Separating Parents for Assisted Living: Tips to Help Them Cope

OldPeopleHoldingHands

My mother struggled with Alzheimer’s for more than twelve years.

For the first five years or so, my father cared for her in their home. Like so many spouses, he outdistanced his resources to cope, and Mom and Dad moved in with my husband and me. We shared responsibilities for their care with my brother and his wife for eight more years.

But as Mom’s condition degenerated, it soon became clear that she’d need to be placed in an assisted living home for those with Alzheimer’s. But what about my father? My dad made a heroic and challenging decision: to move into an Alzheimer’s facility with just six residents in order to stay with my mom.

But few spouses have the opportunity to make that decision. Many face the pain of separation, forced upon them by illness and aging.

Dave Singleton, award-winning writer and Caring.com expert, offers advice for what family can do to ease the trauma and provide support for their loved ones who face separation. Click on Dave’s name to read his entire article, which is excerpted below.

  1. Determine in advance how the relationship will continue.“Before anyone makes a move, encourage your parents to map out how the marital bond will carry on,” says Mary Koffend, president of Accountable Aging Care Management. Of course, if a parent has dementia or Alzheimer’s, it could be impossible for them to make such a plan. But assuming they can, “if Dad now lives in assisted living, then maybe Mom comes over every day for dinner.” Or perhaps she joins in on a regular activity that they can both enjoy on-site, such as discussions, book clubs, craft sessions, games, gardening, playing cards, or watching television.
  2. Ensure that the facility supports the couple.“The key is to promote the couple’s identity as a couple as much as possible, or desirable, for both partners,” says Cheryl Woodson, author of To Survive Caregiving: A Daughter’s Experience, A Doctor’s Advice. “Make sure the facility is convenient for the healthy partner in terms of transportation, access, and schedule.” If transportation to and from the new living facility is an issue, arrange in advance for a loved one or paid caregiver to drive, so that your parents get time together. “Even if it’s brief, at least they talk a bit, kiss good-bye, and off one of them goes,” says Koffend.
  3. Help your parent with feelings of guilt and inadequacy.Chances are the parent remaining at home feels tremendous guilt as well as sadness over the separation. “A parent might feel like he’s no longer honoring his wedding vows, or that he isn’t doing enough,” says Koffend. You can be supportive by being the voice that reminds Dad that he’s doing all he can. Give him a dose of what Koffend calls “reality therapy” — in other words, talk him out of wishing for what can no longer be. “Help parents understand the choices they are faced with, and reaffirm that they made the right choices, emotionally and logically,” says Koffend.

You can find more information about caregiving at Caring.com and information about Dave at http://www.DaveSingleton.com.

Assisted Living: What’s Best for Your Loved One?

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I don’t call my dad at 4:30 in the afternoon any more. That’s because he’s usually playing bingo with his buddies at his assisted living center.

And I couldn’t be more proud. Two years ago, when our family made the decision to move my father into an American House assisted living center after the death of my mother to Alzheimer’s, I was concerned that Dad wouldn’t adapt to his new environment.

I was wrong. It took Dad a while to find his niche in the social circle, but once he hit his stride, he was off and running. Today he enjoys outings with our family, but he can’t wait to get “home” to his routine and his friends.

So what is assisted living, and how do you know which center is right for your loved one? Is it a nursing or retirement home with better food? Here are a few facts to consider:

  1. Assisted living communities are unique. My mother and father lived together for a time in an intimate assisted living facility geared for the needs of those with dementia (although my father did not have dementia and insisted on living there out of devotion to my mom). That facility was licensed for 7 residents and offered dementia-specific care. In contrast, the community where my father currently lives is licensed for more than 100 and offers a wide variety of social programs with varying levels of care.
  2. Assisted living communities provide wide-ranging levels of care. The term “assisted living” is not limited by a national definition. Therefore, facilities can have wide-ranging levels of care, depending upon their individual license status. Some provide apartments for residents with greater independence, and others provide care for the bed-bound or multiple levels of care. Consider your loved one’s needs for both the short-term and long-term as you evaluate assisted living options.
  3. Assisted living provides options for those who do not need nursing home care. Residents who choose assisted living can typically care for the majority of their activities of daily living (bathing, dressing, feeding themselves, mobility) and do not require the assistance of skilled nursing. They are able to maintain supervised independent living in small apartments where a variety of support services may be offered.
  4. Assisted living can be affordable. Assisted living is often a more economical option than in-home health care or nursing home care. Assistance is often available to veterans–a benefit called Aid and Attendance, and those with low incomes can apply for assistance at your local Area Agency on Aging, which can be located at www.eldercare.gov.

For more information on assisted living options or ratings on assisted living facilities in your community, visit Caring.com.

And for an excellent form on evaluating assisted living facilities, visit aarp.com.

Calling Dad

Shelly's mom and dad

Shelly's mom and dad

Today I plan to call my dad. It’s been over a year since he and Mom moved out of my home and into a care facility three hours away near my brother’s home in Rochester, Michigan. The transition was tough. But Mom’s Alzheimer’s was progressing into the final stages, and she needed more hands-on care than we could give in our homes. Now, a few months past her death, we’ve moved Dad into an assisted living home more appropriate to his needs.

When I call Dad, I’m always listening for the things he’s not saying and paying attention to the nuances of what he is saying. Losing a wife after more than sixty-five years of marriage is devastating, and he’s ready to join her. He has a bad heart, and every month or so we get a call that an ambulance has been called to his exercise club or assisted living facility because he’s been seen clutching his heart or gasping with chest pain.

At eighty-seven, he has atrial stenosis, a pacemaker, a DNR, and a staunch aversion to treatment or intervention that would extend his life. He enjoys cranking an exercise bike up to full throttle and riding for an hour. He frequently walks from his assisted living home to the corner pharmacy in zero degree weather. On ice.

At times I feel like the mother of a teenager all over again, as I feel my blood pressure skyrocket as we talk. My father still enjoys life–good food, his children and grandchildren, reading, good conversation, learning. He’s committed to living his life fully, and he’s grateful for all that he has each and every day. But he’s also ready to “launch,” as he puts it. God’s pre-arranged the time. Some days I get calls that the ambulance has been called at two in the afternoon, and by four Dad’s hauling tree limbs around a friend’s yard.

So when I call Dad, I often have to give myself a few reminders. I take a deep breath and tell myself that he’s more than elderly–he’s an elder. I remind myself that loving him means enjoying him, encourging him, listening to his silences, and giving him the right to live his life to the fullest to the end. Love also means exhorting him at times, when his decisions, like all of ours, sometimes stray outside the bounds of love.

I’ll breathe a bit easier when the spring thaw hits and temps come up again. But then Dad will almost certainly dig out his personally-engineered slingshot and head across the death-trap of a road in front of his assisted living home and into the woods across the street to find good targets. The warmer weather will give him an opportunity to walk farther and stomp down a few more fifty-five-mile-an-hour roads that have no sidewalks.

Lord, give me wisdom.