How to Determine if a Nursing Home is the Right Decision for Your Aging Parent

She stood in the middle of the kitchen, wringing her hands. “I can’t find my pots and pans. Someone stole them.”

Her comment was one of the reasons we began looking into the nursing home option. Mom’s cognitive decline became even more evident during the next months. We toured several facilities with our checklists handy. But it was a medical emergency that sealed the final decision. The doctor’s order underscored what we had to do, “Your mother can no longer live in her home.”

What are some of the questions a family needs to ask as they consider the options? How can we best choose what is right for our parents during the final season of life?

1. Can she still function as she did in the past?

In Mom’s case, she could no longer find her pots and pans. She started to throw away her bills instead of paying them. Shopping for groceries or deciding on a meal became an ordeal. She lost weight because she forgot to eat. It became more evident that her ability to function alone and in her own home was impaired. Something had to change.

2. Is there a physical danger?

One of the first signs is when a parent leaves the house without turning off the stove or locking the door. Another indication for Mom was the frequency of falls. We would visit her and see another gash on her face or a scratch on her arm. One day my sister found her unconscious in the back yard. If it is becoming physically dangerous to stay in the home, then the tough decision has to be made.

3. Is the parent growing more frustrated and/or fearful living alone?

Mom often believed her dreams were reality. Nightmares about someone breaking into the house. Hallucinations about family members stealing her clothes, her checkbook, her money. When a parent struggles to pay the bills, to maintain the cleanliness of the home, to fix meals and to deal with the isolation of living alone – it is time to make a decision. No one should have to live afraid in their own home.

4. Is the primary caregiver showing stress?

In our family, my sister was living with Mom. My brother and I noticed her personality changes, the extreme fatigue and other physical ailments caused by stress. It was time to rescue my sister by helping Mom find a suitable place to live.

5. What does the doctor say?

In our case, we had the memo in black and white. Medical professionals are trained to recognize the signs, and they can help families determine the best timing for this difficult decision. In my mother’s case, we had the advantage that she worked as a nurse her entire life. So whatever the doctor said, she was programmed to believe it.

6. Is there a satisfactory option near home?

The transition is not easy, no matter how pliable the parent. But if a nursing home or assisted living facility is in their hometown – a place they know about – that makes the move a bit easier. If some of their friends or members of the church live there, that also helps ease the transition. Some churches have their own sponsored facility so moving in feels more like a reunion.

7. Is there enough money?

Families must be practical. In today’s economy, the best facilities can cost from 3,000 dollars to 8,000 dollars per month. Our loved ones may live a long time, even after they move into the facility. Calculate the cost. Determine if there is a long-term care insurance plan and what the savings account looks like. Or is it time to sell the family home to pay for Mom’s care?

This point also brings up the importance of family planning. Talking about the issue years before it becomes necessary will help relieve everyone’s mind. Who is the financially-minded person in the family? She or he should be appointed as the power of attorney for all financial and medical decisions. Do this sooner rather than later. 

8. Are there any other options?

Some family members may feel they are “called” to take care of the aging parent. Perhaps a good friend can be enlisted to come “sit” with Mom or Dad while the siblings are working. Some cities have daycare for the elderly where they provide a safe environment and brain-stimulating activities. Some families choose to hire an individual to take care of a parent. 

9. Is there agreement within the family?

The nursing home decision can tear families apart. If no pre-planning was talked about and the question has never been discussed, siblings can become opponents. Hopefully, everyone will be on the same page. But the question must be asked, “What if we do this? Is everyone willing to work together for the transition?”

Ultimately, we need to bring our decisions to God and ask him to help us react with clarity. We should also bring our parents to God and ask for comfort and mercy in their final stages of life. 

The nursing home decision is always difficult, but we can work together within our families and within our faith to make the best choice possible. Then do the work in our own families to make it easier for our children to someday decide where we need to live.

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