Talking with loved ones early about options is important when making life care decisions

Thomas Hanks, The Columbus Dispatch
·6 min read
The Ohio Living Westminster-Thurber retirement community, seen here in the foreground in this file photo, with the city of Columbus skyline in the background.
The Ohio Living Westminster-Thurber retirement community, seen here in the foreground in this file photo, with the city of Columbus skyline in the background.

It can be a difficult and often daunting decision.

The decision to move a loved one into assisted living or a skilled nursing care facility is never an easy decision, but there will come a time when medical experts say it is the right choice for some seniors.

It's common to feel a variety of emotions including guilt, shame, fear and anxiety, as well as unease, no matter what you chose to do. As a result, it may be hard for families overwhelmed by the weight of such a difficult decision.

So, when is it time to put a loved one into assisted living? Here are some tips to keep in mind as your family goes through this process:

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Know the various options

There are various options out there for seniors who need care, such as assisted and independent living. There are also skilled nursing facilities, which are inpatient rehabilitation centers most often used for continued medical care after a hospital stay.

Assisted living gives seniors access to assistance with tasks necessary for everyday life, such as bathing, dressing, using the bathroom, eating, housekeeping, money management and shopping.

"Assisted living is fine for someone who needs supervision, like my mother did," said Pete Van Runkle, CEO of the Ohio Health Care Association. "She went into assisted living and she was getting three square meals a day ... she put on some weight, and was doing quite well."

Independent living is for seniors who are still well within their ability to take care of themselves, and want to enjoy a social, lively community. Some help, however, is available for those who need it.

Have your loved one's medical needs grown more complex?

Complex medical needs can often become hard to manage, such as recovery from a stroke, or a fall.

"At some point, it becomes too much," Van Runkle said. "Most people that are in skilled nursing facilities have multiple chronic medical conditions, or their cognitive status becomes too difficult to manage."

Assisted living facilities can help seniors with the aforementioned daily activities, as well as even providing transportation to doctors appointments. Nurses, certified nurse assistants, physical therapists and other medical personnel often make up the staff at these facilities, and for seniors who may need this level of medical attention, it can often be a matter of life and death.

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Start early and involve your loved ones in the process

"The thing we tell people always is to start early," Chuck Gehring, president and CEO of LifeCare Alliance, said. "It's important to get started early and involve them (your loved ones)."

If your loved one can still make their own choices or make known their own wishes, it is important to respect those wishes and take them into account while searching for a care facility, Gehring says.

"If they do fall as an elderly person and break a bone, or they have a stroke, a heart attack, or something like that; they may need rehabilitation," he said. "It would be better if the person had already said 'Here's where I want to go to do that.'"

Gehring says it is also important to discuss with your loved one the locations of important documents — whether it is a living will or a military service record, such as a DD-214 certificate of release or discharge from active duty.

Location, location, location

While that 40-mile drive to see a loved one in a nursing home or other facility may be tolerable at first, consider what it'd be like to make that drive during adverse weather, such as a snowstorm, after a long day at work or every day.

"You can't park people 40 miles away from you because you're in love with a facility and hope that you're going to get there all the time," Gehring said. "It just isn't going to work."

If the nursing home isn't near you, it should be near another family member who can easily get to your loved one in a time of emergency.

What about aging in place?

The Franklin County Office on Aging's Senior Options Program, for example, looks for any unmet needs for seniors, and provides services such as home-delivered meals, personal care, housekeeping, minor home improvement, respite care for caregivers as well as adult day care.

"When we review applicants for our Senior Options program, we look to see if there is an indication of an unmet or an under met need in order for them to be enrolled in the program," Amy Finke, deputy director of communications for the Franklin County Office on Aging, said in an email. "Daily tasks that were once simple, such as replacing a lightbulb, walking up a set of stairs, bathing, or remembering to take their medication, have now become an everyday challenge."

Kathy Mogavero, 64, of the Northeast Side, said that services provided by LifeCare Alliance have made it possible for her to stay in her home.

"They come to check on me, and at Christmas and Thanksgiving, they brought me groceries," she said. "They told me about Legal Aid, and they told me how to use it — for free. So I was able to get a will, I love them."

Mogavero said she was also able to get a bedside table, similar to those used in hospitals, in order to eat and drink.

A two-time cancer survivor, Mogavero says that she has been a Lifecare Alliance client for almost two years. Initially, she said, it was very hard to ask for help.

"I'm the type of person, I don't like to ask anybody for anything, and it was hard for me to say, 'could I possibly get someone to help me?'" she said. "I've fallen quite a few times, and it's hard for me to run the sweeper upstairs, carry it up the steps."

If Mogavero didn't receive these services, she said it would be very difficult, almost impossible to live at home.

"It's nice to have people who really care for you and don't want nothing for it," she said.

For information on aging resources, contact the following organizations:

thanks@dispatch.com

@hanks_t99

This article originally appeared on The Columbus Dispatch: When is it time to send a loved one into assisted living?