Aging is more art than science. Each person ages at a different rate and may face varying health challenges as the years march on. Because of this, navigating health care decisions later in life isn’t always a straightforward proposition. One of those decisions may be trying to decide when is the right time to move into an assisted living community, and when to begin making plans for such a transition.

What Is Assisted Living?

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A 2019 study from the Centers for Disease Control and Prevention found that in 2016, 28,900 assisted living and similar resident care communities were in operation in the United States. Assisted living facilities can take a range of forms and provide various kinds of services intended to support older adults who need a little assistance in completing the tasks of daily living.

But before you even get to the finer details of which community would offer the best fit, you’ll need to decide if and when it’s time for you or a loved one to move into an assisted living facility. It’s a common concern. “This is a question that I get every day,” says Dr. Susann Varano, a geriatrician at Maplewood Senior Living, a Westport, Connecticut–based senior living residence company. One of the challenges in answering this question well lies in the fact that “it’s a very personal and at times sensitive topic to bring up at any age.”

When to Make the Move

Most of us aren’t too thrilled how the passage of time might make us a little less able to do the things we used to enjoy so easily – and how it can take a toll on our health. Some people strongly resist the notion of moving to an assisted living community, even though it might be the very best thing for everyone involved. But it’s a complex concept that many people need some time to adjust to.

That said, there are some clear signals that indicate it may be time to move from an independent living situation into an assisted living facility, including:

• A worsening of medical conditions, an increased number of falls and overall increased frailty.
• Difficulty managing domestic finances or other money problems.
• Difficulty keeping the house clean and a decline in ability to care for oneself.
• Depression or social isolation.

“There are some classic scenarios,” Varano notes, such as a senior who has recently lost the spouse responsible for taking care of the housework, meals and shopping. The surviving spouse may struggle to cook or clean adequately while also being very lonely after the death of a partner.

Some families find that speaking with the senior’s doctor, a financial advisor, an attorney or even a counselor who works with families facing these challenging situations can also be very beneficial in determining when the right time to move is and how such a change can best be executed. These professionals can provide insight, suggestions for where to start and a yardstick for how other families have handled similar situations.

Similarly, trying to loop in family members can be both challenging and rewarding, so think carefully about who should be involved in the process, not least of which is the senior himself. In some families, the adult children of seniors think they’re doing the best thing for an aging parent without taking into consideration what the parent actually wants, and that can lead to resentment. Clear and open communication can help alleviate these issues, and the more conversations you can have with all interested parties, the better.

Before you even start the conversation, write down your own concerns and the points you want to get across to your loved one. Do some research on options and what might be a good fit for your loved one so you have some suggestions at the ready as the conversation evolves. Then, start talking. Some things to keep in mind about these conversations:

• You don’t have to do it all at once. You can make small inroads before you sit down for a really big talk.
• Try to do as much of this sort of communication in person so you can pick up on body language and other nonverbal clues about how your loved one is feeling.
• Be empathetic and try to understand how difficult these conversations can be. But don’t pity them – we should all be so lucky as to reach the age of needing a little extra support.
• Start with a general discussion of what life is like at home for your loved one. Ask about safety issues or challenges they might be having, and if these can be easily remedied, such as by installing extra hand rails around the bathtub. Look into making that happen for the short term, until a more final decision about future care has been made.
• Ask if your loved one feels lonely. One of the biggest upsides to moving to assisted living is the big increase in social stimulation. “The primary end point (for assisted living) is the social model. The secondary endpoint is a medical component,” Varano says. Things like community dining and activities can be a big help if a senior is feeling lonely.
• Ask if your loved one wants help with housekeeping, laundry, running errands or other daily chores. They might be struggling in silence and hoping you’ll offer or find them some help.
• Listen carefully to the answers. Really listen to what your loved one is saying, and aim to ask open-ended questions that allow them to bring up any issues they may be facing.

As difficult as it may be, begin having the conversation with loved ones about their future plans earlier rather than later. “The best advice I can give anybody out there is to pre-plan,” Sorensen says. This means sitting down and having the difficult conversations about finances, wishes and the legal arrangements that will need to be put in place prior to an advancement of certain health conditions such as Alzheimer’s disease.

Elaine K. Howley, Contributor

Elaine Howley began writing for U.S. News in 2017, covering breast cancer and COPD. Since …  Read more

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