Home vs Facility Placement for Elders


There’s Really Only ONE Reason to Relocate Someone

Many of us have or are wrestling with the care of our health compromised aging parents, physical and/or mental. There are numerous variables at play making every individual’s situation unique. At a minimum, issues include medical conditions, cognitive function, finances, availability of caregivers, family dynamics and more. There is no one size fits all solution.

Regardless of the complex interplay of factors, when the proverbial dust settles, the singular reason to reevaluate living at home is safety. That doesn’t mean someone who requires full time supervision and/or physical assistance can’t receive it at home. The logistics however can be daunting. Either rotating family members, hired caregivers or a combination of both along with the necessary equipment has to be arranged and monitored.

Consider these true experiences.

Poisoned Food:
One evening Carolyn discovered that her mother Stella had thrown away all of the food in her refrigerator. “It’s poisoned!” Stella insisted. Carolyn was stunned. Her mother had never acted paranoid before. Carolyn dutifully replaced the groceries and reassured her mom that the food was fresh and definitely not poisoned. Stella seemed becalmed.

Mother and daughter spoke every day and Stella insisted she was cooking and eating fine. The following weekend however, Carolyn discovered her mother’s refrigerator empty again. Mystified, Carolyn tried probing questions to help unveil her mother’s new, bizarre fears but Stella’s explanations were inconsistent.

After weeks of medical assessments, Stella’s blood work revealed severe anemia and other metabolic problems brought on by prolonged poor eating habits. Carolyn stepped out of her daughter denial bubble and acknowledged her Mom needed more supervision. Either round the clock caretakers or placement in an assisted living center. Weighing all of the options, Carolyn decided on relocation to provide maximum safety.

Locked Out:
Jeff lived close to his mother Delores and visited daily. He recognized that she wasn’t “quite as sharp” as she used to be, but dismissed any serious issues. Other siblings, neighbors and Jeff’s wife however, had concerns about Delores’s competency.

After a rash of break-ins in the neighborhood, Jeff decided to replace the locks at his mom’s house. The new locks, including a deadbolt, required new keys and a new sequence of procedures. Jeff reviewed with his mom what he considered to be innocuous instructions.

The inability to learn new information is a hallmark of dementia and Delores struggled to grasp the changes. She was just savvy enough though to sense her son’s emotional frustration and bluffed her way through the directions with validating remarks. “It’s fine. I’ve got it honey.”

Only Delores didn’t have it and it wasn’t fine. It was the deadbolt that threw her the most. When the power went out one afternoon, Jeff drove over to check on his mom. Through the locked door, he asked his mother to let him in, but Delores responded saying that she couldn’t “find the key for that bolt thing.”

“It doesn’t have a key mom; just slide the bolt to unlock it.” It was 2 minutes before Delores could process the directions, forgo looking for a key and slide the bolt. Jeff was finally convinced his mom wasn’t safe alone in her home. The decision was made to move her into a senior center. Delores also had developed health problems overlooked by her false promises of being “fine”.

In these situations, the extended families made the choice to relocate their parent into a facility in lieu of arranging 24-hour in-home care or moving the parent into one of their homes.

All Things Unsafe

Unsafe environments take on many forms, not just inaccessible entries or stairs; Mishandling medications; Poor eating habits; Shower/tub safety; Vulnerable to letting strangers in; Inability to call for help; Altered judgment; Impaired driving skills; Confusion; Wandering.

The variables and dynamics involved are considerable. Regardless of the specifics, any situation which compromises an individual’s ability to live safely at home warrants reevaluation. It’s difficult to remove one’s rose colored glasses and really see your parent’s needs clearly. I know; I’ve been there. But take them off before it’s too late. I’ve been there too!

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Elaine C.Pereira

About Elaine C.Pereira

Elaine retired in June 2010 as a school Occupational Therapist where she worked with special needs children. She lives in southeastern Michigan with her husband, Joe. Between them, they have five children — Joe has three sons and Elaine has twin daughters-and soon-to-be five grandchildren. Elaine has a Bachelor’s Degree and Master’s Degree in Occupational Therapy from Wayne State University. Elaine is the author of I Will Never Forget and she was inspired to tell her mother’s incredible story in part to help other caregivers coping with memory loss issues in their loved ones. I Will Never Forget

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