By Mary Brophy Marcus
While some older adults willingly move to assisted living communities and nursing homes — knowing they need more support and care — others refuse to leave their homes. If this is happening with a parent, it can help to identify the reason why, says Dr. Susan Leonard, assistant clinical professor of medicine at UCLA Medical Center.
“Older people value their independence,” she acknowledges. And when they lose their ability to take care of themselves, they may not want to face it. It may cause them to lose hope.
It will likely take time — and multiple conversations — for you to show them that things are changing and that they need to accept help. Talk with them and let them know you’re worried that they’re not eating properly or keeping the house clean, or if they’re falling more often (bruises on the limbs can be a sign of this). These are all signs that they need additional care. If they have vision and hearing loss combined with arthritis, diabetes, Parkinson’s or other chronic condition, discuss your concerns about their health and the need for a bit more care. Talk with them about the benefits of living in a place where they don’t have to worry about cleaning, grocery shopping and cooking.
Here, Leonard and other experts offer pointers on how to proceed if you’re still getting pushback from your older loved one.
Start slowly with care at home
If a parent still won’t budge, Leonard suggests easing into it. A few first steps she recommends:
- Begin with caregiving at home first.
- Hire a home health aide or nurse a few hours a week.
- Get a parent used to a trusted but non-family member helping out.
Amy Goyer, AARP’s Family and Caregiving expert and the author of the book “Juggling Life, Work, and Caregiving,” recommends talking with your loved one about other changes that need to happen to reduce the risk of injury if a parent wants to stay in their own home. Suggest getting someone to help with transportation (if their driving is becoming difficult or there have been accidents), and moving their bed to first floor.
You might also set up meal delivery, advises Goyer, who cares for her 92-year-old father, who has Alzheimer’s, in her own home. “Almost anything can be done in this age of so many home- and community-based services,” she notes.
“They have to process it, to have it click in their mind that this is reality. You can say, ‘It’s going to be hard, but we have to focus on your health and safety.’”
— DR. SUSAN LEONARD, ASSISTANT CLINICAL PROFESSOR OF MEDICINE AT UCLA MEDICAL CENTER
Plan for the day when it’s no longer safe to age in place
Plan in advance with a parent before they become sicker. For example, if a parent has cancer and is still able to live at home but may need more medical support down the road, do research now and find assisted living communities or nursing homes together online. Then, set up a tour, and meet the staff.
“Some places will allow a temporary visit,” explains Leonard. “A parent can do it almost as a trial run. That may be a way to ease into it.”
You’ll want to preempt emergency situations, of course, however, if your loved one does have a fall, it may not be safe for them to return to their own home. They may need to stay at a nursing home or rehabilitation center for medical support. If this should happen, you can explain that this time away from home is not necessarily permanent, but in order to ensure their safety in the future, a move to a long-term care facility could be called for.
Acknowledge that change is hard
Be aware that when a parent does move, leaving behind a home full of memories and often beloved belongings could spur a grieving process. “It’s important to let them go through all those emotions and to try to not minimize it,” notes Leonard. “Let them be frustrated and angry. Let them be sad.”
That means that you have to acknowledge the difficulty of the move as well. “When you try to dismiss it and say ‘it’ll be fine,’ then they are more likely to try to fight it,” points out Leonard. “They have to process it, to have it click in their mind that this is reality. It’s better to say, ‘It’s going to be hard, but we have to focus on your health and safety.’”
