Many people like to think that their life is going to remain the same forever. They imagine that they’ll live in the same house or apartment and keep up with their same routine until they die from natural causes at a very old age, preferably doing something they love like gardening or while out for a run. 

While this is a nice idea, it’s not always a realistic one. Of course, it’s recommended that people do everything they can to remain healthy as they age. This means eating well, staying active, keeping up their social life to avoid isolation and prioritizing sleep, however, the reality is that regardless of how healthy someone’s lifestyle is, there’s a good chance they might still need some additional support as they age. 

This doesn’t mean that older adults can’t still lead vibrant and stimulating lives, but simply that it’s normal for everyone to change and slow down as they grow older. While maintaining healthy habits are important and helpful, it’s inevitable that our bodies grow stiffer and a little less flexible, and that we all might have trouble recalling a name now and then or deal with a bit of confusion. 

Some might face unexpected illnesses or injuries that might require a level of care they are not able to access at home. Older adults are at an increased risk of injury due to falls, according to the CDC, with close to 40,000 individuals over the age of 65 dying from falls in 2021, and many others resulting in emergency room visits and life-changing injuries. And cognitive decline and conditions such as dementia and Alzheimer’s disease can also result in a drastic change of circumstances. 

But while some illnesses or injuries happen without warning, often the need for help can develop gradually. You might not notice that your loved one needs help until the situation has become serious, and then you suddenly need to jump into action right away. 

Having to arrange care quickly can put a lot of stress on a family, so it’s always preferable to recognize the signs that your loved one needs help as early as possible, so that you can sit down to have a chat about next steps. Not only is it less stressful, but it can also help with the adjustment of making such a change, as major life transitions can often be disorienting and upsetting to older adults. So, let’s look at 5 signs you should look out for in your loved one that could signal the need for assisted living.

Changes in Mood

It’s totally normal for people to go through a wide range of emotions each day – it’s one of the amazing things about being a human being! But at the same time, most people are fairly predictable. We all know that person who is always cheerful and up for any adventure, or that person who always seems to see the glass as half empty and tends to lean towards complaining about whatever is annoying them that day. 

So, with that in mind, it’s important to pay attention to the mood of your loved one to see if you notice any dramatic changes in their mood and behavior, as this might signal a decline in their mental state, such as Alzheimer’s disease.

Mood swings don’t have just one reason behind them, and there might be a perfectly logical explanation behind them, so one of the first things you should do is get curious. Did something good or bad recently happen to your loved one? Has there been some kind of major change in their life? Finding an explanation doesn’t mean they don’t still need support, but it can help you determine exactly what kind of support they’re in need of.  

Many older adults are faced with the struggle of losing their friends and companions as they age, which can be a very difficult reality to come to terms with, and might naturally result in some changes in mood. 

For others, they might be dealing with cognitive diseases or they might have always been moody, but the fluctuations in their emotions have increased with all the changes that accompany age. Some older adults might also struggle with a lack of purpose and feel that they are being left behind by the rest of society. 

Regardless of the reason behind it, mood changes in your loved one should never be ignored. Maybe they just need someone to talk to, but they also might require more extensive support and community, so it’s always worth a conversation if you notice that their mood is different than it used to be. Here are some behaviors to look out food:

• Lack of interest in activities they once enjoyed
• Excessive irritability, and lashing out
• Periods where they seem abnormally happy for no reason
• Cancelling on appointments or events and generally being antisocial

Issues with Cleanliness

Another common sign that an older adult needs help is that they are having trouble maintaining themselves and/or their living space. When this happens it might be accompanied by clear signs that your loved one is struggling with sadness or depression, or they might not even be aware that they are not able to clean and organize in the same way they used to. 

When your loved one is struggling with cleanliness that might be in regards to personal hygiene, or their living space. Let’s look at personal hygiene first. 

Someone who is having trouble with their personal hygiene might not shower frequently. You might notice they have a strong body odor. It is also very likely that they might not regularly launder their clothes, and you might notice stains on their outfits. Their breath might also be unpleasant and you might notice signs of tooth decay. 

When someone is having trouble with their personal hygiene they might also have greasy and unkempt hair. They might have trouble cleaning up after using the washroom, which could lead to other odors and issues with proper cleaning of their bathrooms as well. 

For someone struggling to maintain their home it is likely that you will find a lot of dirt and dust on the floors and surfaces, such as the kitchen counters. Toilets and showers might display a lot of grime and even mold. There also might be a lot of dishes and clutter, the latter of which can also present a major tripping and fire hazard. 

It might not just be cleanliness as well. For many older adults, taking care of the needs of a home may grow to be too much of a burden for them to continue taking on. Cleaning out gutters or shoveling snow off the walkway may no longer be safe or even doable. Of course, don’t write off your loved one if you notice a little bit of a mess or that they are a little slow to clear their driveway. But, if you notice that they seem to be struggling with keeping up their hygiene and household tasks then at the very least you should have a conversation. Maybe they need to hire a housekeeper or a gardener, or maybe the time has come for them to get more well-rounded support at an assisted living residence. 

Confusion and Memory Issues

It’s normal for everyone to struggle a little bit with their memory as they get older, but if you are noticing that your loved one seems to be experiencing frequent confusion or memory loss, then that might be the sign that they are dealing with some health issues that need immediate attention. Here is what you should look out for when considering confusion or memory problems in your loved one:

• Frequently forgetting the names of people they know well. 
• Constantly retelling the same stories, with no memory they that have already shared this same information.
• Confusion regarding their regular routine, where they are or who people are who should be familiar with them. 
• Forgetting something they’ve done many times before, such as getting lost while out on a familiar walking route.
• Constantly misplacing and losing items 

The National Institute on Aging offers some other guidelines on what to watch out for, as well as some of the differences between a more serious cognitive condition and the normal amount of forgetfulness that comes with age. But, it’s always better to be safe than sorry. If you suspect any memory or confusion issues with your loved one it’s always better to get it checked out than dismiss it, even if you’re sure it’s nothing. As with everything on this list, it’s always best to investigate, even if the issue seems minor. Best case scenario is that there’s no need for further action, and you’re shown your loved one that you care enough to speak up. But even if it’s discovered that your loved one needs further help at least you can rest easy knowing that you addressed it as early as possible, therefore getting them help as soon as you could. The earlier an issue is addressed the better chance that your loved one can have a higher quality of life for their remaining years. So never wait to speak up.

Family Support is No Longer Possible

Most of us would do anything for the people we love. Many adult children take on the role of caregivers to their parents, putting aside their own social lives and sometimes even careers in order to be able to do so. But sometimes the needs of your loved one might be more than you are able to provide for them. This could happen in a variety of ways:

Loss of Opportunities: Caring for your loved one would mean you need to take too big of a financial hit for you to be able to handle. Or perhaps the amount of care they need means that you would need to turn down career opportunities that could set you up for the rest of your life. 

Neglect of Family: Your loved one might be taking up so much of your time that you are not able to give enough attention to your children or partner and it’s beginning to put a strain on those relationships. 

Burnout: Caring for your loved one has put such a stress on your life that you are now experiencing burnout and it is affecting all areas of your life. The Cleveland Clinic offers more insight on burnout in caregivers here. 

Safety: You might want to care for your loved one, but their condition has become too unstable for you to be able to safely provide for them. They might frequently wander off and get lost. They might not be able to navigate the house without assistance, and easily fall. They might leave the oven on or engage in other activities that are dangerous to you and others in the home. They also might be very agitated due to medication or a cognitive condition and be verbally and even physically abusive. 

It’s never easy realizing that you are not able to provide the care your loved one needs, but if any of the above points speak to you then an assisted living residence will likely provide your loved one with the attention and support they need. And that way you can take care of your own needs so that you can show up for them in the best way you can offer. 

Isolation

Finally, you’ll want to keep an eye out for any indication that your loved one is dealing with extreme loneliness and isolation. This could happen at any time, but can be especially common for older adults who have recently lost a spouse or dear friend, or have moved to a new city or neighborhood. 

Older adults who are suffering from mental illness might also isolate themselves due to feelings of depression or grief. Someone who was previously very social might become withdrawn and quiet, and seem completely uninterested in visiting with friends or participating in activities they once enjoyed. 

If your loved one doesn’t seem to go out anymore, and doesn’t seem to be connecting with friends and other loved ones, it might be a signal that they need further support and could benefit from being part of a larger community to keep them company. 

Talking about assisted living with your loved one might bring up a lot of emotions. Some older adults are very resistant to the idea of change, and might view assisted living in a negative light. Because of this, it’s important to be patient and kind to your loved one when bringing up the topic. Be sure to listen to their fears and concerns, but then gently remind them of your concerns and all of the reasons why you think this might be a beneficial transition. And, of course, it’s always a good idea to consult with your family doctor to see if they have any further recommendations or concerns. At the end of the day assisted living is simply about providing your loved one with the best support and community for their needs.

So, the time has come for mom or dad to move into assisted living. This is often a very difficult time in a family’s life, and you and your parent might be experiencing a lot of emotions about this major life transition. 

While it’s completely natural for everyone to have some complicated emotions about this move, the transition itself doesn’t actually have to be painful. With a little bit of planning and discussion you can help your mom or dad find an assisted living facility where they feel comfortable and safe, and you can relax knowing that they are being well taken care of. The following are some tips to help you and your parent find the perfect place for them to enjoy a happy and healthy future. 

Their Needs

The first thing you’ll want to figure out is exactly what kind of support your parent needs. Assisted living is often used as a broad term, so depending on what medical issues your parent is facing, they may be in need of extensive care, or simply a place to build community and have some support with basic tasks. 

There are several living options to consider. Let’s start at the lowest level of support:

Independent Living

Independent living is a living environment where your mom or dad would still be living on their own, but would be living in a building complex that was specifically reserved for retirees. Independent living arrangements usually include amenities such as lunches and dinners, special events and fitness classes. Independent living is a great way for older adults to have a support network of friends and workers nearby while also enjoying support for their daily needs. Most independent living homes also offer light housekeeping and shuttles to nearby grocery centers and malls.

This is the right fit for a older adult who doesn’t have any major medical needs, but who is struggling to maintain a home or growing tired of cooking for themselves. It helps older adults to be more social and live independently for a longer period of time.

Assisted Living

Assisted living can be fairly similar to independent living, where a older adult has their own apartment and is still fairly active, but this kind of living is most suitable for those who require daily care with activities such as bathing or the administration of medication. This might look like a caregiver coming into the apartment every day to help with the specific needs of their client.

Assisted living can also look like a more intensive care experience where everyone in the facility is receiving more focused care. People in assisted living might have an apartment but generally don’t have a kitchen and will usually have all of their meals prepared for them. 

Long Term Care

Long term care is the most intensive out of all of the living arrangements. This is generally reserved for older adults who are experiencing extreme physical or cognitive difficulties. There is a lot of care involved with very hands-on, 24 hour staff, and, if your parent is dealing with a condition like dementia or Alzheimer’s, they will likely be in a locked ward to ensure their safety. 

It’s like that if you are reading this then your parent is firmly in the assisted living category, but it’s always good to know the differences. Sometimes a condition progresses rapidly, or your parent may actually be in much better condition than you thought and might need very little support. Knowing what to expect in the different living situations can help you to know exactly what to look for. Here are a few things to consider:

• How mobile is your parent? Do they need to use a cane, walker or wheelchair
• Is your parent struggling with mental health issues?
• Does your parent have a diagnosed memory disease?
• Does your parent have a complicated medication routine?
• Does your parent require regular physical therapy?
• Can your parent clean their house?
• Can your parent cook healthy, nutritious meals for themselves?
• Can your parent bathe themselves? 

All of these questions should help you figure out the kind of care your parent needs when looking for an appropriate care facility. 

Location

When looking for a care facility for your parent the first thing you’re probably going to think about is the quality of the care home. And, while it’s of course important to find a well-reviewed and comfortable home, the location of that home is almost equally important. 

It can be quite disruptive for older adults to be moved far away from the neighborhood they’re familiar with. In fact, abrupt moves can result in a condition known as relocation stress syndrome. According to Social Work Today, relocation stress syndrome can happen within days, or sometimes even as long as several months after a move. Older adults experiencing this condition might be angry, depressed, and erratic, display aggressive mood swings and a wide range of physical symptoms. These physical symptoms can include a rapid heart rate, weight changes, nausea, poor sleep and increased substance use. 

While sometimes a move is unavoidable, you should always work with your parent and a support worker to make the move as gradual and sympathetic as possible. Most older adults have lived in the same location for many years, and are comfortable in their routines. Ripping them away from that to suddenly be placed in unfamiliar surroundings can be extremely traumatic. This is especially true for older adults who are experiencing memory failure. Research shows that many people, even with cognitive decline, still have a grasp on their long term memory,  but have much more trouble with more recent memories. This makes it very difficult to navigate a new space where they don’t have any established connection. 

That’s why it is not only important to consider the physical location of where your parent ends up, but also what supports will be in place once they arrive there. You will want to ensure there’s a strong support system in place to walk them through this major transition. 

Ratio

While you’re browsing for an appropriate facility, likely using a site like A Place for Mom, you might be tempted by the attractive amenities provided at certain spots. However, something very important to consider is not just what’s on offer, but how many people are providing those services. 

A piece by the National Institute of Nursing Research found that large ratios between nurses and patients (that is, when a single nurse is assigned to a large number of patients) the rates of deaths and rehospitalizations were much higher than if a nurse was assigned a much lower number of patients, and patients were tended to by more medical professionals overall. 

In an ideal situation you will want to look at a ratio of around six patients to one nurse or care worker. Of course, you’ll want to interview any potential facilities, and also look at online reviews of the location. 

Feel

Have you ever heard the term “the vibes were off”? While it might seem silly to base your decision of care off of a vibe, the concept is not totally ridiculous. You can tell a lot by the feeling of a place, which is why it’s always so important to visit facilities in person to understand the kind of environment your parent might experience every day. Here are some of the things you should look for when visiting a home:

• Cleanliness of the establishment. Walls, floors and bathrooms should be clean and dry. There shouldn’t be any dirt or trip hazards. You should also inquire about ventilation and how often vents are cleaned. Proper ventilation is a key component of keeping sickness at bay, and can also help with symptoms of asthma and other breathing issues. 
• Cleanliness and attitude of the residents. You should look for residents who seem clean and well cared for. Do they look happy and seem to have good relationships with the staff? If any of the residents seem scared or withdrawn, especially in their interactions with staff, then that is cause for concern.
• Safety procedures. Check to see what policies are in place for a disruptive patient, a cognitively impaired resident who leaves a secure area, and what happens when a contagious illness begins to spread throughout the facility. 

Vibes can be incorrect, but it is still important to trust your gut. If something feels off then that usually means it is. Don’t ignore that feeling. After all, it’s your parent’s health that is at stake. 

What’s Important to Your Parent

While delicious meals might be your top priority, that might not actually be the most important thing for your mom or dad. So, sit down and talk to them and find out what they care about most when thinking about the best assisted living facility for them. They might want to enjoy a good social life, so looking for a place with a bustling event calendar and lots of community lounges would be a good choice. Maybe they want to make sure there’s a chapel so that they have somewhere to pray, or a barber or hair salon so they can regularly look their best. 

Don’t push them if their idea of a comfortable home doesn’t match yours. Just think about the dignity you’d want to be granted if you were in their position. While you might not be able to grant all of their wishes, it’s important to do your best to find something that ticks some of their boxes. Your attention and understanding will mean a lot to them. 

Cost

Of course, a lot of your decision making during this process is going to come down to cost. Many assisted living facilities are expensive, and you might be limited to homes that accept Medicare. Always be sure to speak with an insurance provider to find out what kind of care your loved one is eligible for, and speak to any potential facilities as well, to make sure you’re not going to end up paying for any hidden fees. Think about finding a facility the same way you would search for a house. Sure, there might be features you would like, but what is it that you can truly not live without. Deal breakers are a helpful way to find the best spot. If you haven’t taken the time to go through dealbreakers with your loved one then you might miss out on an amazing spot because you thought something was a deal breaker when it was really just a preference.

Cultural Comfort

Our world is made up of billions of people with different backgrounds and experiences. While it’s always good to interact and make friends out of people who are different from you, it can also be important to have a network of people who understand the same cultural experience as you. There’s a camaraderie and a shorthand that people from the same backgrounds face that people outside of it just might not understand, and if you don’t have anyone to share that with then it can be isolating. Of course, there are many ways to share culture, whether that’s someone from the same race, the same religion, the same sexuality or even from the same state. When thinking about an assisted living facility it’s important to find out whether or not your loved one will experience any kind of cultural isolation that could be damaging for them in that space. If someone isn’t free to be themselves, then it’s easy to become withdrawn, and that can be extremely detrimental to one’s mental health. 

Consider the Long Term

When thinking about appropriate living arrangements for your loved one it’s important to think about the trajectory of the rest of their life. While we can never completely predict the future, their current health condition and age can usually provide some idea of their life expectancy and health needs. The reason you want to think about the future is because it might impact the kind of home you chose right now. If, for example, your parent has been diagnosed with a cognitive disease they might still be in the early stages, and perfectly capable of living independently. So, it might be tempting to place them in an exclusively independent living facility. However, you know that down the road their care needs will grow more and more extensive, so it probably makes more sense to place them into a facility that can transition them into that kind of care on site, which saves your mom or dad an unnecessary move. 

In another situation, perhaps your parent has been diagnosed with serious heath conditions, and are already in their late 90s and are unlikely to live for many more years. This might mean the budget doesn’t need to be so tight, and you can splurge on some more extravagant care during their final days. 

At the end of the day the best choice is the one that feels best to you and your loved one. So remember to trust your gut, and be patient during this major transition in your parent’s life.