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My sisters and I were fortunate when it came to my parents’ last chapter. Before my father’s Alzheimer’s became obvious to all but my mother, they moved from the West Coast and selected a senior living facility, with step-up care, to be near their three daughters. The facility had a memory care unit, which allowed my parents to seamlessly stay in the same place, even as my father began slipping away.
While our situation was idyllic, life doesn’t work that neatly for all families. There are many more stories of frustration and despair, stories of older parents unwilling to leave their home, and grown children scrambling to figure out the appropriate next caregiving steps while working and parenting their own children. One friend recently told me that her 91-year-old parents finally sold their home. But they were unable to part with most of their possessions, so they moved into a condo because they wanted to “think about what made sense next.” That friend is ready to tear out her hair.
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So many factors go into the decision around choosing the right living situation for older parents. And when multiple siblings are involved, it can complicate matters. For those who have ruled out home health care or living with family members, there are a bewildering number of factors in choosing a senior facility.
And while there are no one-size fits all solutions, there are important questions to ask that can help shortcut the decision-making process for all involved. Some are as basic as the size of the facility and number of beds, the cost structure and the proximity to a hospital and family. Others are more subtle, requiring observations. Such as: How much light does the facility or the room get? Do the residents seem happy and engaged?
Amenities like transportation services for appointments or the existence of a nurse on staff for things like changing bandages can make the difference in a loved one’s well-being and the family’s peace of mind. Dining services and healthy food options are as important as the policy on visiting hours. “How does it smell?” was a piece of advice I got from more than one person, suggesting that a pervasive smell of urine might require a deeper look.
One of the most universal pieces of advice was to ask questions about continuing care when you are looking at facilities. Many people regretted not having their loved one in a facility where they could “step up” to more comprehensive care, including nursing home care with hospice. Several people I interviewed shared the pain of both the family and loved one in having to make a transition to a new situation while they were ill or even dying.