This is my personal experience, but one that I hear from others is sadly all too common.

Choose assisted living, particularly memory care, very carefully.  If your parent is healthy and thriving and just needs help with housework or managing medications, assisted living may be appropriate.  ADLs  (activities of daily living , and IADLs, Instrumental acitivites of daily living , are the skills needed to live independently — dressing, shopping, cooking, doing laundry, managing a phone.  When wrists are bad, or knees are weak, these simple tasks become difficult.

Look for signs of change in key areas like weight loss or gain.  Early dementia patients often forget to eat, or eat all day long.  Has Mom fallen several times? Is their balance impaired? Is Dad struggling with a health condition that is worsening?  Diabetes or COPD?  Dress and hygiene are a big clue. Are they depressed and not bathing or so afraid of falling they skip the shower? Does your once glamorous mom stop wearing lipstick? Has your dad stopped shaving or forgotten how?  These are all clues that something is amiss.  Also as people age they have trouble regulating their body temperature.  A cold room will not encourage a shower, and often what you feel is sweltering is perfect for a fragile elder.  It may take them nearly twice as long as a younger person to return their core temperature to normal after exposure to heat or cold.  The normal homeostatic mechanisms that help them regulate body temperature are declining.  They are not being eccentric, their body systems are wearing down.

But here is the hardest part. No one wants to leave home and it’s my opinion that many go downhill the moment they do. However lovely the facility, no matter the plants are lush, the fountain in the entry is elegant, or however meticulous the mint leaf is applied to the dollop of whip cream on the pie in the dining room, what matters is how does Mom and Dad fit it? Are they individual  people or just Room 102 to the staff?

The other issue to be aware of is  that in their own home, either married or single, elders do not perceive they have aged. They have an intellectual awareness of their age and know they can not do as much as a 20 year old, but they arrived here in the third age in small doses and are still managing at home with much of their intellect intact.  So they feel “fine”! Do you feel old?  But  when they arrive in assisted living, surrounded by  stainless walkers, canes, oxygen tanks, bent heads, and often medicated fellows, they get depressed.  There are mirrors everywhere for them in the faces of the other residents and there is no denying they are old and suddenly the body reacts that way.  I have seen many vibrant and active 80+ year olds spiral down after moving to assisted living.

Often, what these elders need is some in home help. Someone to tidy up, prepare meals, take out the trash, dispense meds, change sheets. And the all important companionship. Strong personal attachments are formed if the caregiver is truly loving and concerned for the elder. This can be life altering for the elder parent.

I am a strong advocate of aging in place.  Modify the house, adjust levers and knobs to be easy to navigate, make showers negotiable, put a high watt bulb in the refrigerator so food can be identified, organize delivered groceries, or Meals on Wheels, and get the all important companionship arranged, particularly for a single older person.

Give great thought before you commit an elder to a facility. While the word care will appear over and over in the marketing and often  the name, it is really a “system” and your parent or loved one will be forced to fit in and comply.