A member of the Daughterhood community recently asked for advice with an assisted living situation that many families are dealing with. To answer this question, Anne Tumlinson, founder of Daughterhood, asked DailyCaring and Dr. Leslie Kernisan, founder of Better Health While Aging, for suggestions. Here’s how we responded.
What to do when there are problems in assisted living
When an older adult with Alzheimer’s or dementia gets settled into an assisted living or memory care community, the last thing you want to do is put them through another move. But what if they’re not getting proper care from the staff?
When an older adult doesn’t get the care they need, families typically meet with administrators and staff to discuss concerns and fix problems. Things usually improve after that. But sometimes, nothing changes – even after months of meetings.
At that point, families wonder what they should do. Is it better to move a senior with Alzheimer’s who knows where their room is and has become comfortable in their new home? Or is it better to take the risks that come with poor care and avoid the disruption of a move?
We’ve got some advice on making that decision, how to find a better assisted living community, and how to minimize the disruption to your older adult’s life if a move is needed.
Should you move someone with Alzheimer’s?
When making the decision to move a senior with dementia, it’s important to weigh the risks of staying in the current community against the disruption of a move – these 3 tips will help.
1. Exhaust all problem-solving options
First, make sure you’ve exhausted all the possible options for solving the current problems. If meeting with administrators and staff isn’t getting you anywhere, contact the local ombudsman.
Ombudsmen are advocates for residents of nursing homes, residential care homes, and assisted living communities. They may be able to speak to the administrator or offer advice to improve the situation.
2. Consider the issues
Think about the problems with the community and the consequences if they’re not fixed. Are they major health and safety problems that could cause a significant health problem or lead to a rapid decline?
Or, are they less serious care issues? Having ongoing problems that administrators and staff won’t fix isn’t good, but if the situation isn’t likely to harm your senior’s health, avoiding a move may be more important than an A+ level of care.
3. Be as sure as you can be
Before putting your older adult through a move, be as sure as possible that the next assisted living community will be better than the current one.
How to find a better assisted living community
Here are 3 tips for finding an assisted living community that’s a better fit for your senior and their care needs.
1. Use a checklist
Having a list helps you evaluate and compare important aspects of the communities you visit. We like this one.
2. Get help from an expert
Looking for another assisted living community can be overwhelming. Consider hiring a senior housing expert or a geriatric care manager to guide you through the process.
Senior housing specialists are like real estate agents who specialize in senior living. They know the local market, the reputation of the various communities, and help find the right place based on budget and care needs. Like real estate agents, they don’t charge you for their services. Find out more about senior housing specialists here.
Geriatric care managers are specialists who help improve your senior’s quality of life and reduce family stress. They also know the local senior housing communities and can advise you on the best place for your older adult, but they charge for their services. Get more info about geriatric care managers here.
3. Talk with staff, residents, and families
When visiting an assisted living community, talk with staff, residents, and visiting family members. They’ll likely give you the scoop on what the community is really like.
How to minimize disruption if a move is needed
Older adults with Alzheimer’s or dementia may become disoriented by a move. If the move is necessary for their long-term well-being, try these 5 suggestions to minimize the disruption.
1. Keep the move a secret
Activities like packing and planning the move can be just as stressful and confusing as the move itself.
One way to minimize disruption is to not let your senior know that they’re going to move and keep any move-related activities hidden from them. Doing the packing and actual moving in secret will take extra planning, but may be well worth the effort.
On the day of the move, have one person supervise the actual move. Another person takes your senior on a special outing. When they return from the outing, go directly to the new place. How much explanation or discussion about the fact that this is a new and different place will depend on their cognitive ability.
2. Make things look and feel the same
When setting up your older adult’s new living space, make everything as similar as possible to their previous place. That includes the room’s layout, furnishings, bedspread, linens, etc.
Talk with the staff and tell them about your senior’s daily routine and preferred activities at the previous community. Ask if it’s possible to stay on that schedule and do those same activities as much as possible.
3. Be there to comfort and observe
After the move, it’s usually helpful to be there as much as possible to provide comfort and a familiar face. However, some older adults actually do better when left alone with care staff for the initial transition period. It may be a good idea to use the method that worked well when you transitioned them to the previous community.
Whether your senior knows you’re there or not, it’s a good idea to observe and make sure the care level meets your expectations. Visit at random, unannounced times and show up during important care activities like meals, incontinence care, or bathing to check on what’s happening.
4. Use medication with caution
Many doctors will prescribe sedatives like Valium, Xanax, Ativan, or Klonopin to make a move easier on older adults. However, this isn’t necessarily a good approach because these drugs sometimes cause more confusion or agitation.
Experienced geriatricians like Dr. Kernisan prefer resorting to a few small doses of antipsychotic medication, rather than using popular sedatives. Dr. Kernisan’s top recommendation is to provide your senior with lots of family support via non-drug techniques like reassurance, comfort, and pleasant distractions.
5. Get expert advice before the move
The Alzheimer’s Association is a great resource for advice and suggestions on these tricky situations. When you speak with one of their family care specialists or social workers, you can describe your older adult’s mental, physical, and emotional state and get tailored ideas for minimizing the disruption brought on by a move. They could also help you come up with a plan to make the actual move easier too.
Daughterhood’s mission is to support and build confidence in women who are managing their parents’ care. Founder Anne Tumlinson coaches women and men to insist on excellent care and a meaningful experience for their parents. For the last 23 years, she’s worked to improve how America cares for its frailest, most vulnerable older adults. Anne has testified before federal commissions and Congress as well as consulted with hospitals, nursing homes, assisted living providers, and home care companies.
Better Health While Aging is a health and caregiving education website created and curated by Dr. Leslie Kernisan. She’s been practicing geriatrician since 2006 and has a special interest in family caregivers. Dr. Kernisan is board-certified in internal medicine and in geriatrics. She’s a Clinical Instructor in the UCSF Division of Geriatrics and a graduate of Princeton University, Case Western Reserve University School of Medicine, and the UC Berkeley School of Public Health.
By DailyCaring Editorial Staff
Image: Marion NearSay