As much as you might like to avoid the difficulties of transporting your parent directly to assisted living, there are no shortcuts. You may dread having to talk about the move, to even making adjustments after your loved one is safe in your chosen community.
Jump ahead to these sections:
- Signs It Might Be Time for Your Parent With Dementia to Move to Assisted Living
- What Happens If Your Parent With Dementia Is Resistant to Assisted Living?
- Tips for Talking About Moving Your Parent With Dementia to Assisted Living
- Tips for Talking About Moving, Transitioning, and Getting Your Parent With Dementia Adjusted to Assisted Living
The bumps in the road might be minor or they might be significant. If you are making this choice, it is because you need to. Whether it is for your parent’s safety or to relieve you of overwhelming caregiver duties, it can be a hard but necessary move to make.
Signs It Might Be Time for Your Parent With Dementia to Move to Assisted Living
As a caregiver, you may be reluctant to consider moving your parent with dementia to assisted living. There are legitimate and appropriate reasons for delaying a move to assisted living, but pushing yourself or your loved one past a certain point may exacerbate problems. Going past that point may even create new ones. Recognizing some of the signs that it might be time for a move can help you make the decision.
1. Safety for your loved one or yourself
As your parent progresses through dementia, you may start to notice that they aren’t safe when left alone without supervision. Sadly, some people with dementia become angry, aggressive, and can strike out at family members. A combination of physical and cognitive problems can lead to dangerous behaviors, confusion, and disorientation. Here are some safety risks you may be encountering with your parent.
- They are not safe in the kitchen and leave the stove unattended.
- Likewise, they can’t use utensils safely or appropriately.
- They drive unsafely and get lost or have accidents.
- Your loved one has physical problems that increase the risk of falls.
2. Unable to care for themselves
At some point, your parent may gradually reach a point of needing maximum assistance with bathing, dressing, medication management, hygiene, and toileting. Even before arriving at this level of assistance, it might be time to consider assisted living.
3. Caregiver burnout
Taking care of someone with dementia is exhausting work. It is a 24/7 job. Caregiver stress and burnout are common and can be challenging to recognize and cope with. The mental and emotional stress of caregiving can be complicated by loss of employment while caregiving. At some point, it makes sense to move your parent to assisted living where they can receive round-the-clock care, and you can become a family member again and not just a caregiver.
Wandering is a dangerous behavior that can be life-threatening and/or lead to serious injury. Aside from watching your loved one constantly, there are systems you can put in place to manage wandering, but it might be easier, safer, and more convenient in the long run to consider assisted living.
5. Isolation and loneliness
Isolation and loneliness are not limited just to people with dementia. Older adults who are unable to drive or have little access to social activities can suffer from loneliness. Dementia is, by nature, an isolating disease. People may often feel uncomfortable around people with dementia, and the ability to engage with others is limited.
Loneliness can lead to or exacerbate mental health problems like depression and anxiety. In assisted living, activities are designed to keep people with cognitive impairment engaged.
6. Cost of care
If you are paying privately for caregivers to take care of your loved one, it can get very expensive. Caregiving costs can soar if 24-hour care is needed. Depending on where you live, the cost of assisted living could be less than what you are paying for caregivers and without the headaches of managing multiple people in the home.
What Happens If Your Parent With Dementia Is Resistant to Assisted Living?
There may be no more heartbreaking and stressful situation to deal with than a parent with dementia that resists assisted living. Just when you have convinced yourself that it is in everyone’s best interest to make a move to assisted living, your parent refuses to go. Our next section provides some tips about talking with your parent. However, it is worth remembering that even thoughtful planning and careful communication may not always work.
You and your family will have to decide on the best way to manage the resistance and whether to override their objections. Legally, you can’t force someone to do something against their will, even with guardianship in place. Families have been known to literally pack up their parent’s belongings and move them despite their resistance. An action such as this has ethical implications, and you have to decide if you are comfortable with this approach.
A more compassionate way to deal with resistance is to be very clear about the reasons for the move and the fact that the move will occur. For someone with dementia, they may forget the conversation the next day or even the next hour. You can try writing down the plan in simple plain language, and when the day comes, prepare for some emotional upheaval, but stay focused on the task at hand and offer lots of reassurance and support.
The good news is that once you get your parent to the community, the staff is usually very skilled at these situations. They understand how difficult and stressful this is for your parent, and they know how to make the transition a positive one. The staff may even ask that you leave immediately and not visit for a few days to give your loved one a chance to adjust. In other cases, they may encourage immediate visitation.
Talk with the assisted living staff about your parent’s resistance, and they too may have some good suggestions. In some cases, they may even come to the home to discuss the situation with your loved one. The more familiarity your parent has with the staff, the better.
Tips for Talking About Moving Your Parent With Dementia to Assisted Living
Moving can be traumatic for anyone. Imagine your parent with dementia who is confused and disoriented, to begin with, and things can get a little rocky. A thoughtful approach that considers your parent’s fears and anxieties will help things go more smoothly.
1.Finding the best assisted living for your parent
Finding care for aging adults can be daunting, especially if you live in a community with lots of choices.
Take your time finding the best assisted living by visiting, talking with the staff, and most importantly, asking about their program for people with dementia.
2. Be transparent and honest about the move
The best approach to a loved one with dementia is to be honest about the reasons for a move without being condescending. There may be many reasons why a move needs to take place. You don’t necessarily have to cover them all. Keeping it simple and concise will help.
You might be a burned-out caregiver because your parent with dementia refuses help or requires more than you can provide. These are legitimate reasons but can make you feel like you are giving up. You have to decide whether being transparent means you are willing to let your parent know that you are unable to handle the stress.
People with dementia often aren’t capable of realizing that they have declined and may need more help with tasks like cooking, driving, hygiene, and bathing. Your loved one may think that everything is fine at home, and there is no need to change. Arguing your point is unlikely to help.
3. Show respect
Respect goes a long way. Acknowledging your loved one’s fears and anxieties lets them know that you have concern for their feelings.
You might try allowing your family member plenty of time to process the information and express their emotions. Accept that there may not be any resolution, but don’t let that distract you from your efforts.
4. Stay calm
Getting angry, regardless of how frustrated you might be, is unlikely to help and may hurt.
Do what you can to regulate your emotions, which will help set the tone for a calm conversation. People with dementia are often sensitive to the psychological mood of their environment and the people in it.
5. Write things down
One of the frustrating aspects of dementia is that sometimes people repeat the same questions over and over again. They don’t have the short term memory capability of retaining what you have said.
One idea is to write down the reasons for a move and put the document in a prominent place. That way, when your loved one forgets why they are moving, they can refer to what is written.
6. Engage other family members but make sure they are on board
Before deciding to move a parent to assisted living, involve the rest of the family in the process. As the primary caregiver, you feel like you are the best person to make this decision, but talking with the rest of the family is the right thing to do.
Families don’t always agree that moving your parent with dementia into assisted living is the right thing to do. Having open conversations around the pros and cons of such a move is healthy. If there is so much disagreement that things can’t be resolved, consider hiring a mediator who can help everyone reach consensus.
Assuming you can get the family onboard, enlist their help with talking to your parent. This is not to give the impression that you are all ganging up on mom or dad, but more an effort to support you and reinforce the reasons for the move. Strategize with family members that are closest to your parent. Sometimes a sister or brother can have more influence than you will.
7. Visit the chosen assisted living several times
Visits to assisted living really do help. Transitions are hard at any age, but for someone with dementia, change can be very distressing. The more familiarity with something, the better. Several visits to the assisted living community of your choice allow your parent to connect with staff and see other residents.
Most assisted living personnel are familiar with working with people who have dementia and are skilled at coordinating visits. Staff can sometimes find a resident to introduce to your parent, hoping to establish a connection.
Tips for Talking About Moving, Transitioning, and Getting Your Parent With Dementia Adjusted to Assisted Living
You have had the thoughtful discussions, made your case for assisted living, and now it is time for the move. This is where the work really begins.
Your attitude and planning will make all the difference during the most challenging part of the process. Here are the tips to get you started.
8. Downsize with care
Moving from a home to an apartment in assisted living requires some downsizing. Your parent has understandably become attached to their belongings and the memories connected.
Here are some suggestions on how to make this less painful and more pleasant for everyone.
- If you can, ask your parent what items are essential to bring along to their assisted living space. If they aren’t able to tell you, do what you can to select photos and memorabilia for their room or apartment.
- Say that you will store all remaining items so that your parent can exchange some things for others later. Knowing that their belongings are safe and accessible can help reduce anxiety.
9. Make the move seamless
Packing and the move itself can be very distressing for someone with dementia. There are some ways to ensure that things go well.
- Arrange for packing of all belongings without your parent present.
- When the move occurs, take your parent out for the day to a park or lunch. Think of anything that is pleasant and distracting.
- Ask another family member to unpack and place everything before your parent returns. This might seem like a lot to do, but if the whole sequence of events is tightly scheduled, it can work.
- When you bring your parent back to assisted living, their room with all of their familiar items is organized and put away.
10. Stay as long as possible
The idea is not to foster dependence on you but to offer support. On the day of the move, stay as long as you can to help your parent familiarize themselves with where things are. If it is near mealtime, walk with them to the dining room and stay for the meal.
Re-acquaint your parent with people they have met during the tours you did. Repetition is important for someone with dementia. Let your parent know you will be back the following day. Hopefully, your parent will be exhausted from the day’s activities and have a good night’s sleep.
11. Visit often
Bring the grandkids and other members of the family for visits. Visits bring reassurance and comfort. Arrange to arrive at mealtimes if possible, which is a time to bring some joy to what can be a solitary activity.
The tendency will be to visit less and less as time goes by. Try not to let this happen. Schedule your visits each week, so nothing else gets in the way.
12. Be prepared for your parent to want to come home
It is not unusual for a parent with dementia to repeatedly say that they want to go home. Don’t overreact. Be prepared with something to say or do when this happens. People with significant dementia can usually be distracted by some other conversation or activity.
If distraction doesn’t work, try to be reassuring and calm. Sometimes “home” doesn’t necessarily mean a place, but is more about memories. Perhaps your parent doesn’t feel safe where they are, and going home represents a place where they felt secure.
Or perhaps your parent is lonely. Talk with the staff about ensuring that your parent isn’t dining alone or feels alone in activities. Ask the staff to help provide your parent some extra companionship.
13. Problem solve
Problems will happen. There could be problems with other residents, staff, or your parent becomes agitated and anxious. Approach each issue as being one that can be solved. It can be complicated to figure out and understand the thoughts and feelings of people with dementia.
You know your parent. Think about who they are and what they care about. Those things don’t usually change, and sometimes, problems are the result of loneliness, pain, discomfort, or restlessness. Talk with your loved one about how they are feeling and what they need. You may be surprised at your ability to find out the root of the problem.
Moving a Parent with Dementia to Assisted Living
Moving a parent with dementia to assisted living is a big step to take. With careful planning, you can make the transition a safe and happy one for everybody. Take on the challenges with an attitude of resolve, respect, and care.