When is it Time for Assisted Living or a Nursing Home?

By: Clare Absher RN, BSN

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A family is often faced with the difficult decision of when is the right time to move elderly parents or loved ones to assisted living or possibly a nursing home. Each family situation is very different and it may help you to answer some of the following questions when considering this decision.

  • 1. Can your loved one move about safely in home including negotiating stairs, getting in and out of bathroom and narrow doorways?
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  • 2. Have frequent falls become a problem recently, and if so, is he or she willing and able to use an assistive device such as a walker or quad cane?
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  • 3. Does your loved one have and use necessary safety equipment such as raised toilet frames, bath tub seats, and personal emergency devices?
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  • 4. Have any accidents occurred recently with appliances in home such as the stove or forgetting to turn it off properly?
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  • 5. If your loved one smokes, has he or she had any accidents such as burn holes in clothing or bedding?
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  • 6. In the event of a fire, do you feel your parent would follow appropriate emergency measures including calling 911 and leaving premises?
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  • 7. Is your loved one bathing regularly and able to maintain adequate hygiene including grooming such as hair washing, shaving and oral care?
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  • 8. Is your loved one changing clothes daily or has he or she developed the habit of wearing the same dirty ones over and over again?
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  • 9. Has your loved one become progressively dependent on help with Activities of Daily Living? (eating, dressing, bathing)
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  • 10. Does you loved one allow outside help when needed to come in and help with personal care, housekeeping chores, and meal preparation?
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  • 11. Are you able to find qualified home care assistants in your area to relieve you of some caregiving responsibilities?
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  • 12. Has he or she or become easily threatened or suspicious of others, taking medications, or eating certain foods?
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  • 13. Is your loved one eating properly, suffered recent weight loss, dehydration or simply refusing to eat become a problem?
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  • 14. Is your loved one taking medications on schedule, following correct dosages, and willing to use an organizer/reminder device if necessary?
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  • 15. Has your loved one gotten lost or unable to remember personal information such as address, phone number, contacts that enable them to return home?
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  • 16. Are your caregiver duties causing you to be sleep deprived, miss a lot of work, or be unable to manage other household responsibilities?
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  • 17. Is the amount of home care assistance needed likely to become so great that it is not an affordable option for your family?
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  • 18. Is your loved one willing to participate in an adult day care program to relieve some of the family caregiving responsibilities?
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  • 19. As a primary caregiver, is your health at risk or neglect of other family matters causing serious problems?
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  • 20. As a primary caregiver, do you have the support you need and are others in your family willing to help out?

Answering yes to some of these questions does not necessarily mean that your loved one must be relocated to assisted living or a nursing home. However, if you determine that many of your answers are yes, then it is possible that having your loved one remain at home is no longer a viable option.


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