes sense for your family, a living will. Knowing what a loved one’s wishes are can make life so much easier should decisions have to be made.

Physical Considerations

Among the things to consider is the physical part, of course. Issues like:

1. whether the facility is clean and well cared for,
2. whether the walls are nicely painted or if the paint is chipping,
3. if the facility is well lighted,
4. if the rooms/apartments are big and airy and
5. if the common areas are well decorated
6. if the facility is properly equipped for the older adult to reside there safely; Are there grab bars in slip-prone areas? Are there panic/call buttons installed in easily accessible places?

are all important.

When it was time for my parents to go into assisted living, my husband and I were the ones to do the initial touring of the facilities. We went to every place we could think of; some we felt my parents would like, other we knew they’d hate.

It’s crucial to know whether your loved one will like the facility or not but it can be challenging to quickly assess it. Below are some suggestions to help you when you go on a tour.

1. Does the staff seem friendly? Do they smile and acknowledge you when you pass in the hall or are they sulking and scowling?
2. Do they speak to residents in a warm, loving manner or are their voices terse as though having to speak to the residents is just one more thing they have to do in the course of their day?
3. Take a look at the menu. Do residents have choices with regard to the food? Do they seem to enjoy the food? Asking them, something simple like, “Does that taste good?” could give you a lot of information.
4. And what about the residents? Do they seem happy and engaged with what they are doing or do they seem depressed? Are there sufficient activities for them to choose from or are they just sitting around, watching TV, and waiting for their next meal?
5. What kinds of activities are there? Do performers come in to entertain? How often do they come in? Are there parties scheduled? Trips? Are residents encouraged to participate? And what about those residents who prefer to be left alone to read or think? Can they do that without being “forced” or harangued by staff to join in when they don’t want to?
6. What about the quality of medical care? Is there a department on site with staff available 24/7? If not, what preparations are in place should a medical emergency occur? If so, is the staff caring and knowledgeable? What about psychological services? Are there any? If so, how often does a professional come in? Weekly? Monthly? And what kind of professional are we talking about? Psychiatrist? Psychologist? Social Worker?
7. What about “aging-in-place?” Is the assisted living facility able to accommodate increased needs or will your loved one have to be transferred to a different facility (i.e. nursing home) should his/her physical condition deteriorate?
8. And finally, what about the hospital the assisted living facility is affiliated with? Is it located close by? Does it have a good reputation?

It’s important to look at the facility carefully and not be afraid to ask questions. Does the facility meet your standards for what you think would make your loved one happy? It’s a question that you (if you’re the one going on the tours) are going to have to answer. Not the facilities’ social worker. Not the executive director. YOU. You are the one who knows your loved one best.

Emotional Considerations

It’s here that we find ourselves on a somewhat slippery slope because when it comes to emotional considerations, it cuts both ways.

Sure, we need to be mindful of our loved one’s emotions as they enter into this new phase of their lives. We want them to be happy and feel at home, safe and secure in their new “digs.” To that end we can bring some familiar objects. While some assisted living facilities permit residents a myriad of personal objects, others don’t. It’s a good idea to check with your loved one before the decision is made to see how important certain objects are to them, and then check with the facility as to what can and cannot be brought in. Your decision as to which senior living facility your loved one enters might hinge on this issue alone.

While we have to be mindful of our loved one’s emotional states, we also have to be mindful of our own as well.  We have to be cognizant of where we are in the process and when we might be having difficulties. It’s important that we reach out to our support system should issues come up. After all, not only are our loved ones transitioning into a new phase of their lives, so are we.

Karen Bromberg is the founder of Helpyouthru.com. She is a certified yoga instructor and a certified caregiving consultant, helping overwhelmed family caregivers with resources, research and relaxation, brainstorming ideas to help make their family caregiving experiences more rewarding and less stressful. She is the author of “The Unsuspecting Caregiver: My Experiences In The Wake Of Hurricane Sandy And The Lessons I've Learned From Them,” which is available on Amazon.com.  If you’d like to get in touch with Karen. please feel free to email at her staff@helpyouthru.com