As a physical therapist working in hospitals, family members of older adult patients often pull me aside to ask “do you think mom is going to be able to go back to living in her home?” I never know quite what to say. I do my best to give my honest opinion, but it usually comes out as a vague statement that barely answers the question. Something like, “we’ll do our best to get her home, but eventually you may want to start looking into other options.”
I realize that such a vague answer is really not helpful. Given the opportunity, most older adults would choose to remain in their homes for as long as possible. They often do not realize the severity of their health and mobility problems. They truly believe that they’re just fine at home. “I’m fine. I’ve been living there for 43 years” they’ll say. Their children are then faced with the difficult task of helping their parent determine if staying in their home is really the best option.
What I’ve finally realized is that, as a medical professional working with a largely geriatric population, I have a responsibility to provide a better answer than “we’ll try, but….” Or “let’s just wait and see if….” The people asking the question do not want to be brushed off or given false hope. What they want is a way to make the decision for themselves without the guilt and constant fear that they’re making the wrong decision.
For all of you out there that fit this description, this article is for you. By the time you’re done reading, I hope that you will have a clear list of issues that indicate when older adults need more help than they are currently getting.
Then, over the next few weeks, I’ll give you details about what the different options are if your aging loved one is not safe at home. We’ll talk about the typical price range of each option. Finally, I’ll give you tips on how to make the transition easier if you and your family decide that moving is the best choice.
For today, let’s start with the signs that indicate it may be time for older adults to move out of their homes. These signs can be grouped into several different categories.
When is it time for an older adults to move out of their home?
They can’t manage their medications correctly.
- They are taking too much or too little.
- They’re not taking them at the right time
- They aren’t getting they’re prescriptions filled as needed.
- They’re forgetting doses.
- They can’t open the pill bottles or medicine boxes.
- They’re refusing to take needed medications.
They are not eating or drinking enough.
- They’re frequently hospitalized with dehydration.
- They’re skipping meals.
- They aren’t able to prepare meals for themselves.
- They’re not able to follow the diet plan that the physician recommends.
- They’re not able to get food or groceries into the house.
- They are losing weight.
They have a drug or alcohol problem.
- I believe this one is pretty self explanatory, but let’s expand. Major issues include mixing alcohol with medications or smoking in a house with a person who is on oxygen.
Home safety is an issue.
- The home is unsafe due to hoarding or an infestation.
- They can’t keep up with the necessary home management. For example, there are maggots in the trash or mold covering the dirty dishes piling up in the sink.
- They can’t safely access all the necessary areas of their home due to stairs or other barriers.
They have difficulties with financial management.
- The monthly bills aren’t being paid so water/electricity has been cut off.
- There are piles and piles of mail that are not getting opened.
- They cannot afford to pay for the in-home care that they need.
- They’re vulnerable to financial predators. They could be taken advantage of online, in person, or over the phone. Click here to learn more about the type of elder financial fraud known as the granny scam.
They have physical limitations.
- They’re unable to safely get out of the house on the own. THIS IS REALLY IMPORTANT! If a person is so frail that they cannot get themselves out of their house without assistance, then they should NOT be living there without 24 hour supervision. They need to be able to get out in the event of an emergency.
- They have been falling.
- They’ve had at least one fall that they weren’t able to get up from. They were left to lie on the floor for several hours.
- They’re barely able to move from one room to another due to weakness, balance deficits, vision impairments, etc.
- They need help with daily tasks like bathing, using the toilet, and getting dressed.
- They can’t (or shouldn’t) drive, and they don’t have other options for transportation.
- They’re incontinent and are unable to manage their clothing after accidents.
They have other limitations.
- They are refusing the help that they need in their home.
- They’re unaware or in denial of their limitations.
- They wander and are at risk for wandering away from home.
- They have an irrational fear of falling or of being alone.
I know, I know…..that is a long and exhausting list. And let’s be clear…. I’m not saying that if an older adult meets one of these criteria that they should immediately move out of their house and into a nursing home!
Rather, my hope is that this list will help you to identify current limitations that make living at home a safety concern. Then you’ll know what action steps you can take to remedy the problem. If you find that there are one or more problems that you can’t fix by: increasing caregiver support, setting up a meal delivery service, making home modifications, etc…. then you need to start looking into your other options.
Stay tuned for a detailed look at what those other options include. I’ll be back with that info over the next few weeks.
Until then, stay safe.
Are you confident that your parent is okay to stay in their home, but you want to help as much as you can? Then check out the freebie that I created just for you!