Preparing For Assisted Living Arrangements: Bringing Your Parent Home
Assisted Living Arrangements- Bringing Your Parent Home
The second in a series of articles based on a personal blog written by Cathy Jason, owner operator of A Senior Blessing. The blog focuses on the path Cathy took in preparation for her mother’s eventual long-term stay at her house. The process includes an exploration of the initial thoughts of uncertainty that she faced; to the steps she took in preparing her home for her mom’s arrival, to practical suggestions as to how to make the home environment as comfortable as possible for her mother’s stay.
Cathy’s retelling of this process is insightful; it is a narrative full of tips and practical strategies benefiting to those of us facing the inevitable question of long-term care for a parent. Especially when it’s a decision that has our parent moving into our home to live with us.
Preparing the Family and Home for What’s Ahead
One of the first questions that comes to mind and one that is constantly asked of me is, “So Cathy, what do we need to do to make our home as safe and comfortable as possible for our parent?” Such a great question! And one that needs addressing prior to your parent coming home to live with you. But, first things first, let’s address the first step when considering bringing your parent home to live with the family.
Step 1: The Initial Meeting with the Family
The initial family meeting is so important. It addresses and identifies not only the question of safety and comfort for your parent, but it prompts discussion for other areas of responsibility that the family needs to consider.
There will be many topics to cover. As the family dynamic will inevitable change. Living with a parent with special needs and limitations requires sensitivity and commitment by all family members, so it is important that everyone living at the house participate in the meeting. Emotions may be high, as some freedoms that we take for granted at the home, will suddenly be challenged. As such, new responsibilities to assist in the care of the parent should be defined, explored and discussed. Additionally, extended family that support the parent in other ways may also want to be included in this initial meeting. Modern technology allows a family to stay “connected” even if they cannot be together. Consider setting up a video phone conference call via Skype, or use Apple FaceTime Video Chat, or Facebook video conferencing. In short, the immediate and extended family does not need to be in the room physically, but can still participate in real-time during the meeting via video chat.
To keep the meeting on track, I had an agenda prepared that everyone could follow. I recommend having one person be the facilitator, this person should be assertive enough to keep communication flowing and to ensure that everyone on the call or video conference is being heard. It is also this person’s responsibility to make sure that questions are answered and areas of responsibility are assigned.
All participants on the call or at the meeting should realize that this may not be the only meeting that takes place. Rather, it should be an ongoing conversation with a standing date and meeting time. Things change and new decisions for your parent need to be addressed. As I noted, it is important to have this meeting with your immediate siblings that are able and willing to participate; and if your children are age appropriate, invite them to be active participants as well. The focus of the meeting needs to have all participants working towards this specific goal: What outcomes will be best for mom or dad? And what is workable and realistic for the family to consider as appropriate support to the new living arrangement?
Topics for the First Meeting:
- Who will the parent live with?
- Who is the main care giver?
- Can we hiring in home caregivers to help main caregiver
- Who chooses a care giver company?
- Determine budget for care
- Do siblings share in the cost of the care?
- Will the Main Caregiver work full time, part time, or not at all
- Living will (is there one?)
- Power of attorney? Who?
- Medical power of attorney? Who?
- Medical instructions (providing a DNR if that is desired)
- Short term options
- Long term options
- Who handles the finances?
- Adult day care options
- What to do with your parents’ home?
- Who will be responsible for overseeing the home sale?
- Who is responsible for their belongings? An estate sale? Etc.
- Whoever takes care of your parent must take time away with their spouse and children to keep their marriage and immediate family healthy! this must be agreed upon.
As you can see, these are some tough question to navigate through. Some, more so than others. Another question that I often hear is this, “Are Mom (or Dad) a part of this initial meeting? I believe it depends on the parents emotional and cognitive capacity. If your parent suffers from intermediate or an advanced stage of Dementia or Alzheimer’s, for example, then having them in the meeting would not be appropriate as the conversation and decisions that are reached could be beyond their comprehension due to their condition. If, on the other hand, the parent is self-aware and able to reason and communicate their opinions, then their participation and involvement is important. Just remember that they may, in time, forget the decisions that were made. Even decisions that had their initial support. A recording of the meeting may be appropriate to help reinforce the decisions that were reached during the meeting. If possible, getting a parents’ conscious support of their future living arrangement with the family is essential.
So, the agenda was followed, all the participants were in attendance and the meeting was a success! Areas of responsibility were assigned and the family has decided that grandma is coming home to live with the family. Now take a deep breath because it is important to not rush this decision and move grandma in too quickly. Take time to assess and prepare your home environment and living space. Do you remember when you were bringing a newborn home from the hospital for the first time? Some of the same preparation needs to be done. It took us a full month to complete all we wanted to have in place before we moved mom in with us.
Step 2: Readying Your Home:
Here are some steps we needed to take in preparation for my mother’s long term stay with the family and some you should consider as well:
(Your list might be much shorter or longer)
- Install an alarm system. The door sensors chime when a door is opened and alerts you when someone is coming and going. This is great if your family member is prone to wandering day or night. Gives you the ability to know what’s going on in your home.
- Clean the carpets and flooring (we have a dog, cute and clean, but a dog)
- Add motion sensor night lights in their room and standard night lights around the house
- Check all fire, smoke and carbon monoxide alarms ( replace them if needed)
- Pest control- is there standing water that might draw misquotes?
- If necessary, order a wrist device that, for their dignity, looks like a watch but is a tracker GPS device (if they are a wanderer) you can track them with your phone. (We decided to order a bracelet that has all of her information on the back, instead.)
- Their bathroom (this is one that took the longest as we had the bathroom completely redone.) We made the space safe and fresh for mom. We removed the tub and turned it into a large tiled shower with a low step entrance and ADA rails. The showerhead has an overhead faucet as well as a handheld one. The water faucets have a temperature regulator in it to protect her from getting burned. The toilet seat is at ADA height. She loves this space and now actually likes to take showers! This is worth every penny!
- Fresh, calm, neutral paint for her room as my darling daughter had loved her pink and salmon walls (French theme)
- Create their spot. Maybe one comfortable chair in the living room and one in the family room so that they know they can go read or watch TV and they are not in someone’s spot. Also, it needs to be easy to get in and out of. Think easy to clean and wipe up also.
- Dining table (Ours was one of those cute high bar tables with high chairs. Completely impractical for a 92 year old! We had to get a lower one as she had great difficulty getting on and off the high chairs!)
- Order a light weight, ergonomic, folding wheel chair if necessary (we use it for long walks. i.e. going to the zoo). mom loves being escorted about. This has been invaluable!
- Order a walker for those longer walks when they want to stay upright (Medicare will pay at some suppliers for a walker or wheel chair)
- Fire extinguisher up to date and charged
- Housecleaner (check into pricing and references) I opted to do it myself
- Create an emergency folder ( if you have a DNR and all health care information, including list of medications and emergency numbers of family members as well as their doctors numbers)
- Get CPR certified (you will feel more confident in any emergency)
- Heart defibulator unit (not sure correct name) unless you have a DNR
- Large First Aid kit
- Contact their pharmacy and set up having their medications delivered to you at your home( you will love this) we get them in a blister packs and keep them in a cute container box with a master list of all medications to know what to reorder to keep it organized
- Decide who is responsible to fill the box each week and keep track of the refills needed( mom takes 8 different kinds!) it is nice to share this responsibility as you are already doing a lot ( my kind husband does this chore for me)
- Evaluate Health Insurance options. Maybe need to add or take away features in plans as they may not have been looked at in years.
- Set up first the doctor appointment with their main doctor to get a baseline of how their health is and what to expect. You will now be their advocate and their eyes and ears. Most likely a full annual exam with blood work. Evaluating meds to make sure they are all still all necessary.
- Make time for the first few months doctor appointments for: their Alzheimer’s evaluation, dentist, dermatologist, eye exam, possible hearing exam (mom and let all of these go and needed new glasses, got hearing aids for the first time, and she had cavities) I needed to be in the meeting with the Alzheimer’s evaluation as I could then ask questions specific to her situation’s. You now need to be in all these visits to be their eyes and ears. You are now their advocate and memory. These visits will keep you busy at first but then things settle down when all the medical is in balance. This way you can make sure they are taking only medications they need. Now they can get blood work done as needed. (this may have been ignored before) Dr. visits will be on a more moderate pace.
- Get a physician’s request for a handicap hanger for any car they ride in to take to the DMV if your parents has difficulty walking this will be very helpful for the future. This has proven to be invaluable as some days she is able to walk just short distance. Or when it is raining this can be very concerning to her. For me too, it is hard to walk in the heavy rain holding an umbrella over the two of you long distances.
- Look up your local areas Alzheimer’s care giver support group they usually meet once a month. I cannot stress how important it is to be in contact with other caregiver’s going through the same things you are.
- Look into a store that can deliver groceries in a pinch (in California, Von’s Grocery store is one of the providers of this service) you can order and pay online.
- Look into “Dr. on demand” in your area if that would be an option for you to skype the visit after you have your baseline with that Dr. It is a relatively new program that could be very useful to you. Especially in bad weather or if you are far from town or out of town traveling.
As you can see, addressing the tough questions that come with relocating and supporting a parent with special needs during the initial family meeting, and accommodating your home to meet the needs of a parent will require a lot of commitment and organization on the part of the entire family.
I knew that my family could handle the changes and challenges that bringing my mom home created in our lives. In my job as a consultant to families looking for living assisted options for their parent, I constantly remind them that the journey of caregiving is all about good clear planning and being flexible; enjoying the ride, and honoring and loving your parent. When those areas are considered, the memory and family experience that you will have with your parent is well worth the challenges you and your family will face.
Next: Preparing and Providing Workable and Enjoyable Living Spaces for Your Parent.