AARP Hearing Center
What Are the Signs My Parent Needs Assisted Living?
A doctor’s advice on how to know your parent needs more care than you can provide
James Yates
My mother lives alone and I worry about her. How do I know when it’s time for her to go to an assisted living facility?
This situation is different for everyone. A lot of people say, “Dr. Adam, my mom told me never to put her in a nursing home.” Or, “I couldn’t do that to my father.” And I get it. You don’t want to go against their wishes. Unfortunately, too often it comes down to the matter of a parent’s safety. When this happens, as difficult as it might be, it’s time to think about options. Let’s look at the circumstances that might lead you to consider an assisted living facility.
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I would say the primary one is if your parent is having a tough time managing day-to-day activities: tasks we take for granted such as dressing, bathing, doing laundry, brushing teeth and using the toilet. The Centers for Disease Control estimates that approximately 14 percent of adults over 75 years old need assistance managing these kinds of chores. Keep in mind that if your parent is unable to properly take care of his or her body, this raises the risk of life-threatening infections..
An inability to prepare food is another red flag, usually heralded by weight loss. This could be the result of a shrinking appetite. But many times, it’s simply difficulty negotiating food. Maybe they can no longer shop, cook or even think about meals. This can contribute to malnutrition and dehydration, both also life-threatening.
If your parent forgets to take medication or takes more than the prescription allows, they’re in dangerous territory. Just this past weekend I received a call from a family whose mother couldn’t remember if she had taken her pills — and took more. It was a medication with serious side effects. Her frantic daughter called because she found her mom confused and lethargic, the result of being overmedicated.
Another big concern is what I call “terminal loneliness.” Studies show that people who become isolated are more susceptible to cognitive loss and depression. If you see that your mom or dad is becoming confused on the heels of solitude, it’s a signal they need a higher level of care. Confusion can easily trigger a disabling injury.
This brings me to falls, which I consider a huge concern. About 1 in 4 adults over 65 fall every year. While not all tumbles are catastrophic, around 37 percent of folks suffer an injury that requires medical attention. If someone is alone in their home when they fall, it can lead to serious complications, even death.
Finally, I want you to consider your own well-being. If you’ve been the primary caregiver and feel burned out, or you’re coordinating care and it’s becoming increasingly challenging to your mental and physical health, then assisted living for your loved one may be the answer.
Approaching your parent with this option — especially if they’ve previously voiced opposition — can be tough. But truthfully, a good assisted living facility can open a new world for an aging person, one that offers not only safety but a social climate, educational opportunities, an introduction to hobbies, even trips to lectures, museums and concerts.
You can stress these benefits while making it clear that an assisted living facility is not a nursing home, which offers intensive medical care. I suggest you make a list of assisted living facilities near you and then visit them. You might want to have the AARP caregiving checklist on hand for questions to ask at assisted living facilities.
While your parent’s autonomy should be honored, so, too, should your concern for their well-being. Framing the conversation around concern, not loss, can open the door to mutual understanding. The goal isn’t to win a battle but to build a bridge to safety and care.
That said, there’s no one-size-fits-all script. What works for one parent may feel like betrayal to another. What remains consistent is the importance of compassion, patience and persistence. Balancing their wishes with their needs may not be easy, but with love as your compass, you can navigate gently and wisely.
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