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Knowing When It’s Time To Move
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The decision to move a loved one into a senior care facility can be a very emotional and stressful decision. “While there is great talk about “aging in place” or staying in the home as long as possible, the truth is that there are not enough care-givers, paid or unpaid, to serve all the folks who need assistance of some form or another,” says R. Steven Johnston BSJ, MCM, former owner of a Home Instead Senior Care franchise in Columbus, Ohio. The following is a guide to help you decide if it’s time to consider assisted living or another senior care option for an aging parent or loved one, as well as next steps when you are ready to move forward.

SAFETY BECOMES A CONCERN

disabled older woman fallen on floor and caring young assistant
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With the risks of a forgotten flame or a bathroom slip, safety is of paramount importance when considering care. “The clear, number-one sign is safety of the senior,” says Johnston. “When it becomes apparent they can no longer live safely at home, it is time to move on.”

CONFUSION BECOMES COMMONPLACE

man in 50s sitting on couch looking confused
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Confusion is a common problem with seniors suffering from dementia. Bouts of confusion can be brought on suddenly by infections such as urinary tract infections (UTIs), an injury, or a stroke. Confusion resulting from these typically clears up when treated. But other instances of confusion that may stem from dementia and a decline in health and should be taken as a serious sign that care is needed.

HEALTH ISSUES REQUIRE REGULAR ATTENTION

nurse speaking to senior woman with vexed expression while senior husband puts arm around her
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Whether your loved one has a chronic illness that needs daily management, is getting frequently injured, is struggling with mental health issues or if are recovering from surgery, it’s critical to take these things into consideration when deciding if a senior care facility is needed, according to Johnston. If a loved one’s care needs aren’t getting met despite the efforts of others, it’s time.

HOME CARE BECOMES A CHALLENGE

Home Care Becomes A Challenge
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When making this decision, it is important to think about whom the caregivers will be if the senior continues to stay at home. If the next able-bodied relative lives too far away, is too busy in their own lives, or is uncomfortable with the level of care they would need to provide, then keeping the senior at home just doesn’t make sense, Johnston says.

MEMORY LOSS BECOMES MORE FREQUENT

Older woman consoling her depressed husband
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Memory loss can range from the relatively benign aspect of losing track of where things are kept — which can sometimes be addressed by memory-boosting activities— to the more concerning issue of forgetting hygiene routines. The severity of the memory loss should be an indication of what the senior care needs are and should be seen as a factor, if not the only one, in assessing care needs. Not all instances of memory loss indicate dementia but should be assessed by a doctor.

CAREGIVER SAFETY BECOMES A CONCERN

Caregiver Safety Becomes A Concern
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The decision for residential care must be made with the caregiver in mind as well. If a family member is the caregiver to a senior relative and has been hurt trying to help the aging loved one get into or out of the tub or bed, then the situation is becoming too dangerous for a non-professional caregiver for the elderly person to stay at home.

THERE’S AN INCREASE IN AGGRESSIVE BEHAVIOR

There’s An Increase In Aggressive Behavior
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Aggression, both physical and mental, and severe agitation can begin to happen with dementia. This specific problem can start to occur in the late afternoon and evening hours and is called Sundowners Syndrome. Because the risk of aggression can be result in violent episodes and harm to either caregivers or the elderly person, this is not a problem that can be overlooked.

CAREGIVER STRESS BECOMES AN ISSUE

Caregiver Stress Becomes An Issue
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It can become an incredible amount of physical and emotional stress helping a loved one age. When it comes to the point that a person is overstressed, it’s disrupting life and family life, or care is causing anxiety, depression, or frustration, the cause could be caregiver burnout. These are all signs it’s time to find a facility to better help a senior age, even if the transition is challenging.

OUT-OF-CONTROL SPENDING IS A CONCERN

Out-of-control Spending Is A Concern
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Spending money without knowing or remembering it goes along can often arise with memory loss. Donating to the same charity over and over, falling for money scams — especially scams that specifically target seniors — or not remembering to pay bills can all be issues that can result in a higher level of senior care needs. This problem can also snowball into home insecurity if funds meant to pay bills are misspent, and can make a senior a target of those who might wish to take advantage of loosened purse strings.

WANDERING BECOMES COMMONPLACE

Wandering Becomes Commonplace
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In people with dementia, wandering due to disorientation is a risk. Even if the caregiver steps away for a second to use the restroom or do a simple chore, the person with dementia can easily wander and get lost or hurt.

ADDRESSING MOBILITY ISSUES AT HOME BECOMES COSTLY

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Homes can be modified to account for mobility issues and there are many therapy options that can help a senior get around at home. But at a certain point the cost of modifications and therapies add up, and it’s a much better solution for a senior to be in a facility that is set up to meet their mobility needs.

DAILY ROUTINES BECOME CHALLENGING

post-it notes on fridge door asking reminder questions
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A loved one may start having trouble managing activities of daily living (ADL). This can be a sign that assisted living might be a good option. ”Individuals should consider assisted living if the are unable to independently handle any three of the following ADLs: dressing, toileting, medication administration, ambulation, transferring from bed to chair, and ability to feed yourself,” retirement facility expert R. Steven Johnston says.

THE COSTS OF HOME CARE BECOME A BURDEN

man in hospital bed with nurse holding hands
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The cost of senior care at home can become financially challenging for many people. A home health aide can cost roughly $22 an hour or $528 a day if needed around the clock, according to a recent cost of care survey by the insurance company Genworth. If you simply can’t afford this, then it’s time to start looking for a senior care facility. While Medicare does not cover assisted living, it may still be a cheaper option than paying for a home health aide. The average cost of assisted living is $4,000 a month or $48,000 a year.

BE AWARE OF TAX ISSUES

Son reviewing paperwork with elderly father
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You can probably find an aide for less than $22 an hour, but retirement facility expert R. Steven Johnston warns against this. “Trying to hire someone directly and not paying payroll taxes could be the most expensive move ever,” he says. “The big concern should be workers compensation if the hired help is injured on the job somehow. They could sue and end up owning the house or all the savings the resident has. It is worth it to pay the taxes, and issue the correct tax forms, or use a firm like Home Instead Senior Care which performs those functions as well as scheduling, training and supervising the caregivers.”

NEXT STEPS

nurse attending to a cheerful elderly woman sitting in a wheelchair in a nursing home
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The best case scenario is that you’ve already worked out a plan for your loved one before the need arises, but often times that isn’t the case. If your loved one is able or you are the senior and making the decision on your own, retirement facility expert R. Steven Johnston recommends taking a tour of several facilities, have a meal, maybe even stay the night and really get a feel for what it would be like to be a resident. As the caregiver, there are a variety of important factors to consider when researching assisted living and other senior care options. Among the many considerations, you should be aware of how far of a drive it would be from you to the facility, check the facility’s Medicare scores, observe the cleanliness and care provided by the staff, look at the range of services offered, and talk to current residents about the food and the overall care they receive.

Meet the Writer

Raechel Conover has been a staff writer for Cheapism since 2010. In that time she has written hundreds of stories and review articles for the website, many of which have also appeared on Yahoo, MSN, TIME, The New York Times and various other websites. She also played a key role in developing the Cheapism blog and served as the blog manager for a number of years.

Now with three young kids she remains a regular contributor to Cheapism.com. She’s a self-confessed shopaholic and frugal mom, always scouring the clearance racks for deals, utilizing local resale websites, and stacking coupons. When she isn’t writing or deal hunting, she can be found taking full advantage of free community activities and events with her husband and children.

Raechel has a bachelor’s degree in Journalism and Communications from The Ohio State University. Based in Dublin, Ohio, Raechel also does freelance writing work and social media consulting for local companies.