Time for Senior Care?
The tell-tale signs to look for when deciding to take that important step with a loved one
As people age, many will get to a point where they are no longer able to care for themselves without a lot of help. Family is not always available to provide the level of care needed, and some individuals with dementia need 24/7 supervision and assistance. These are all reasons why senior care facilities play such a vital role in society today.
Senior care is such an important offering because it increases the safety, wellbeing and quality of life for seniors, but deciding when the time is right is not always as simple as black and white.
“People need to start thinking about senior care when they start to notice that their physical or mental abilities are changing,” says Lisa Matherne, LCSW, director of behavioral health at Thibodaux Regional Medical Center in Thibodaux. “You might start to have difficulty getting up from a low chair, getting in and out of the shower, etc. Most people do not realize that their mental abilities are changing unless they have someone in their life who notices.”
David Schonberg, owner of Schonberg Care — which has four facilities in Louisiana, including Vista Shores Assisted Living and Memory Care in New Orleans — says with more and more individuals being in better health and living longer, the result is a greater demand for assisted living and memory care communities.
“Once it is determined that you or a loved one may be in need of the additional daily support that assisted living provides, that is a great time to begin touring local communities in your area,” he says. “Discuss your personal situation with the executive directors at those communities and allow them to answer any questions you may have and provide you with additional resources that will aid you in pursuing the right next steps for you.”
Jere Hales, chief operating officer of Lambeth House in New Orleans —which offers both independent and supportive living options — says it’s never too early to start planning and ideally, it’s recommended that planning be done when a person is independent and prior to an acute physical or cognitive decline.
“This ensures that the senior’s personal preferences are known and can then be honored,” she says. “There is, of course, a greater urgency in planning and the implementation of that plan once a senior’s safety or health is involved. If there is a decline in one’s mental or physical capacity to the extent that the senior is no longer safe to live independently, then additional care and support like those offered in assisted living or nursing care should definitely be considered.”
John “Jay” Rive, Jr., executive director of Kenner-based Brookdale Senior Living Inc., suggests the more a person can include their senior loved one in the process, the better the situation will be.
“You want them to give you some ideas if something were to happen; your mom or dad may have an idea or may not, but at least it begins the discussion in a non-threatening manner,” he says. “The follow-up to that discussion could be making plans to visit some places and see what they are offering to see where they feel would be the best place for them.”
Daniel J. Ritter, executive director of Inspired Living at Kenner — which, in addition to independent, assisted and memory care, also offers a short-stay option — believes the best time to look for senior care is before safety becomes a concern.
“When a loved one starts to need help with their ADLs (activities of daily living), like dressing, grooming, bathing, etc.), that is definitely a sign,” he says. “Or if you notice that your loved one may not be taking care of themselves hygienically, then that could also be a sign that they may need help.”
Ideally, Ritter shares, people should start looking for a facility in advance, while they are still independent, so when the right time comes, the research is done and an injury or fall doesn’t make the decision for someone.
Knowing the Signs
The signs and symptoms of when to encourage a move to a more supportive setting are typically not episodic, but rather newly observed patterns of the older adult having difficulty doing things that have been a familiar part of their routine but are now a challenge.
“When assessing an individual’s needs, aspects of their daily that should be considered include: the individual’s ability to drive and navigate/get around independently, their ability to take care of their own grooming and basic needs, the current level of assistance they are currently receiving from loved ones, their current level of social interaction and activity with friends and within their community, and their current overall wellbeing and quality of life,” Schonberg says.
Hales notes physical changes might include continual or progressive mobility issues, especially those that result in frequent falls. Cognitive declines might present in the consistent inability to remember or recall new information or misplacing items or storing them in odd places. Other signs to look for include clutter around the house, weight loss and unsanitary conditions in the home.
“There’s not just one sign; it’s a combination of a number of these that ultimately begins the process,” Rive says.
It’s also important to have regular conversations about a senior loved one’s social needs — which can be equally as important as physical needs.
Melanie Martin, senior lifestyle counselor at The Trace in Covington — an independent, assisted living and memory care neighborhood of 94 apartments, says that in addition to physical needs, some choose to move to The Trace to avoid boredom and loneliness.
“Our youngest resident right now is 62 and our oldest is 102,” she says. “Some of them were functioning just fine but they were lonely, maybe their spouse passed away and their kids and grandkids have their own lives, so they ended up just sitting at home watching TV. That’s not conducive to good physical or mental health.”
In addition to a “world-renowned chef,” Martin says The Trace offers residents a long list of social activities, from the traditional standbys like bingo and rummy, to crawfish boils, shopping excursions and casino lunches.
“We had a Mardi Gras parade this year and we typically have pep rallys during football season where we invite local high school cheerleaders,” she said. “We’re definitely out and about doing a lot of things in the community as well as keeping residents busy here at home.”
Questions and Tests
In addition to medical tests, there are tests and evaluations, often administered by neurologists, that can determine a person’s cognitive status. Hales says these are used to diagnose different forms of dementia and can provide a baseline for observation, treatment, and can also be used to determine the appropriate level of care for an aging adult.
“If there is any concern about whether a senior can continue to live independently, the best course of action is to consult the senior’s physician so that the appropriate care and support can be determined and coordinated,” she says.
Some tests can take place without the input of a physician.
Matherne notes that the Mini Mental Status Exam is used by many physicians as a basic screening tool, and it’s widely available on the internet if people want to try it.
While asking questions can help, Ritter feels it’s really observation that is key to making the right determination.
“For instance, if your loved one tells you that they took a shower this morning but it looks like they haven’t bathed or changed clothes in a week, then that is certainly a problem,” he says. “I always like to ask questions about medications. Ask them what each pill that they take is and why they take it. Are they taking their meds? How does the pillbox look? Do any meds need refills?”
Med management is a key component of moving into senior living as the facility will take care of refills and ensure that their daily medications are given.
Getting Seniors Ready
Selling a senior on senior care can be tough, and often a lot of apprehension comes with it. While there are several books that can help with these difficult decisions, most believe the best approach is to have “the talk” early.
“Plan accordingly with advanced directives, power of attorney, etc., because as dementia sets in, these things will be hard to achieve without going through interdiction or possibly seeing your loved one get hurt or injured at home, which is not fun,” Ritter says. “One book that I always recommend is ‘How to Say it to Seniors’ by David Solie.”
Some people have less family involved in their daily life, so moving into a facility that will have more people around, activities going on and assistance with daily life activities like cooking can be a solid selling point.
“We focus on those positive areas as much as possible,” Matherne says. “While at-home assistance is available, it can be much costlier than some senior care alternatives.”
It’s a big life move, so it’s safe to assume there will be some apprehension, and offering support and understanding will go a long way.
“Therefore, the best response is compassion, being careful not to dismiss the emotions of the senior,” Hales says. “Perhaps the best approach is to review the challenges with the older person emphasizing the need for safety and the fact that the support they need will be available. Although many older adults refrain from asking for additional help, many are relieved when it is finally made available to them.”
Prepare For Senior Care
Plan financially: Consult a financial planner so you know what you can truly afford. Understand your savings and insurance options, which could cover the costs of moving into a facility or getting assistance at home.
Involve your loved ones: Assign a power of attorney to make decisions on your behalf. Also, have open discussions with family regarding the amount of assistance they may be able to provide, physically or financially.
Look around: When looking for senior living communities, be sure to research and tour local options and ask questions to help you make the decision that will be right for you and your family. Ask about hidden prices and all-inclusive care.
Downsize: Organizing one’s life and decreasing the overwhelming task prior to a transition to a different level of care can make a big difference, so starting earlier in life makes a great deal of sense.