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Caregiving Reality

Moving to Assisted Living

Photo by christian koch on Unsplash

Recently I have been in the position to witness a number of people making the transition to assisted living. This can be a very difficult period of change, fraught with stress and emotionally upsetting moments. In this article I will discuss some helpful ways to make the move to assisted living a less difficult experience.

Let’s take it from the top. Every move to a new home is stressful and this doesn’t get any easier the older we grow. Minds and bodies become less flexible and we have less energy. So have a lot of patience for your loved one who is moving to the assisted living facility, even when they seem a bit unreasonable or needy.

Every move to assisted living is unique to the person and the facility they are entering. Recognizing the uniqueness of every move is important, but in spite of that truth there are two basic kinds of moves. The first type of move is one by someone whose life situation would benefit from assisted living, but in spite of this need for a bit of added help they still retain their mental abilities. In this situation perhaps they simply no longer wish to be responsible for their own residence, or perhaps the frailty of old age means they need someone around more often. For this person the move is something they can understand and recognize for what it is. On the other hand, the second kind of move is by someone who is in some stage of dementia. Their mental abilities are failing and their ability to understand the move is impaired to some degree. They may have a limited ability to understand what is happening, or very little understanding at all.

Some of the tips I will give for promoting a smooth transition for a person in the first group can be applied to someone in the second (dementia impaired) group. That said, the worse the dementia the more a person will not be helped by tips applicable to an able-minded person.

If The Person Moving Does Not Have Dementia

  • Talk about the move in advance. Maybe you are a son or daughter trying to convince your parent that now is the time for the move. If they are resistant, don’t just force the move through. Take the time to explain the reasons why you think the move is necessary, and then listen to them. For many people it is very traumatic to leave a home they have lived in for a long time, perhaps as much as fifty years. It might take some time to convince them, and if they are persuaded they will need time to process, talk about it, and grieve this life transition and the things they are losing.
  • Involve the person moving in the process. In theory this might seem obvious–the person moving has to be involved in the process–but in practice the adult children often feel they don’t want to burden Mom or Dad with all of the decisions that must be made. It can also feel like less of a hassle to make all of the decisions for the parent. Both these impulses have an unintended side effect of keeping the parent moving to assisted living out of the loop. For the person being moved this lack of information can be very stressful. Of course you don’t need to involve Mom or Dad in every little decision throughout the moving process, but don’t leave them sitting in a corner clueless about what is happening either.
  • Be clear about how many physical possessions can come. A move to assisted living is usually a downsize. If this is the case, not everything the person currently owns can come to the new residence. A reduction in possessions must occur. The further in advance of the actual move that you downsize what needs moving, the less stressful the actual move will be. In the worst case, if you totally neglect this point and (for example) move Mom and she finds out she can’t keep a quarter of her things, it will be emotionally devastating for her. It may feel very tedious to figure out how much stuff can come to the assisted living facility in question, but making the effort to do this in advance will make the transition much smoother.
  • Visit often. If you can’t visit because of distance or time constraints, then keep as in touch as much as you can through whatever means possible. Be as present as you can in the period leading up to the move and in the period immediately after the move. All the best efforts in the world can’t completely remove the stress of this move, but the more the person who is moving feels like they are not alone the less stressful it will be for them. And after they move there is often the fear that they will be forgotten. Keeping in touch will put this fear to rest and enable them to feel more at home in their new life.

If the Person Moving Has Dementia

If someone moving to assisted living has only very mild memory impairment the above tips can still be very helpful. However, the worse the dementia the less helpful the above tips will be. If someone is suffering with significant memory impairment some of the above suggestions can become downright counter-productive. So here is a list of tips specifically for those suffering with memory impairment to help them in the transition to their new home.

  • Provide as many familiar objects as you can in their new home. Sometimes a person with dementia moves across the country to be in a facility close to a loved one. In such situations it may not be feasible to move all of the old furniture they were familiar with, but as much as possible decorate the new home with familiar objects to bring recollections of the old home. This will make the memory impaired person feel more comfortable.
  • Put up notes in the rooms reminding them that this is their home. It can be very alarming for a memory impaired person to feel like they are in a home that is not their own. Also put up notes reminding them where needed things are located and how to use things like the coffee machine, TV, and similar things. Old routines and locations can anchor someone with dementia, and changes in these things can be profoundly disorienting. These notes can help in the process of re-orienting them.
  • Provide something which explains to them why they moved and where they are. What is most appropriate will depend on the person and the nature of their dementia. An example would be a letter left on their coffee table which would say something like, “Dear Mom, I hope you are enjoying your new rooms! You are now living at XYZ facility. You moved on DATE XYZ. If you need anything you can call me at XYZ.” This can help reorient them to where they are and why.
  • If possible provide opportunities for your loved one to reflect positively on the past. For example, create photo memory books for them to flip through, and hang old photos on the the wall. Memory books in particular can help a person with dementia feel connected to their past when unfamiliar surroundings can make them feel adrift.

Along with all these tips, don’t forget to reach out to the resources available in the assisted living facility itself.

There is no magic fix to remove all of the stress associated with the move to assisted living, but with thoughtful planning and patience the move can be much less difficult than otherwise. Good luck with your move!

Photo by Jarosław Ceborski on Unsplash

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