How Do I help Mom choose between Home Care and Assisted Living?

As Dorothy says in The Wizard of Oz, there’s no place like home. Most of us prefer to live in our homes with comfort, familiar surroundings, safety, and dignity. Our moms (and our dads too!) are no different, and the thought of moving out of their homes can be traumatic. There comes a point for most seniors, though, when they can no longer live safely on their own without help. For example, they may no longer be able to safely prepare meals for themselves, bathe without help, or walk without assistance.

When your mother reaches this point in life, you can help her make wise choices about how to get the help that she needs. Usually, the options boil down to two choices, either (1) remaining at home and receiving help from caregivers, sometimes called companion caregivers or home care aides, or (2) moving to an assisted living facility. If Mom remains at home, she can arrange for caregiver visits on any schedule that she needs. If she moves to assisted living facilities, she will be provided with regular healthy meals and socialization, but not one-on-one care.

Timing, as the saying goes, is everything. If the best choice is to move to an assisted living facility, seniors should do so while they are still healthy and mobile, before they need one-on-one care or assistance, and before external factors like neighborhood safety become a problem. Waiting until the need to move becomes an emergency almost negates the reason for assisted living, which provides assistance with meals and socialization, but usually not with one-on-one care.

Obviously, care needs factor into this decision heavily. As stated earlier, if eating and socialization are the primary concerns that your mother needs help with, assisted living may be a good solution. If she needs one-on-one assistance with walking, bathing, or medication reminders, assisted living may not the answer.

Another thing to consider is your mother’s long-term medical outlook. If Mom has care needs that will increase markedly over time, assisted living may not be the answer. If she will eventually need 24 hour supervised care, such as for Alzheimer’s disease, then a single move, from home care to an Alzheimer’s Unit, may be less stressful for her than to have to make two moves.

One more factor to consider is where your mother’s quality of life will be optimized. What makes her most happy and satisfied? Does she prefer being with groups of friends, or does she prefer “alone time”. Does she prefer to be alone, or would she like playing bridge with friends? Does she make new friends easily and like people, or does she prefer minimal change in her life?

Finally, the choices made must fit within a long range budget based on probabilities of longevity (given family and personal health history). One day in an assisted living facility costs about the same as 6 to 8 hours of one-on-one home care. The difference lies in the care services that are not included with assisted living, but that are included in home care, such as individualized meal preparation, light housekeeping, laundry, individual transportation, and more.

Deciding whether to remain at home or to move is not an easy one and there is no singe right answer for all cases. Whether your mother or father chooses home care or assisted living, you will face a whole set of new concerns in knowing how to decide which home care agency or assisted living facility to select. In the future, I will discuss how to make wise choices when you reach that point.

– Tim


Originally posted 2008-05-09 01:52:00.

Tim Colling
Tim Colling

Tim Colling is the founder and President of A Servant's Heart In-Home Care, which provided in-home caregiving services in San Diego County, and also of A Servant's Heart Geriatric Care Management, which provided
professional geriatric care management services and long term care placement services in San Diego County. Tim has more than 30 years of experience in management in a variety of industries. He held a Certified Care Manager credential from the National Academy of Certified Care Managers. Tim is also a Certified Public Accountant (retired), and received his Bachelor’s Degree in Accounting from California State University at San Diego. In addition to writing blog posts here for the Servant’s Heart blog, Tim also is a regular contributor to and to as well as blogs of other eldercare services provider companies. Finally, Tim is also the president of A Servant's Heart Web Design and Marketing, which provides home care marketing as well as website design and online marketing for those who serve the elderly and their families.

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