The thought of moving can be overwhelming for anyone, but is particularly frightening to seniors. My experience has been that most seniors aren’t aversive to actually living somewhere else as much as they are the moving process itself and the magnitude of the decisions that have to be made in a short time span. This thought process often leads more seniors back to bed than to action......

Determining When to Move

There are several indicators of when a move should happen:

1.  When the care needs of the client exceed the abilities of the caregiver:  Sometimes the  physical assistance, geographical issues, and time constraints simply aren’t doable.

2. Social Isolation:  When a client is no longer able to drive, has physical mobility issues, loses a spouse, etc. , the ability to interact with peers diminishes radically. This is a leading cause of depression and nutritional decline (who wants to cook for one?  why bother?).

3. Can’t afford the cost of in-home care:  companion care-giving costs about $12-15 per hour;  certified nursing assistants cost about $14-18 per hour;  LPN / RN cost about $25-45 per hour. This can add up quickly if the assistance needed adds up to more than 20 hours per week.

4. Resistance to in - home care:  Some clients are so fearful of being robbed or taken advantage of, that they won’t allow anyone in their home. Other clients are too regimented or controlling for in-home care to work.

5. Maintenance / up-keep of  the home is too overwhelming:  this becomes obvious in older homes as yards, plumbing, electrical, roofs, etc. decline.

6. Safety Issues:  clients with memory loss or dementia can simply become too much of a safety risk to manage at home.

What Living Arrangement Alternatives Are Out There?

Unfortunately, most seniors and their families seem to feel that there are only 2 options for living arrangements:  home or nursing home. This is simply not true. There are many alternatives in between: 

1. Independent Living:  This is an apartment like setting that has amenities available to its residents, but they must be self sufficient with care. Some arrangements offer meal plans and transportation. Apartment costs range from $1250 to $2000 per month, but usually include utilities.

2. Assisted Living Facility:  This type of setting provides a room or an apartment with housekeeping, meals, social activities, personal care and services, medical monitoring, and transportation. Some facilities are large and resort -like;  others are private homes with one or two bedrooms for residents. Basic ALF care can cost from $1500 to $3500 per month depending on the size of the living area and the amount of assistance required.

3. Nursing Home:  This type of facility provides room and board  with a planned, continuous medical treatment program including 24 / 7 skilled nursing care, personal care, and custodial care. This type of setting caters to clients that require a large amount of assistance for activities of daily living. Average monthly cost: $4800 per month.

4. Continuing Care Retirement Communities:  This setting offers all of the above under one roof. The clients usually have to pay a fairly steep entrance fee, but  have a reduced monthly fee for the level of care, and the guarantee that they will always have whatever  they need - even if they outlive their finances.   Entrance fees vary widely, but start at about $50,000 for a one bedroom apartment. Some entrance fees are refundable within a certain time span.

Before The Move........

There is a lot that needs to be done before the move:

1. Research!  Use the internet;  ask for recommendations from friends / pastors / doctor/ family

members; seek professional advice from a local Geriatric Care Manager; call the Dept. of Elder Affairs to get a listing of the licensed facilities in your area; visit health fairs;  call AARP

 2. Visit the places that interest you:  Go with a friend- make it an outing;  arrange for a tour that will include a meal;  interview other residents; make notes of what you like and don’t like.

3. Ask the right questions:  Pets allowed?, parking arrangements, guest apartment availability; church service availability, transportation, activities, exercise / wellness programs, computer accessibility, laundry assistance, what’s included with the monthly fee?

4. Locate and price out moving companies:  There are movers that handle everything - it may be worth the extra cost.....check on availability; make sure that the company is licensed and bonded.

5. Measure the space that you are moving to:  this will help with deciding what to take....

The Move Itself......

Moving day is very emotional and stressful for all. Here are some tips to keep the stress down:

1. Hire help to do the packing:  there are professional people that do this, or a companion can assist with this in a more relaxed situation.

2. Label boxes by room:  this makes set up on the other end much easier

3. Have help available on both sides: helps to smooth the way

4. Get the mom and dad out of the way:  watching this process is stressful and emotional. Get them engaged in a fun activity somewhere else so they can‘t see it in progress.....

5. Personally handle items that are valuable or sentimentally important:  nothing worse than losing that prized heirloom....

6. Set up the room on the other side completely: you want mom and dad arriving to a finished product - not a pile of boxes and debris.

Reasons for Resistance to Moving

No one likes to give up their comfort zone. Change is hard for all of us. The most common reasons for resisting the moving process are:

1. Fear of the unknown:  What if I don’t like it?  What if I don’t make any friends?

2. Changing a routine:  We all have our little rituals... moving means  change:  sometimes this might just be a timing issue, but often it involves changing doctors, food preferences, friends, sleep patterns,etc.

3. Can’t handle the moving process:  the less required of the aging parent in this process, the better.

4. Too many decisions to make all at once:  this can be reduced by not trying to get rid of everything all at once. Take what you think will be needed, and lock up the rest. Decide on what to get rid of as a separate process.

5. I can’t afford to move:  research funding options. Do a paper cost comparison:  remember that ALF costs include care, food, utilities, housekeeping, maintenance, etc.... The price tag sounds big until you add it all up....Check out long term care insurance policies in possession. Consult with a professional care manager on public assistance eligibility or veteran benefit options.

6. Letting go of memories: many seniors are holding on to memories of life in their home - even though it hasn’t been that way for many years.....

Overcoming Resistance

1. Simplify the process:  don’t overwhelm the resistant parent with detail

2. Visit the facility prior to the move:  walk through the daily routine

3. DO NOT sell the house for at least 3 months:  there is a comfort to knowing that the house is still there.

4. Leave items not taken in the house or in storage:  you can always change your mind and go get something you didn’t think you would need.

5. Have mom and dad “try out” the facility first:  many facilities have guest apartments that enable you to do this.

6. Leave options open:  Reassure the reluctant parent that there are other options if they really aren’t happy after a couple of months.

7.   Keep the companion coming:  have the caregiver come to the facility to help keep the routine normal

8.   Enlist facility staff to help with orientation to new  environment.

9. Never argue with angry parents who have been forced to move:  They have a good reason to be mad...disengage from the conversation, reassure them that you love them, and leave the scene... come back later as if nothing happened and carry on. The message will quickly get across that angry conversation goes nowhere. You are doing the best you can to meet their needs and keep them safe.

Forcing a Move

Sometimes, caregivers have to force a move with loved ones that aren’t capable of making the decision on their own. Here are points to consider:

1. Know what your legal rights are:  you may need legal documentation to support you

2. Get everyone on the same page:  if any family members waiver in the decision, it will all fall apart.

3. Use the strongest point of influence to break the news:  this might be a doctor, pastor, or primary family member

4. Stand firm:  Know that what you are doing is in the best interest of your loved ones!

For more information regarding this or other issues relevant to care-giving, contact:

Elder Advocates Incorporated| 407.898.9080 | www.elderadv.com