I am writing this as I visit my aging mother who lives across the country from me. She can no longer travel to Florida to see me, so once or twice a year, I trek to Los Angeles to pay her a visit. She lives alone. She walks 2 flights of stairs to get to her apartment. She has pulmonary disease. She has problems walking. She has less and less strength each time I see her. This time I was “lucky” enough to visit when she had a follow up appointment with the pulmonary specialist. It was a long day, with many tests, and many long wallks down long halls and long waits. She usually does this alone.
The diagnosis: still the same. Not better. Go back on the medicine that makes you even sicker, even weaker.
Even though she still drives, still plays majong, still goes to religious services, my mother’s decline is noticeable; everyone would agree on that. But no one can say how fast her abilities will fade.
This is what I heard all week, in between the bouts of terrible coughing: How will I pack all this stuff up when I have to move? And this is what I saw all week: my once active mother who could not stand to stay in the house for one whole day, sit and stare at all the medications on her kitchen table, trying to remember if she took it all.
So even though it’s not yet time for her to move, even though I answer all her questions with “We’ll cross that bridge when we get to it” (this makes her laugh), I know that it’s probably time to start to plan. I mean after all, that is what I do for a living. But, this is MY mother.
I will preface this by first saying what I believe in my heart: Aging parents should stay in their own home as long as they want and as long as they are safe. And, if at all possible, they should live with a family member if that is what the parent wants. But, of course, that option is not always feasible, and in my mother’s case, she does not want this. She is a social person. She does not want to sit alone all day waiting for her adult child to come home from work.
So, I’ve come to think that assisted living might be the best option for her. Where to start? At a loss, I did what I usually do when I don’t know the answer. I googled it. And I will share what I learned. Here, on my blog. And in the office with my clients, when I get back home.
- In advance, visit as many assisted living places as you can, even some that are out of the way.
Investigate which ones are close to your preferred hospital, and to activities your parent enjoys.
Look at their actual units, both ones that are larger than you think you’d take and those that seem smaller. You’ll be surprised at how different each unit looks in real life than on a printed floor plan.
Meet with their Executive Director and their Directors of Nursing and of Activities. Ahead of time is the best time for expressing needs and concerns. Eat a meal at each place, preferably in the company of some residents. You’ll get a different feeling for the facility sitting in the dining room. And this is a great way to sneak a peek at how facility staff actually treat and interact with residents. Inspect their Alzheimer’s or Skilled Nursing units, if they have one. You might eventually need these facilities. Ask around with doctors you know to see if any facility has a better or worse reputation than others. Sniff around, literally. If the facility smells good, that means it’s well-cared-for and clean.
Talk to their references. Share this task with siblings so you can compare notes. Find out their wait list policy. Some places will keep you in your wait list priority spot indefinitely and allow you first right of refusal on each new unit that comes up.
- Get paperwork in order. This may mean putting in place a broad enough power of attorney so that you can move your parent without their say so if the need arises. Each state has their own requirements for powers of attorney. It’s good to have an attorney assist with this.
- Keep talking with your parent about the issue of moving. There are pros and cons worth airing on both sides. This is a tough decision for everyone. It’s sensible to allow time for the idea and its ramifications to sink in.
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If memory and dementia are concerns, have a neuropsych evaluation done of your parent’s cognitive functioning. This should be more extensive and detailed than an internist’s evaluation and may give you a clearer understanding of your parent’s condition and what lies ahead.
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Visit a few assisted living facilities with your parent. One writer offered the following strategy: First show them a facility you know they won’t like, perhaps one that’s even a little crummy. The two of you can then agree that place isn’t suitable for them, which puts you on the same footing. Next, take them to the facility you prefer, which will be in direct contrast to the one they just saw. You just may hear “Yes, I could live here!”
Here’s the most valuable piece of advice: don’t wait until you have a crisis on your hands. Be willing to take control of the timing of the move. Don’t wait to get a call from neighbors saying your father has fallen and is in the hospital, or that your mother has gotten lost while driving and couldn’t find her way home for two hours. Moving to assisted living will be easier for your parents–and you!– if they are in good health and good spirits.
I am available to assit you with your elder law needs. Please call for help with medicaid, veteran’s benefits, and legal documents, such as wills, trusts, powers of attorney, health care directives, and living wills. Don’t wait until it’s too late.
Debra G. Simms
Attorney at Law
Orlando
Daytona Beach
Toll Free: 1-877-447-4667
