The Caregiving Dilemma

The idea of aging gracefully at home or in the company of loved ones is an idea many older adults hold dear. Unfortunately, life sometimes has different plans. The challenge for caregivers is recognizing when the comforts of home no longer allow someone to live independently or safely.

In the event of a broken hip or other life-altering health event, the signs are obvious. But in the instance of normal, healthy aging, recognizing the signs can be a bit trickier. It's easy—and often correct—to chalk forgetfulness or loss of stamina up to simply getting older. But as these small things add up, they can and should be warning signs that independent living may no longer be the best option.

Here are just a few of the warning signs that may indicate that it's time to look for other living options:

Physical deterioration: issues with balance and falling, significant weight loss, loss of strength, or issues doing basic daily living tasks such as showering, getting dressed, or eating independently

Mental deterioration: loss of memory, including confusing names, dates, and locations, are important warning signs of dementia and Alzheimer's and should not be ignored. They can lead to issues related to personal and physical safety.

Lifestyle deterioration: the home not being kept as tidy as is normal, objects stored in odd places, physical damage, such as unexplained dents to the car, damage to the garage door or sidewalls, signs of fire in the kitchen, or appliances left on when not in use.

If you have reason to think it's time to make a move to long-term care, your next step should be to discuss it with other family members. You need to make sure that everyone is in agreement and start developing a plan for what the future will hold for all. Things to consider include: who is close enough to provide hands-on support, what type of care should be considered (in-home vs. at a facility), what are the financial realities of the type of care and are the financial resources available to fund it, do you need to establish a Power of Attorney or Conservatorship, and, do you need to hire an elder attorney.

It is important that every member of your family "care team" is on the same page regarding the plan. Then, and only then, should you have "the conversation" with your loved one. It's important to approach the subject with compassion and at a gentle pace. It's natural for people to be protective of their independence and their home. You don't want them to feel like they are being forced into something they don't want. Share your concerns for their safety and well-being. Point to specific concerns and challenges they’re facing and explain how your care plan can actually improve their quality of life and relieve them of some burdens and worries.

Don't expect immediate buy-in. Give your loved one time to consider what you're suggesting. Revisit it honestly with them, reviewing what they're being asked to give up and what they might gain from a change. When approached thoughtfully and at the right time, it is possible for this challenging conversation to go smoothly and lead to a change for the better for all.

Suzanne Anair is the administrator at the Centers for Living and Rehabilitation in Bennington.