Things You'll Need:
- Yellow pad and pen
- Phone number of your state's Office on Aging
- List of senior apartments, assisted living facilities and
- nursing homes (available from your state long-term care ombudsman's office
- Results of parent(s) medical exam
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Step 1
Be prepared to discuss senior housing options with your parents as they age. Seniors who are still active and fully capable of managing their own affairs may decide that they want to sell their large home and move into independent senior housing. Senior communities are available in almost every area of the country, and they range from the very luxurious to the quite modest. In any case, parents whose children are grown may decide they want a smaller place to live, with more people in their age group to socialize with. If they express this desire to you, see if you can sit down with them and talk over their decision. It's important for their happiness and well-being that they choose the right place, and you can help with that. Determine whether they're considering a lease or a condominium purchase.
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Step 2
Contact your state's Office for the Aging (or similar name) for a list of independent senior apartments. Your local Area Agency on Aging can also supply housing lists. Call to find out what amenities they offer, the base cost and cost of add-ons (congregate meals will probably be extra). When your loved ones have narrowed their search to two or three places, see if you can visit with them. Go without making an appointment to really get the feel of the place. Ask any questions that come to mind, including how management handles someone who eventually needs ongoing assistance with the activities of daily living. Review the lease or purchase agreement with your parent, if she agrees to that. You may wish to have a lawyer go over it with you and your parent. After all, this is an important life decision. Remember, though, that independent senior housing is generally meant only for healthy, active seniors who can take care of their own needs. Don't confuse these facilities with assisted living.
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Step 3
Make sure your loved one is getting the medical attention he needs. Seniors should have a thorough medical exam every year, preferably by a physician specializing in gerontology (the care of the elderly). If you see your parent slowing down physically to the point of having difficulty managing stairs or preparing meals, you may want to start thinking about assisted living. Your parent's doctor can be very helpful, but your parent must sign a Release of Information so that you can discuss your parent's situation with her. Communal living facilities usually offer three meals a day and limited medical care (e.g. a nurse on duty during the day or a doctor on call). A facility may have add-on costs for extra services, such as walking with your loved one or daily administration of medicine. Again, get a list of assisted living facilities from your state's Office on Aging. Be aware, not all states require all assisted living facilities to be licensed by the state. For example, in Michigan, about 60 percent of facilities that call themselves assisted living are not licensed; they use the term as a marketing tool. You can find if a place is licensed from the Office on Aging -- or simply by asking at the admissions office. A licensed facility must meet certain state standards, and inspection reports must be filed with the state. Reports are required to be kept at the front office of the facility. Ask the admissions representative to show you inspection reports, and clarify what is included in the list of add-on services (and how much they cost). If the facility is not licensed, be even more thorough in your investigation.
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Step 4
Get a neurological evaluation from your loved one's physician if you notice her losing her ability to function mentally with day-to-day tasks. The oft-repeated bit of advice is that it's not significant if she loses her keys often, but it is significant if she does not know what they're for when she finds them. A neurological exam can reveal early signs of dementia, which can be slowed by medication if caught early. This may mean that your loved one needs to be in a dementia unit or nursing home. Again, a discussion with the doctor is important. But now you need to seek the advice of your state's long-term care ombudsman. Each state is required by law to have such an ombudsman, as well as local long-term care ombudsmen scattered around the state. Their office can give you a list of nursing homes and dementia units in your area. To find your state's Long-Term Care Ombudsman, call your state government information number or the office on aging. Nursing homes and dementia units must be licensed, and their inspection reports must be kept at their front desk. Check them out, pay a personal visit, and talk to front-line staff. You are allowed to do this for your parent's well-being. Only if your family and your parent's doctor agree that such a facility is necessary should you take the critical step of helping to apply for your parent's admission.
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Step 5
Make sure that you understand the financial ramifications of admission to a nursing home. They can cost as much as $6,000 a month, or much less, depending on the state in which they're located and the level of care they offer. Generally, your parent is required to "spend down" his combined assets, excluding his home and various other items, until he has about $2,000 left. At that point, he becomes eligible for Medicaid, which will pick up his nursing home costs and leave a minimal monthly allowance for him. Children are not required to be financially-responsible parties for their parents, even though some facilities may tell you that you are. Your state government information office can direct you to a Medicaid representative who can send you information on the "spend-down" and its exemptions.
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Step 6
Some children of elderly parents choose to have their parents live with them, regardless of dementia and physical infirmity. There are many support groups and informational organizations in place to assist these children in their roles as caretaker. One of the best-known is the Alzheimers Association, with offices in every state. Children and their aging parents may agree that the parents will stay in their own home. Whether the elders live with their children or remain in their home, it is wise to plan on having home health aides for part of the day. Some of these aides are certified and can help with medications, baths and other personal hygiene issues. Others cook and clean. Books such as D. Helen Susik's "Hiring Home Caregivers" are a great help in understanding what to look for in home health aides. But allowing the frail elderly to "age in place" (i.e. at home) is the most frequently-cited improvement in senior living options. And the cost of living at home with the care and assistance of aides and grown children is considerably less expensive than a nursing home or dementia unit, in almost all cases. Whatever living option is ultimately chosen, the selection must be made with careful consideration and with lots of input from all concerned. With the care and compassion of family and geriatric professionals, the quality of life of our seniors is improving, to the benefit of our society as a whole.
