My father-in-law is turning 86 this December and lives alone in a small town close to Kansas City. Many of his friends have moved to new living arrangements or passed away. He isn’t able to play golf as he used to play nearly every day in the summer. My wife worries about him being safe, about his memory, about him driving, falling, etc. Is it time to discuss new living arrangements with him? Yes. But his answer is “no.”
He is not unlike many of our relatives; wanting to live at home, remain independent, and not worry about the cost of moving. However, he has increasing physical and medical needs that range from assistance with walking by using a cane to certain transportation help. Home maintenance is not easy, and I am certain his home is not to where he would normally expect it to appear or function. His social networks and neighborhood have been limited dramatically as well.
The challenge we are all facing is how and when to begin the discussion of alternative living arrangements and at what point are we forced to make the decision for our loved ones. As you begin this journey, take stock of the current status or level of function of your relative. Go through the following steps:
- Level of Care. The future is impossible to predict, but maintain realistic expectations about capabilities and what needs will arise in the coming years. If a medical condition exists that may worsen, what does that mean? If you are unsure, do some research or ask their physician. Are you already at the point where you or they need help?
- Location and Accessibility. Even if completely independent at this time, circumstances can change. How far are they from existing support and assistance, shopping and groceries?
- Social Support. How easy is it to visit friends and engage in social activities?
- Caregiving Support. Family members will occasionally need help to meet the needs of the individual.
- Finances. Create a budget now and investigate long-term health insurance options.
*Lawrence Robinson, Joanna Saisan, M.S.W., and Monika White, Ph.D. September 2013.
These issues will be important as you determine the level of need of your loved one. The holidays often prompt these discussions as family members are home and able to spend time with their aging parents. You may choose to assist them in remaining at home, or moving to an independent living, assisted living or nursing home. You do have options, and it’s important to take time to review the steps above now so you can make informed decisions about their future needs.
Gregory Sweat, MD, is the Medical Director of the Shawnee Mission Physicians Group and practices Family Medicine at Shawnee Mission Primary Care - Prairie View Medical Building.