After my mother passed in 2010, my father’s geriatric doctor and my older sister, a retired nurse, began urging dad to move into assisted living. He was very resistant and repeatedly dismissed their advice. His sentiment was “I have a house that’s paid for, why would I want to pay rent somewhere else?” But there was more to it than that. He loved puttering around on his one-acre lot and watching deer and other wildlife that frequently traveled to and from the forest preserve next to his property. Witnessing nature is what made dad feel free and alive and gave him immense joy. He said, “I’d feel like a caged animal in an apartment.”
I did not want dad to lose his sense of freedom and joy. The problem was that he was living with advanced macular degeneration, arthritis and needed to use a walker in a house that was not designed for mobility device accessibility, aging in place or his particular needs. Because he couldn’t get his Driver’s license renewed, due to his vision impairment, he was dependent on my brother, who lived about 40 minutes away, for transportation to appointments and to get groceries and prescriptions. (This was before car services like Uber or restaurant, grocery and pharmacy delivery services were readily available.) There was also the challenge to not slip and fall on snow and ice during the long Midwest Winter months. Not an easy task for anyone, let alone older adults with diminishing balance and vision.
How do you tell your parent what to do, or keep them from tossing your advice to the wind, because they still view you as their child? Parents believe they know best because they are older. I see this dynamic firsthand when I am the professional working with families.
There comes a point when you simply need to reverse roles. That time is when they’re no longer making good decisions and need a guardian angel to step in and protect them, before something bad happens. You need to be the parent.
In 2011, I was just one year out of design college and working for a commercial senior living design firm. I was intimately aware of the benefits of senior living communities and assisted living. I was trained in how the body ages and how to design with those needs in mind, which is highly specialized. However, at that time, I was not focused on residential design for older adults and had not yet become a Certified in Aging in Place Specialist. Nor was I aware that 99% of residential homes need remodel design to accommodate the changing needs of adults 55+.
Living in a different state halfway across the country made it tough to help or see what was really going on with dad day-to-day. Every time I talked with him, he said everything was fine.
However, when I flew back to Ohio for a visit, I discovered there were life-safety issues with dad living at home. I watched him turn on his gas stove and crank up the flame to about 8-inches high because he couldn’t see it and thought the stove wasn’t working. He confided that he had been falling but hadn’t told anyone. I even uncovered “stranger elder abuse,” as dad had been repeatedly preyed upon for money but didn’t realize that he was being scammed. They had built up trust with him over several months and dad was allowing them in the house. Dad simply thought he was helping someone in need and didn’t tell any of us about any of it.
I immediately sought counsel with our Elder Law Attorney, who referred me to the County Prosecutor, who advised that this would not end well for my dad if it continued. The only legal way to stop it would be to declare him mentally incompetent. I refused to demean dad like that – plus, he was as sharp as ever. I believed there had to be another way to protect him.
I knew, despite how much dad didn’t want to leave his home, he needed to move to assisted living, for his own safety and wellbeing. In the right senior living community, he would have extra eyes on him daily, and care as needed, which was important with his rapidly deteriorating vision, and it would keep the predators away. He would have opportunities to socialize with peers and make new friends. Nutritional meals would be provided, and he wouldn’t be eating alone. Housekeeping and laundry service would be provided. His risk of falling would be significantly reduced as good communities are designed by professional senior living interior designers to prevent fall and accidents, accommodate walkers and wheelchairs, and be safer, overall. Dad would also be much safer without a stove or a house that he insisted on maintaining himself (including going up on the roof!)
However, as confident as I was about how much safer and better off dad would be in assisted living, given his needs and situation, he was not. So, I had to assertively reverse our roles, be the parent, take the lead, jump into action, take the heat, and talk and persuade him through every step of the process and move. It felt awkward and uncomfortable, but Dad’s safety and well-being was far more important than my uncomfortableness. It was tough and exhausting, but so worth it.
Many times, the existing home can be professionally designed and remodeled for Aging in Place, which safely keeps them at home. Other times there are extenuating circumstances, like with my dad, where the best solution is assisted living.
Step One – A Loving Intervention
Because parents are usually more willing to take advice from professionals than from their own adult children, I engaged a professional senior advisor and called a family meeting with dad, my siblings and the advisor.
It was effective and impactful for dad to have a professional talk with him about his needs and how his current home wasn’t meeting those needs. It was powerful for dad to hear all his adult children (who don’t always agree on things) in unison supporting and agreeing with the advisor.
Bingo! By the end of the meeting, dad made the decision to move to assisted living.
Step Two – Finding the Right Place if Home Isn’t an Option
Moving is particularly tough on seniors, so you’ll want to get it right with the first move. I recommend engaging a Senior Placement Specialist to bring forth your best options. They’re like Realtors®, except they are solely focused on senior living placement and their service is no cost to you. They serve as a great advocacy resource.
A senior placement specialist will take you to tour appropriate senior living communities or care homes they have already vetted, based on your budget for rent and care, needs and lifestyle preferences. They provide better, more individualized service than the online service companies that you see advertisements for on TV that simply give you a list of communities and leave you to figure it all out on your own.
Whereas, good placement agents have many resources and help you every step of the way, including the preparation and paperwork for move-in, as required by community management and state laws. Plus, they are aware of which communities and care homes are the best and those to avoid.
Please don’t make the mistake of presuming you can find and choose the best place on your own. Take this example with my well-meaning sister and brother and how it could have gone very wrong.
My older sister (the nurse) wanted my dad to move into an assisted living community just down the street from his house and close to her, and my brother and sister-in-law wanted dad to move into a brand-new Brookdale community (largest senior housing provider in the US) close to their house. Either makes sense, right?
I investigated each. The problem with the one down the street from dad was that they only offered shared rooms. Dad, being a very independent, strong-willed person would have absolutely hated that as he would lose independence and privacy. My sister wasn’t aware of the shared rooms set up and acknowledged she didn’t know enough about senior housing to ask the right questions. The problem with the new community close to my brother was that it was only memory care and my dad did not have dementia or Alzheimer’s.
My siblings are intelligent, educated people, but they, like most people, do not know enough about senior housing to make the best selection. You don’t know what you don’t know. For the sake of your loved one, engage a local professional.
Given my senior living training, I knew what to look for and what questions to ask. So, I promptly vetted several senior living communities for dad that offered assisted living. I narrowed it down to three and took dad to tour them and have a meal there.
When I have clients that want or need senior housing, I refer them to good senior placement agents I know and trust. If you need a senior placement agent in Arizona, let me know. I’d be happy to introduce you to a few.
Another option to find a local senior placement specialist is to look on the National Placement & Referral Alliance website, www.npralliance.org. It’s a Not-for-Profit professional association that promotes standards, ethics and education for its membership, which serve seniors and their families. I serve on the Central Arizona Chapter’s Board of Directors. That Chapter was founded about eight years ago, and the association just went national in 2018 and is quickly developing new chapters.
Step Three – Don’t Let Curve Balls Throw You
Dad and I were in agreement on which community would be the best for him. It was in a pleasant, country-like setting with lots of trees, grass and a pond with ducks. Things he would enjoy and space for him to safely ride his adult tricycle. He said, “If I can’t stay at home this is where I want to live.”
I was so pleased we found a place he would enjoy. We were already to sign the community’s agreement but were told there’s was a six-month waiting list for one-bedroom apartments. Yikes! All they had available was a tiny 385 sq. ft. studio apartment. Double Yikes!
Of course, dad quickly said he could wait. But the reality was he needed it ASAP! I insisted it had to be now and I knew he would not be happy at the other communities. So, we took it and moved forward.
Step Four – Ensure the Apartment Design is Mobility Device Accessible, Senior-Friendly and Meets Specific Needs
The studio apartment was tiny, but I was determined to make it mighty! I went to work leveraging my senior living design skills to improve quality of life.
Downsizing from a single-family home, compounded by the need for a fast move, was no easy feat. But in less than three weeks it was accomplished.
I designed a vibrant, uplifting, ADA-compliant space that incorporated key existing pieces dad wanted to keep and new furnishings that were needed. I implemented senior living design techniques that made his daily activities easier, given his vision impairment, arthritis and need for a walker.
I infused his studio apartment with his favorite colors, which I adjusted for his vision impairment, and things that brought him joy – nature, birds, animals, and music. Large-scale media and artwork were introduced, abundant lighting was provided, and cabinet pulls designed for arthritic hands were installed on the cabinetry.
One would assume that all assisted living community apartments are senior-friendly and set to go from a safety perspective. But I’ve found either in working with clients transitioning into independent or assisted living apartments or when I’m touring communities that many are not as accurate as they should be and need tweaking (even the high-end luxury communities). I have identified senior design gaps for clients and resolved problems to improve safety and make daily activities easier, prior to move-in. There are cases where the architectural design is poor for seniors and that can’t be fixed. It’s best to identify those type of problems when touring and look elsewhere to live.
Also, I help clients that are downsizing into a new home or an independent or assisted living apartment. I help them determine which furniture they want to bring with them. I advise which pieces will and won’t work in the new space. I review a Furniture plan (arrangement), which is a CAD (Computer-Aided Drafting) drawing, revealing precisely which furniture pieces will be moved, where they will be placed and whether anything new is needed. I also assist by selecting and purchasing senior-friendly furniture and furnishings for them.
When needed, I have access to professional organizers that help clients sort, purge, pack and unpack, as well as movers. Often, the families I’ve worked with also have me go back to the house they moved from and prepare it to sell for top dollar.
Each of these services tremendously reduce the stress and overwhelm that older adults feel when it comes to downsizing and moving. In fact, the mere thought of downsizing is so overwhelming for seniors that it’s the number one reason they decide against or put off moving into senior living communities.
Assisted Living Studio Apartment
Step Five – Be Compassionate and Prepared for a 3-Month Transitioning Period
Your loved one will probably not be happy for about three months. That’s the usual amount of time it takes people to transition into apartment and community living. There are new routines to get used to, including new mealtimes and how the community functions and operates. It takes time to feel comfortable, stop being angry about having to move (i.e. losing their independence), and to make new friends.
As for dad, right at the three-month mark he struck up a close friendship with a nice lady that lived there, which made his last 2 ½ years of life more pleasant. He really missed living in his own single-family home but made the best of living at the senior living community, as he understood he was safer there.
The best way to avoid a move to assisted living is to make an investment in yourself and have your home professionally designed and remodeled for successful aging in place before its too late, like it was for my dad. Done correctly and beautifully, it will add value to your home as well.