I’ve spent the majority of my nursing career working with aging adults—the last 25 years as a geriatric care manager (now called aging life specialist) running my own company. It’s a population I adore—I find this population so fascinating and enjoy hearing about their lives and all they’ve contributed to their communities. Most have amazing stories.
Whenever possible, I try to help my patients stay at home with additional help, as that’s what most of them prefer. However, many have been quite happy in senior residences once settled in.
My mom decided to move to an independent living residence when she was 85 because she was lonely and wanted “more excitement” in her life. She absolutely loved it. As an active senior, she swam, took exercise classes, taught knitting to her friends, and enjoyed meeting new folks at dinner every night. She stayed there until she passed away at the age of 98.
If you work with aging adults, you may be called upon to help your patients consider whether it would be best for them to move to a senior facility. Transitions are never easy, and family members can have very strong opinions about whether their parents or aging loved ones should leave the family home. Over the years, I’ve learned some helpful tips for helping patients evaluate their next steps and navigate the process of moving if they decide that’s best for them. I’ve also discovered some options that allow patients to test the waters before deciding.
When helping your patient to consider a move, the main considerations are safety, their need for socialization, and the level of care they require. Many seniors’ homes can be made safe if funds are available for home health services and family members are available to check on them and help care for them. Adequate socialization is also possible at home if there is family support and friends are involved in providing fun activities. Many seniors start with limited home health assistance and do fine for a long time, gradually increasing services as they are needed.
As my patients have aged, some have reached the point where even 24-hour home health assistance was no longer sufficient to meet their medical needs. They began to require specialized services that were easier to accomplish if they had adequate funds (for example, respiratory care, ventilator care, and caregivers specially trained for higher levels of care). At that point, with their needs increasing, it made sense for them to move to assisted living or a nursing home.
Most of us tend to be more resistant to change as we age. This is especially evident when it comes to decisions about moving. It’s daunting to envision downsizing, packing up our belongings, and starting over someplace new, especially for older adults.
It can help to start visiting senior residences with them early before they need to make a change. Many independent and assisted living residences allow seniors to enjoy a free dinner in their dining rooms to help them see what it would be like. The seniors may be surprised to find themselves drawn to the lively atmosphere and the idea of making new friends.
Many senior residences offer “step-up” options, such as a floor within an independent living building dedicated to assisted living care. Some allow residences to move back and forth depending on the level of services needed at any given time.
Small adult care homes of 6-10 seniors may be a good option for seniors who prefer quieter environments. Housed in a residential home setting and staffed by licensed operators, these group homes offer 24-hour personalized attention and assistance with daily living. They provide some limited activities that allow for socialization.
It’s important that the move be your patient’s choice whenever possible, rather than their family’s choice, with enough time for many discussions about patient needs and the pros and cons of all the options. I would often plant a seed with my patients by asking them, “If you had to move for some reason, what would you like to have at your new residence?” This helped us to narrow down what was really important to them at their stage of life. For my mom, much as she enjoyed the delicious free dinner and the new friends she met at her future residence, once she saw the indoor pool, that was it. (She was a lifelong swimmer.) She put a deposit down on an apartment within the week.
When my patients need additional services but are reluctant to leave their homes, I have found that suggesting they “take a vacation” in a senior living residence works really well. The word has positive implications: short-term, easier, a break from life, fewer worries. Based on the happy experiences of many prior patients, I can tout the advantages.
Many people are unaware that senior living residences have guest rooms or suites that can be rented for short stays or short-term rentals. (These rooms are also available for “respite care” for patients when their caregivers go out of town or need a break.) The rooms and apartments are already furnished, the meals are provided, there is often a little store so you don’t need transportation, somebody oversees your meds so you don’t have to track them, and there are events and fun things to go to (games, movies, happy hour, etc.). It really is a vacation if you think about it!
Another advantage is that this allows people to see what living in a senior residence would be like. I’ve had some patients decide to stay once they met some interesting people there and got used to the place.
This plan works especially well for older couples when they need to receive specialized services. People often forget how important it is for older couples to remain together whenever possible. See if it’s possible for both to “vacation” in the same facility so that one can receive care, even if they have to be in different areas of the building or complex, so they can still see each other daily.
Social workers and aging life specialists are often well-versed in the various types of facilities available in their area and can greatly assist. Once you determine with patients and their family members what kind of residence is needed, be sure to call nearby facilities to check for openings. Many have waiting lists of several months or more. It helps to know your area's availability and to keep checking back because things can change frequently.
For patients unsure about making dramatic changes in their living situations, I suggest that they keep their own home or apartment for a bit after they move. This can help ease the decision since they can reverse course if uncomfortable or unhappy in a facility. Some patients, like my mom, settle in quickly. Others find that they prefer quiet and solitude and have trouble adjusting to busier environments. It can be hard to know ahead of time how seniors will adapt.
When discussing living arrangements with my patients, I often encourage them to try a place temporarily to see if it feels right. If it doesn’t suit, we reevaluate. Whether they end up staying in their own home or moving to a senior living residence, when older patients are happy, their health outcomes are better. It’s worth taking some time to help them determine the right environment and be flexible when their needs change.
About the Author:
Joan M. Foust, RN, has five decades of professional geriatric experience in hospitals, skilled nursing and rehab centers, and home health settings. As a geriatric care manager, her passion has been providing creative solutions to the unique challenges of senior living, particularly for patients with memory loss. She is the author of “Creative Caregiving Solutions: A Peaceful Approach to Navigating Your Relationship with Your Aging Loved One.”
Joan is an independent contributor to CEUfast’s Nursing Blog Program.
Please note that the views, thoughts, and opinions expressed in this blog post are solely of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
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