There will come a time when your elderly parent can no longer safely remain in their own home despite the care they may have been receiving from you, your family and other service providers.
The best course of action is to try and be pro-active and have conversations with them earlier when they’ve started to acknowledge they may need some extra help in the future.
It’ also critical to have these discussions while their cognition is still sound, as an already complicated issue can be made worse by resistance from parents who aren’t fully understanding the need to move from their home in which they’ve lived for decades.
Understandably, this is perhaps the most profound emotional and mental adjustments both you and they will face, and so will require you to approach the subject with the utmost care and sensitivity. Additionally, you may have a challenge in handling your own emotions not only throughout these discussions, but also in your efforts to research, plan, coordinate and carry out the move itself when the time comes.
There are 4 main ways in which your parents could right-size.
They may want to make a private move to a smaller, more manageable space. They are fully independent, and are still capable of managing day-to-day tasks and activities.
They may want or need to move in with other family members to avoid leaving a home environment, or may not be able to afford and/or cope with living on their own in a smaller space.
They may want to make a move to assisted living where monthly fees will cover services they’d like help with such as housekeeping, security, grounds-keeping and medical supervision by nurses. They will need to have good cognition and physical independence in order to qualify in most cases.
They may NEED to move to a complex care facility. They are no longer mentally and/or physically independent enough to remain safely in their own home. This threshold is determined by their GP and further confirmed through a proper assessment through their health authority.
Note the first three options are just that – options. They are choices that you and your parents may have, especially if you’ve been able to have some earlier conversations. However, there are still a number of things to consider such as their financial situation, your family’s financial situation, location, mobility issues and access to community services and amenities, etc.
The fourth situation often comes about as a result of crises. Your parent’s health may change suddenly, and even if they’ve already been through a full evaluation by their health authority, they may be placed on a waiting list, and regardless of whether they’re in their own home, living with you, or, as unfortunately happens all too often, lying in a hospital bed, your circumstances can change suddenly and drastically.
It becomes especially difficult if only one of your parents needs to move to a full care facility in order to receive an appropriate level of care that can no longer be maintained living at home. You’re then juggling the needs, expectations and a whole host of practical issues that come up in providing separate, and often different, care for each parent.
I experienced this myself when my mother, who had vascular dementia, needed to be placed in full care while my dad was still mentally able to remain at home though he had issues with mobility. I lived with my parents, so in his case, I was his built-in care and support.
When mom was finally settled at a very nice facility close to us, I had to realize that this was the first time in 61 years that my parents were no longer living under the same roof – and would never again.
We knew intellectually that this was the right and necessary move in order to ensure my mom’s safety, dignity and overall quality of life, but emotionally, it wasn't easy. It was obviously much harder on my dad than me, as it was difficult to adjust to the new reality of his wife no longer living with him.
As his caregiver, I had to be mindful that he would (and did) experience sadness, loss, guilt and even depression, so while physically he was still independent, these emotions were taking a toll on his overall health. Giving him the opportunity to discuss things helped – a bit, but it can take a lot longer – if ever - to become emotionally accepting of how things have changed.
All the more reason why it’s so important to have these conversations earlier on, when your parents can make their wishes known, and you can get clarity on how they want things done. The discomfort of these types of conversations pale in comparison to the discomfort of the stress, uncertainty and disagreements that can arise amongst family members if there’s been no clear communication or directives given by your parents when they were still considered competent adults.
If you have gone through this, or about to, it’s critical to draw on community connections, family and friends as well as your own personal resources. It's also important that you realize this is part of a major transition, for you and them, but to take comfort in the fact that this change is in your parents' best interests.
The best way you can achieve a bit more peace of mind for yourself with the difficult decisions you will have to make around moving your parents is to get the information you need to make sure they are the best-informed decisions possible.
And the best way that starts is with having those crucial conversations with your parents!
© Nancy Glover | Aging With Grace www.AgingwithGrace.ca
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Nancy Glover, a healthy aging advocate, mentors extraordinary women and men who have stepped into the challenging role of caring for their elderly spouse or parent by managing their well-being in the later stages of life. Blending first-hand expertise with practical step by step systems to support the needs, goals, and desires of the elderly spouse or parent, Nancy helps caregivers maneuver the complex and often challenging role with supportive advocacy and resources that equally focus on everyone’s well-being. Learn more about her at www.agingwithgrace.ca and sign up to receive timely information and strategies to empower caregivers and families in transition.