When is it time to consider long-term care?

considerassistedliving_largeFor many families, there comes a time when it’s no longer safe for an elderly loved one to live alone at home. 
As a family medicine physician at The Ohio State University Wexner Medical Center, I specialize in geriatrics and the care of older patients, specifically patients needing long-term and end-of-life care. 
One of the conversations I find myself having quite frequently is with the children of my geriatric patients. 
They’re asking questions about long-term care options, and how to recognize the signs that it’s time their parents should move into a safer environment at an assisted living facility. 
They’re also seeking help on how to talk to their parents about making such a monumental move. Not surprisingly, many of my patients are fiercely independent and reluctant to uproot their lives, even when it’s in their best interest.
What is long-term care?
Long-term care services include a broad range of health, personal care, and supportive services that meet the needs of frail older people and other adults whose capacity for self-care is limited because of a chronic illness, injury, physical, cognitive, or mental disability, according to a report by the U.S. Department of Health and Human Services.
Long-term care services provide assistance with activities of daily living, such as dressing, bathing, toileting and managing medications. These services assist people to improve or maintain an optimal level of physical functioning and quality of life. They can include help from other people and special equipment or assistive devices, and may involve moving from their home into an assisted living facility. 
Assisted living bridges the gap between full independence and skilled nursing. If you’re unsure how to proceed, ask your loved one’s family physician for an evaluation for the level of care that is recommended at this time.
Some people start in assisted living and then may later need skilled nursing help. Family physicians can often help guide these difficult conversations with families. 
What are some signs that someone is no longer safe to live on their own?
I always suggest taking a close look at your loved one’s home when you visit. Notice if they are no longer able to care for themselves, including bathing and dressing themselves, cooking meals, doing laundry or cleaning the house. Is food spoiling from not being used in time? Is the mail piling up? Are bills not being paid on time?
Pay attention if you see signs they are declining physically, mentally or emotionally. Are they losing weight? Are they lonely? Are they confused or forgetful? Do they need help using the bathroom? Is their personal hygiene slipping? Are they missing doctor appointments?  
How can moving into assisted living benefit the whole family?
Moving into an assisted-living facility creates a safer and healthier living environment for the elderly person. Assisted living also offers more opportunities for socializing, making friends and participating in group activities, which can help stave off loneliness.
Such a change often provides relief for their caregivers, too, who are stretched thin. Spouses may have trouble sleeping and may lose weight from the stress of the caregiving situation. They will be so focused on caring for their loved one that they aren’t taking care of their own medical conditions, putting themselves at risk. 
Oftentimes family members can finally start to relax a little bit once their loved one is in assisted living. While it is one of the hardest decisions to make, it can be one of the most rewarding. 
Dr. Donald Mack is a family medicine physician who specializes in caring for geriatric patients at The Ohio State University Wexner Medical Center.