Each week I encounter someone who has promised a family member that he or she would never be placed in a nursing home. Other than extracting and making that promise, families have often done very little planning for the housing needs of senior family members. This article discusses some of the alternatives.
Living at Home
Seniors often express the desire to age in place. So long as home is safe and meets a senior’s other needs, that is certainly an option.
If the senior is incapacitated physically or mentally, I usually recommend an evaluation by a qualified professional. Geriatric care managers can make such a determination and some nonmedical care companies have people on staff that can also assess living conditions.
The questions usually break down into physical facilities and care. Is the physical environment at home conducive to safe living? If not, often the home can be modified with wider hallways, grab bars, walk-in showers, etc.
Is there enough care and stimulation at home? Everyone understands the need for care, food, exercise, medication management, clean surroundings, etc. I think people often forget the need for stimulation. No matter how much a senior wants to live at home, a single family dwelling can be a lonely place, especially as we lose the ability to drive ourselves around.
Assisted Living Facilities
Let’s go back to the promise I mentioned above, that family members make to a senior that he or she would never be placed in a nursing home. Since I frequently visit assisted living facilities and nursing homes that are lovely, lively places, I’ve given this promise some thought.
All too often, we are dealing with stereotypes of nursing homes as they were twenty years ago. I remember visiting the nursing home for a county bordering Nashville/Davidson County in about 1990. It really was a depressing place, smelling of urine, and with the residents lining the halls, all in wheelchairs.
That’s not the reality now. If a senior family member has some degree of incapacity, I urge the family along with the senior to visit some assisted living facilities. They offer food, care and companionship often in beautiful, stimulating environments.
If a senior needs a level of care beyond what assisted living facilities can provide, the alternative is nursing home care. Again, the stereotype of twenty years ago is just not applicable now.
The 2013-14 Directory of Services for Seniors published by The Council on Aging of Greater Nashville and the Seniors Resource Guide both list nursing homes (and assisted living facilities) in this area. Medicare lists nursing homes on its website and ranks them on a one-to-five-star system. If you are not in a crisis, take time to visit some of them.
Planning in Advance
I mentioned crisis in the last paragraph because so often these decisions do get made in a crisis situation. My advice is not to wait until the last minute. Better to make these decisions when the senior can participate.