How to help them do what's best

Strategies for When a Parent Refuses an Assisted Living Facility

by Paige Estigarribia

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Moving a parent to an assisted living facility can be a stressful transition for both parties. Sometimes parents can be very resistant to any kind of transition towards to another type of living or care arrangement. Sometimes they even refuse to consider an assisted living facility.

To help loved ones dealing with this kind of resistance, we reached out to Debbie Drelich, the founder of New York Elder Care Consultants, LLC, for some tips and advice. Here's what she had to say:

Q: Is there a time when family members should begin discussing assisted living facilities as a possible option for care?

Ms. Drelich: I believe that when family members observe their elderly relatives are starting to slow down, it is best to have a discussion as to what options for care they might need in the future, whether it be home care, independent living, senior housing, assisted living or a nursing home. It is important to have an honest discussion. Make sure the relative understands about the plusses of all the possible options. Often people hear things and retain wrong information. This is far better than having the discussion after or in the midst of a crisis. When the actual time for this arrives, some of the sting of the idea will be less. An extreme example that I can share from my work goes back to a time that I directed an independent living facility. Two daughters brought their dad in to meet with us, and he seemed particularly sad. I learned this occurred a week after his wife died. Clearly this was not the best time to have the discussion! His transition was very difficult and painful, though he did eventually settle in.

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Q: What is the best way to bring up a possible assisted living facility transition?

Ms. Drelich: I think it is best to be honest and open from the earliest of conversations. It is sometimes helpful to point out to the parent that this is also for the child's benefit, not just for the older person. For example, saying something like, "Dad, I am very concerned about how you are managing. It worries me to see you like this." Very often older people do not want to be a burden on their family, and in the process, they may even hide things from them. If the family member can openly and caringly stress their concerns, this often makes all the difference.

Q: What can you do if your parent is resistant or completely opposed to an assisted living facility?

Ms. Drelich: Most older people are not jumping for joy to move into assisted living. The need for it is generally a result of a loss, such as the loss of a spouse, financial or physical difficulty in maintaining the home, etc. Therefore, one has to be sensitive to their resistance, and rather than fighting it by saying you have to do this, take the time to hear what they are saying. You may have to back off for a short while, and then gently bring it up again at another time. A trusted physician or clergy member may also be helpful in joining in the conversation about their changing needs and the benefits of relocating.

I remember one daughter who had gotten into the routine of flying down to her mother in Florida at least once a month. When the mother wound up in the ER, she finally told her mother that she was terribly worried and wanted to be able to respond quickly to these emergencies, but she shared that the frequency of these trips were affecting her work and her marriage. Hearing this, her mother finally agreed to move back to New York into an assisted living facility, which was a short drive away from her daughter's home. The positives of this became that it would be less stressful for her daughter and she would be able to see her daughter and family more often.

It is also important for the parent to hear that their adult child is not looking to run their life and he/she is seeking to have the parent be informed about all available choices. This may include saying to them, "Would you come on a tour of some assisted living facilities, so you are familiar with the options out there? It would make me feel better."

Q: Do you find that there are some strategies that work better than others when explaining an assisted living facility as a care option for an aging parent?

Ms. Drelich: I have often found that emphasizing that living in an assisted living facility can enhance their independence and can enable them to have their needs met without having paid caregivers in their home at all times. This is a particularly good argument for older people who really want their privacy and hate having caregivers around. If the older person was at one time more social (and now isn't because of friends/loved one's deaths), I might emphasize that this is a way to not be alone and to have people around to share activities and meals with once again.

If they were a homeowner, I might emphasize that this would be a great way to not have to deal with the stress of maintaining the home, including managing shoveling snow and other repairs.

Lastly, I might also explain that an assisted living facility could provide for a multitude of needs, including doctors on site, physical therapy on site, activities, meals, etc.

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Q: What is the one thing that many people forget to think about when dealing with a parent who is refusing an assisted living facility?

Ms. Drelich: I believe it is that people are afraid of change, and because they currently living in the same location that they raised their family in, there may be very strong emotional component to change. In addition, they may be afraid that they will not be able to manage the physical aspect of the move. They may need reassurance that help with the move will be provided, either by the family or by a senior move manager (a fairly new specialty), and that the family will continue to be involved, perhaps even more involved.

Reviewed September 2017

Debra Drelich, LMSW, ACSW, CMC, is the founder of New York Elder Care Consultants, LLC, a Geriatric Care management and consultation firm that provides assessment, care planning, and implementation and ongoing monitoring of the needs of the elderly.

She has worked in every facet of the senior care industry. Prior to starting New York Elder Care Consultants, Ms. Drelich directed two Senior Apartment Communities, ran a private Geriatric Care Management department of a large geriatric institution, and worked in other community based agencies serving the elderly. She served for two terms as President of the New York Chapter of the Aging Life Care Association, and she also served on the executive board of the national association of the organization.

Paige Estigarribia is a writer for The Dollar Stretcher who enjoys writing about food, frugal living, and money-saving tips. Visit Paige on Google+.

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