Help family with options for elderly member

Don’t expect to find a win-win situation

When an elderly person can no longer live at home without assistance, it helps if the family can look at all the pros and cons of every scenario, Elizabeth Bodie Gross, FNP, MBA, CCM suggests.

"Most of the time, people see only the pros, and it’s only when they are in the situation that they see the cons. They aren’t prepared, and it can cause a lot of anger and fighting," adds Gross, director of Lutheran Home Health Services in Arlington Heights, IL.

Allow the elderly person to have as much control in the decision-making process as possible, the experts recommend.

In the case of people with Alzheimer’s Disease or other conditions that inhibit communication, find out if there is a living will and help the family understand what the person’s intent might have been.

Carole Stolte, RN, MA, CCM, CRC, CCM, CDMS, CPC, director of Maturity Concepts: Care Management and Consulting in Towson, MD, cautions against recommending that an elderly parent move in with the children.

Elder people who live alone often are accustomed to a high degree of isolation. They are used to quiet and may be unhappy with life in a noisy household, she says.

"It would be an extremely rare, unique situation to make a recommendation like that. We want to help all parties maintain as much autonomy as they can," Stolte says.

When elderly clients have to change their living situation, have them list the top five things that are so important to them they cannot give them up.

That way, when you evaluate all the options, you can cut out 80% of the places, Gross says.

For instance, one client said her No. 1 priority was to go to a Jewish facility. Another said he wanted to live within 10 miles of his children.

Those criteria eliminated a number of options.

Gross coordinated the transition to a retirement community for a woman who visited her children extensively during the year. Many facilities would not allow people to live there if they were going to be gone three months out of the year.

"The family found a place that met her criteria, but it wouldn’t have happened if her son hadn’t pushed her to understand why setting criteria was so important," Gross says.

If the elderly person is going into an institution, urge the family members to visit each place they’re considering and gather as much information as possible so they can guide their parent into making a decision.

"No decision is going to be a total win-win situation. There is always a con to the situation, but the family members have to choose the con they can live with," Gross says.

Seniors who are moving into their children’s home or an assisted living center don’t want to give up cherished items. The family should make arrangement for them to bring their special items to their new home.

If the senior is going into an assisted living facility, Stolte recommends delegating some responsibility for visiting so it doesn’t fall on one person.

Make memory books for the elderly person to take with them. Share family photographs with them. Take them favorite meals.

In cases where the family already has moved the elderly person into his or her home or won’t consider other options, Stolte recommends that they call a family meeting to discuss the special considerations they family has to take into account when a senior moves into the house.

Seniors’ decreased hearing and decreased eyesight make it necessary for a family to look at safety issues.

Seniors need a routine, with scheduled meals. This may interfere with a busy household where the children have after-school activities and meals are often on an erratic schedule.

In that case, it might be a good idea to consider Meals on Wheels or a similar option for the senior living in the home.

"That way, she can plan her own day and choose when she is going to eat, rather than being dependent on the family," Stolte says.

If it’s an intergenerational family with small children, talk to the kids about keeping floors and stairs clear of toys.

Pets are another issue. You don’t want the senior getting up in the middle of the night and tripping over the dog. Make arrangements to keep the pets from roaming free in the house at night. n