Choosing an alternative to a current living environment can be a sensitive subject. It can be especially challenging when your loved one does not want to make a change. Relocating to a less independent setting is an individual decision and requires a great deal of thought and preparation.
When is an independent setting no longer appropriate?
- When safety becomes an issue. For example, if this person falls or is at risk of falling; or smokes while on oxygen and falls asleep doing so; or forgets to turn off the stove; or takes medications incorrectly or not at all.
- Your loved one does not seem to be taking care of his or herself. For example, an always “spotless” home is far from clean, hygiene issues surface, or he or she does not appear to be eating or is unable to fix a meal.
- Your loved one is afraid of or uncomfortable being alone.
- When the current caregiver is unable to care for your loved one and other alternatives are not possible, such as additional in-home family member help or private hire care.
- A health care professional has recommended, based on an assessment, that this person no longer live alone.
If you’re an outsider to the situation, you may think it’s as easy as saying, “You aren’t safe living alone.” However, when you have a close, personal relationship with that person, it is very easy to avoid saying those words, even if you know they need to be said. It may be helpful to consider and acknowledge your loved one:
- Have they lived in their home for many years?
- Do they feel things are changing too quickly?
- Has there been a recent “incident” forcing a move?
- Are they unrealistic about their own status?
- Consider their long-standing personality traits; what reaction can you expect?
- Are there signs of cognitive deficits?
- Do you worry about their safety?
- Do they disagree with moving?
If you answer these questions honestly and try to empathize, you will be more apt to understand their reactions. By simply listening to all of their concerns and validating their feelings, you take a step in the right direction. Remember, what you both feel is normal. When dealing with anger, it can be helpful to have the answer straight in your head about what you fear. Are you more afraid of your loved one being mad at you or your loved one not being able to safely live alone?
Rely on the advice of professionals.
If recommendations have been made, make sure your loved one hears them. Often, we think we are protecting them by asking the tough questions when they aren’t present, but they need to hear the information. Arrange family conferences to discuss current status and recommendations so everyone hears the same information.
Above all, be honest and tell them how you feel.
Saying something is so much better than nothing at all. For example, “I’m concerned about you living alone. I don’t want anything to happen to you. I know you may be mad at me and that’s OK. I know it is really the situation you are mad at. But, we need to make this decision and I’d like to do it together.” Often, dealing with the anger at the moment is easier than living with worry each day that something might happen.
Where do I start?
Families who are considering a move to a nursing home or assisted living facility should tour each facility. In doing so, you and your loved one get a feel for several things:
- Location. (Is it easy for family and friends to visit or for the other spouse to drive if they too are elderly or have limited physical abilities?)
- Therapy and activities. (Are the activities suited to the need of the individual?)
- Aesthetic qualities. (Does it feel like a good fit?)
- Cost for each level of care. (When your loved one needs additional help, are the beginning rates altered? Be aware of increases to avoid surprises in the future.)
- Meet with facility staff and talk openly about your hopes for your loved one.
- Prepare your questions ahead of time, so you can be sure you get all the answers you need.
- Ask for the facility staff’s assessment to describe what level of care would be most beneficial for your loved one. Knowing this information upfront can help, because, at times, the line between assisted living and skilled care can be gray and making one move may be easier than facing another move in a short period of time.
Choosing a new setting for your loved one is not easy. Don’t wait to have this discussion until a time of crisis forces a decision, possibly with fewer options. By weighing your options now and communicating, you may alleviate much of the stress that comes with making this difficult decision.
About Hospice of the Red River Valley
Hospice of the Red River Valley is an independent, not-for-profit hospice serving all, or portions of, 29 counties in North Dakota and Minnesota. Hospice care is intensive comfort care that alleviates pain and suffering, enhancing the quality of life for patients with life-limiting illnesses and their loved ones by addressing their medical, emotional, spiritual and grief needs. For more information, call toll free 800-237-4629, email firstname.lastname@example.org or visit www.hrrv.org.