elderly-gentlemanOne of the most difficult things we face in life is deciding when it’s time for a parent or other loved one to move into assisted living. Boy, if only there was an instruction book – wouldn’t that be a best seller??

On the Lookout for Changes

There’s really no way to know for certain, and the decision should be based on practical matters as well as what’s in your heart. Here are eight signs that the time for transitioning to assisted living may be drawing near.

  • Letting things go around the house. For example, lots of clutter, piles of laundry, spoiled food, dying plants, dirty dishes that appear to have been sitting for a long time, overflowing trash, and neglecting pet care tasks such as emptying the cat’s litter box.

  • Neglecting personal care. This can range from appearing disheveled and unkempt to signs of not bathing. Are you noticing that their clothes are dirty or they’re wearing the same thing all the time?

  • Changes in personality. As people age they tend to slow down, but if someone is withdrawing from friends and social activities or giving up hobbies, it could be more serious. Do you sense they feel isolated, lonely, or depressed? Do they rarely leave the house? Do they lack interest in things they used to enjoy?

  • Safety issues such as worsening mobility, increasing number of falls and accidents, inability to properly manage medications, difficult getting up from a seated position, forgetting to turn off the oven or stove, struggling with going up and down stairs.

  • Changes in eating habits. Skipping meals and be a sign that they’re struggling with shopping or preparing meals. Look around the kitchen; do you find stale, expired, or spoiled foods, or multiples of items (for example, more cereal or juice than they can use in a lifetime)? Are they losing weight (lack of interest in food, perhaps) or gaining weight (forgetting they ate and eating again)?

  • Overall cognitive decline. For example, lack of sound judgment, difficulty following directions, increased confusion, or requiring lots of prompts and reminders. Also, rely on neighbors and pay attention when they report observing unusual behaviors.

  • Driving issues. Traffic tickets, unexplained dents or scratches on the car, tailgating, drifting out of their lane, or driving the under speed limit can all be signs.

  • Wrestling with finances. Watch for bills piling up, overdrawn bank accounts, final notices or calls from creditors, evidence they may have fallen victim to a scam, large volume of receipts or thank you letters from charitable organizations, or bills that have been paid multiple times.

Denial is a Natural Part of the Journey

As I think back to when I was grappling with this decision for my mom, all of the signs were there – as was a significant amount of denial on both of our parts.  This is all too common, and if you aren’t sure how to broach the subject, or have a loved one who is fighting you every step of the way, consider consulting with a geriatric care manager.

These professionals are trained in dealing with exactly this type of situation. Put simply, it’s what they do; how wish I had known that 10 years ago. If you’re having trouble finding someone in your area, visit the National Association of Professional Geriatric Care Managers’ website.

Be Realistic About Needs

Last but not least, as you’re evaluating options, remember that by definition assisted living is meant to fill the gap between full independence and skilled nursing.  Ask yourself the hard questions about exactly how much assistance your loved one needs. Some assisted living communities will accept residents who actually require more intensive care than they are equipped and staffed to provide. The result can be disastrous, so this is something to be aware (and beware) of.

We would love to hear your suggestions and comments. What were the deciding factors in your situation? Can you offer advice to those approaching the time for this difficult decision?


  1. Jerry allen matney

    Im at the end of my rope, Im tryjng to hold a part time job, along with managjng my mother her 3 cats and 2 dogs, ghen my small negelcted dog.. Mines neglected because hers demand so much attention that if I show affection to him they get upset then in turn she gets upset that im abusinv her dogs.. When im not. The constant fights, I clean and clean, she messes the place up as fast as I can clean it. Then she complains about the condition of the place. She refuses to leave the house, even though she herself wanted to do rehab, but in the end found one excuse after another why not to go look at places. She only wanted to go on tbe days that I have to work. If i called in the day off then she would cancel. but this isn’t just lookjng for a rehab place she does this sith 90% of her exams check ups, and doctor appointments. She knows I work night shift. But demands to be fed at 5 or 6, when im at work. She says she cant eat after 6. But if fastfood is involved shell call me at work and demand fast-food on my way home. She addicted to shopping networks..But when i buy food for the month we…I wind up feeding it to her dogs. And its off to McDonald’s. She blames her finances being so low on me, she blames that she cant maks her appointments on me,. The conditions of the house and yard on me..I sleep abojt 4 hours a night. If im not at work im cleaning or waiting in my bedroom for her next demands..im at my witz end.im just about ready to leave her. We never had a decent relationship, my mom is a classic narcissist and im the most.worthless person shes known. When I was 7 I saw her laying on the couch with stiches on her belly. i asked if she was alright, what happened. Her reply to this young child was..I had my tubes tied so I dont have another one like you.. Just recently she told me I was thd reason why Amanda never.got.born. I was to blame why she did what she.did..And todays fight has lead.me here. I cant just leave. Shes to lazy to take care of herself, and her.judgement on asking people for help needs work..lots of work.. And if someone makez a mistake she will speak her peace jn a very violent way to the point shell make threats to get her way..take it.from me shell follow through with them to teach them a lesson not to upset her.. I, afraid shes going to get herself killed with her mouth..Please someone tell me or lead me somewhere to help me get her help…To be honest. This hurts me to say, but once shes settled in somewhere im going to give her what she has always wanted from me.. To drop off the face of the earth, im just.not going to die…well maybe a little I will because my atempt to fix whats wrong between us is a complete fail.

  2. Derek Mcdoogle

    In your article, you suggested that lack of sound judgment, difficulty following directions, increased confusion, or requiring lots of prompts and reminders are a sign that you need assisting living. My wife and I just visited my mom last night for dinner and we realized that she was having problems forgetting things. I wonder if there are different levels of assisted living that are available.

    • Heather

      Derek, I currently have a client (I’m a cna) who has all of these issues so her family thought it was a good idea to move her to assisted living. Bad idea because now she has all the same issues with still no assistance but meals made for her. It has to be the right facility! Assisted living is for completely independent elderly people. This article is kind of misleading

  3. mike

    help !!!! i am in a desperate situation. my parents are failing at a rapid rate, im the youngest of 3 and the only one who recognizes the situation and willing to do something about it. my sister is in major denial and my brother ( the oldest ) refuses to do anything except ignore it. I have made several attempts to communicate my concerns to my parents without offending them, only to be met with more denial and growing hostility. to make matters worse my sister not only is in denial she enables them by going along with the unrealistic and SIMPLY PUT CRAZY THINGS THEY ARE ATTEMPTING TO DO !!! any advice would be greatly appreciated

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