When to Consider Assisted Living/Board Care vs. Living at Home

Caregivers and family members who are new to residential care options for their elderly loved ones may be unfamiliar with knowing when the appropriate time has come.

For some, the following questions may have already crossed your mind?

• What is residential care?
• How does someone qualify for assisted living outside of their home?
• What signs am I looking for that make assisted living a suitable option for the elderly adult?
• Where does the line fall between transitioning to assisted living and recruiting assistance for home?

First, one assumption needs to be cleared up:

Just because somebody is elderly does not mean that they automatically belong in an assisted living facility.

Many elderly adults live out the rest of their lives at home safely and efficiently. However, some elderly individuals live with specific circumstances in which assisted living becomes a viable choice.

Now, let’s break down and assess some of the red flags that family members/caregivers should be monitoring.

Three main reasons why the benefits of assisted living would outweigh the benefits of living at home:

• The elderly adult can no longer complete necessary, functional tasks at home safely and independently.
• The elderly adult lacks a support system (family, friends, caregivers, guardians, etc.).
• Professional home health is not working (i.e. not available or not improving the safety of the elderly adult functioning at home).

The following items are observable examples of why an elderly adult may not be able to complete certain tasks independently and safely within their own home:

Poor posture and balance: This only becomes a problem if there is an increase in falls, an inability in getting to other rooms safely (the bathroom, the bedroom, the kitchen, the stairs, etc.).

Severe loss of balance should be a red flag if certain compensation measures have been taken and aren’t working such as use of a walker, a cane, or a wheelchair.

Incontinence: In general, incontinence is a disruption in typical toileting patterns for bladder and bowel removal. This could include medical problems concerning the bowel and bladder, the physical inability to get to a toilet independently, long-term use of catheters or colostomy bags, etc.

Incontinence without assistance leads to filthy living environments, infection, and skin breakdown/wounds.

Memory changes: Increased forgetfulness or loss of memory is common with aging adults. It becomes a safety concern when the home becomes a hazard or when tasks become dangerous: forgetting to turn off the oven, leaving doors unlocked, overdosing on or forgetting to take medication, or wandering off and having no memory of how to get home.

In some instances, standard assisted living care. In more severe cases of memory loss, memory care placement should be part of the discussion.

Vital problems: Persons with respiratory, diabetic, or cardiac-related illnesses may have trouble living at home independently if maintaining healthy vitals (heart rate or respiratory rate) is an issue.

This may include difficult in independently managing blood pressure medication, glucometer readings and insulin, prescribed diets, and supplemental oxygen.

Remember, elderly adults living at home have the option of exploring home health supports as well as increasing those supports when changes arise. Assisted living comes into play when home health supports no longer provide safe living at home anymore.

Note: Residential care or assisted living in California are non-medical facilities, so certain medical conditions that require specific nursing attention may not be allowed.