Older adults and those who love them often spend a lot of time considering whether or not to make a move from living independently at home to assisted living in a congregate setting. For many, the right choice is not always clear.
Two senior care experts — Kathy Messerli, executive director of the Minnesota Home Care Association, and Bobbie Guidry, vice president of assisted living, housing and adult day services at LeadingAge Minnesota — said that many factors should go into making this kind of decision.
The first and most important factor that should be considered is the older person’s feelings about leaving their home for a different living situation, Guidry said.
“So often it can be family members that are worried or concerned and think it is time to make a change. But that may not be in the older person’s value system. Most of us want to stay at home for as long as possible. It is important that the older person is involved in these decisions to the extent they can be,” she said.
Meserli agreed. She said that most older people want to stay put. “Studies show that people would prefer to be cared for at home as long as possible.”
But family members often worry that independent living carries too many potential risks for their older loved ones, and they encourage them to consider moving to senior living out of concern for their personal safety.
Guidry said that she tries to explain that no living environment is completely risk free.
“Over the years, I have often worked with family members who are so risk adverse,” she said. “But risk is part of life. Being in an assisted living setting doesn’t mean there will be no risk to your loved one. Same with staying at home. Every environment has its own risks.”
Factors that trigger conversations
Over her multi-decade career in senior care, Guidry said that she has observed several major concerns that often trigger thoughts about moving into senior living.
- The first is a desire for more social connection due to increased isolation. This often happens when an older adult has lost a life partner or friends and family have moved away or died.
- A second common factor is concerns about physical safety. “Over the years, I’ve heard many people say, ‘I like my home but I have too many stairs,’ or, ‘I had a fall and there wasn’t anyone to respond,’ or ‘I couldn’t get to the phone.’” Guidry said. In these cases, she suggests, “A question to ask yourself or your loved ones is, ‘Is the home set up to be workable with changes that might be happening?’”
- A third concern that Guidry often hears about is changes in the older person’s neighborhood. “Sometimes, as people are aging, they start to feel more isolated or targeted because they are older or alone,” she said. “I worked with a woman who lived in the city and she would stay up all night and sleep during the day because she was afraid that someone would break into her house in the night. She was so happy when she moved somewhere and she could have more comfort knowing that there was someone around to keep her safe.”
- Another issue that prompts thoughts of moving to assisted living is health concerns, Guidry added. “I’ve occasionally had someone who had a diagnosis that they know will limit them down the road and they decide on their own to go somewhere where they will be able to get that support should they need it.”
Guidry said she often encourages families to take their time when considering a move to assisted living or other senior care facilities. “Start with the least intrusive way, unless the person is saying, ‘I would like to move to a community where there are more people around.’ Most people like to have help at home first, like a fall pendant or an emergency alert or someone to help with home chores or to step in if they are having trouble managing their finances.”
Messerli said that with the right amount of support services, many older people, even those facing disabilities, do not have to move. “Oftentimes people can stay in their own home if they have other support systems. It really varies. With the right supports in place, many people in fact can remain in their home until the very end.”
Home care agencies also provide free assessments for families and individuals who are curious if home care is right for them, Messerli explained. “If an individual is not qualified for home care and would be better suited in congregate care, we will tell them.”
When a move is the best option
Though staying at home works for many, for some, moving into a senior-living facility is the best option, Guidry and Messerli said.
For some people, getting older and losing mobility means spending more time alone. This situation might suit an introvert just fine, but it can be difficult for a hardcore extrovert. Messerli, for instance, is a home-care advocate, but her mother chose on her own to live in assisted living.
“She loved it because she was so social,” Messerli said. While her mother’s move to her new facility felt a little bumpy at first, in the end Messerli said that her mother was happy with her decision: “She thrived there because she was able to go down the hall to talk to someone.”
Guidry recalls a woman she knew who’d made the choice to move to a senior facility. “Her own family was sparse and she was so isolated at home,” she said. “When she came to the nursing home she could entertain people again. She was a very social person. She said she was so happy she’d moved there and wished she would’ve made the move years sooner.”
Often the final decision in moving to assisted living or other senior housing comes down to personal safety. Guidry said older adults can weigh this move for themselves, or have open conversations with their loved ones. For this decision, she said, determine “if you feel you’re losing your good judgment or decision-making ability, like your ability to notice hazards in your house. Then it may be time to think about a move.” Sometimes, Guidry continued, people find the responsibility of homeownership to be a source of stress. Downsizing to a senior community can take some of that stress away.
Families interested in learning more about their options can turn to the Minnesota Senior LinkAge Line (800-333-2422), a service of the Minnesota Department of Human Services and the Minnesota Board on Aging. Callers are connected with resources about home care, assisted living and support for caregivers.
In making these important decisions, Guidry said, families should work together, listen to their older loved ones and not assume they know what is best for them: “Knowing the options that are available and considering them through that value lens of what’s important to that person and how they want to spend their lives is essential.”