One of the hardest decisions that families have to make is to move a loved one from their home into a care facility.
All other factors aside, the health and safety of your loved one comes first. Questions can arise about the appropriateness of a loved one’s home. How well do the features of the home meet their current needs? If he/she has difficulty with balance or climbing stairs; is a two story house still the proper place to live? If your father forgets to turn off the stove or has difficulty shopping and determining if food is still fresh enough to eat; should he still be in situation where he cooks for himself? In what ways are the person’s disabilities incompatible with his/her current environment and level of care?

Another factor that guides placement in a care facility is the availability of a local caregiver. Caregiver fatigue and care issues that exceed the caregiver’s comfort zone are often reasons for a move. When a person is living in their home or a family member’s home with assistance, a variety of services are pulled together to meet their needs. Any gap or change in services means that the caregiver must step in to fill the gap. The caregiver in most cases also manages the web of services supporting the senior.

Sometimes the person’s needs exceed what the caregiver can provide. How can a caregiver who works outside the home get up several times a night to care for a loved one? What happens when an individual needs more care with personal hygiene then the caregiver can comfortably provide? Statistics show that incontinence is a common reason for placement. When an individual requires 24 hour care, a care facility may be a more economical solution than providing a one on one caregiver in the home.
When considering a move, start with an assessment of your loved one’s abilities. A geriatric assessment looks at all aspects of your loved one’s abilities. The process assesses his/her abilities on social, emotional, cognitive and physical levels. From the assessment, a care plan is developed with recommendations about what types of support are needed for your loved one to function effectively. The care plan can help you understand if home care is still an option with further support and services added to the mix. It can help you understand what type of care facility is appropriate for your loved one. Geriatric assessments and care plans are not one time events but rather a snapshot of a moment in time that need to be regularly updated.

Conduct a financial review. What assets, investments, insurance and/or savings does your loved one have available to pay for care? If the individual has a spouse or dependent child, how will their ongoing care be funded? What are your loved one’s wishes for a financial funding such as Medicaid. A meeting with a financial advisor may be necessary to understand your options.

On your own and with the support of caregiving professions, learn about the types of care facilities that are available in your community. Begin touring the facilities to get a feel for how they are run. Checklists are available on the web, to help you evaluate and compare one residence to another. Visiting and interviewing at care facilities is often emotionally difficult which makes it hard to rationally assess what you are seeing. The checklists and a comparison spreadsheet rating the costs and amenities of each facility will help with your decision making.