Kate Prior
Americans savor their independence—and dread needing “care.” As a result, “oftentimes people go to assisted living way after they should,” says Dr. John Morley, professor of geriatric medicine at Saint Louis University. The right time’s also when you (should) stop driving: “It’s when you lose your ability to think clearly. If you can’t remember things that were told to you half an hour before, if you’re wandering off a lot and getting lost, being left alone is a problem.”
Other possible signs can be resolved easily without a move, he adds: “If you’re falling all the time and have less muscular mass,” for example, “that can be helped with physical therapy.” There are also in-home care options, such as AccuCare Home Health Care and Assistance Home Care, that allow you to stay in familiar surroundings but add a little support.
If it is time to consider a move, it’s best to seek assistance early, while you can learn your way around and settle in comfortably. If you delay the move to assisted living, Morley warns his patients, “you will more rapidly wind up in a nursing home.”
Ideally, he says, you start at “a senior center that also has assisted living so the move is just a lateral move; that’s much easier.”
How do you know when it’s time to consider a skilled nursing facility? If you can no longer make your way out in an emergency (a criterion for assisted living) or you can’t reliably bathe, feed, or dress yourself.
Leaving your own home’s never easy, and sometimes it takes a health crisis to precipitate the decision. If you’re living on your own quite happily, then hospitalized for some reason and likely to get better, Morley prefers that you go home to recover. But if you’re on the verge of needing long-term care, this is the time to strategize.
“If you can get the three midnights you need [three whole nights in the hospital], the rehab piece is covered by Medicare,” he points out. “That gets you into a care setting, and it’s much easier to make the transition.”
Make sure your hospital stay is a full admission; if you’re only there “for observation,” you won’t qualify for rehab in a skilled nursing facility. If you find out that was the classification, though, you can appeal—and by the time the decision’s made, you may have your “three midnights.”
“What it takes to get your appetite back is to eat. The main thing is to have choices; we always have à la carte options. We make our menus around what the residents like—just from mid-county to South County, the preferences are different!—and we focus on comfort foods: meatloaf, chicken tenders, beer-battered cod, and there’s always tomato soup and grilled cheese, tons of snacks, ice cream. We work with special diets, but it’s been a long time since we thought about any restrictive diet overall. The doctors aren’t even interested.”
—Pat Hawkinson, Nazareth Living Center culinary director
