Making the decision to move an older person from their home to a place where they can live safely is a tough choice for all involved. A move to an assisted living facility is one option. These facilities provide care for people who need services such as medication reminders, meals, transportation, and some assistance with activities of daily living, like bathing and dressing.
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Why might a person resist moving to a place where than can get help with daily activities? Fear is a common reason. Home has a deep symbolic meaning for most people, representing safety, security and identity. People work hard all their lives for their home and the thought of leaving home is something that people resist.
Concerns about money may play a role. Many people believe that Medicare will pay for long-term care in an assisted living facility and then are shocked to learn that it doesn’t. Medicaid is limited in the help they provide in an assisted living facility situation. Plus, not all assisted living facilities accept the Medicaid waiver program. Finally, there is a long waiting list to get the Medicaid benefit for assisted living level of care.
No matter why a person is resisting a move, waiting too long can have serious consequences. Though waiting too long typically doesn’t directly cause legal problems, a person who may be resistant to moving may also be the type of person to put off creating the estate planning documents that everyone needs (Will, Durable Power of Attorney, and Advance Directive for Healthcare.) This procrastination can create many legal headaches for family caregivers.
Consider the Power of Attorney and Advance Directive for Healthcare, two essential estate planning documents where a person names the individuals they authorize to make financial and medical decisions for them in the event they are incapacitated. Anyone who puts off creating these documents who later becomes incapacitated is unable to give anyone that authority. They have missed the chance to create the proper authority. This creates legal problems that family caregivers will have to solve. The solution often comes in the form of petitioning the court for guardianship over the elderly relative, legal procedures that are difficult, costly, public, and the source of much conflict.
The irony here is that saying no is a way that many older adults preserve some sense of control. However, saying no to creating estate planning documents guarantees that the older adult will have no say in life-altering decisions once they lose capacity. An older adult who puts off creating these documents who later loses the capacity to execute them gives up the ability to choose which facility they want to live in. They also lose the ability to choose who gets to make financial and healthcare decisions for them.
Saying no to assisted living again and again can also have care-related consequences. An older person who is struggling to manage the activities of daily living today isn’t going to find those tasks any easier to manage tomorrow, next month or next year. Waiting too long often means that the older adult’s needs increase to the point where assisted living is no longer an option. From a mobility and cognitive standpoint, if an older adult waits too long, he or she might not meet the admission criteria for assisted living. For these folks, waiting too long amounts to a choice to go to a nursing home.
There are also social consequences. An older adult living alone often lacks the opportunity to interact with others. This makes them more vulnerable to isolation, loneliness, and depression, all of which can hasten physical and mental decline.
And then there’s the impact on family caregivers. In many cases, it’s the spouses, sons, daughters and grandchildren who are picking up the slack, turning themselves inside out to allow their loved one to live “independently” at home. That independence is usually an illusion however, and eventually, even the most patient and well-meaning family caregivers will buckle under the pressure. These situations are often the source of much conflict in families.
Here are some steps to take if you are facing this situation:
Do Your Homework
First, use your favorite search engine to compile a list of assisted facilities in your loved one’s area. Fine out as much as you can about each one, and then identify two or three that look promising. The elder care coordinator at Burzynski Elder Law is familiar with the assisted livings in Southwest Florida and can be a resource to help our families find the right fit.
Tour Assisted Living Facilities
If your loved one is open to looking at assisted living facilities, arrange to tour the places you think are most promising.
Use Short-Term Respite as a Trial
Many assisted living facilities offer short-term respite care, anywhere from a week to a few weeks. This is a great way for an older adult to experience life in the facility. If your loved one is willing, arrange for a respite stay. In many cases, people who initially resisted the idea of assisted living warm to it after a respite stay. It’s worth a try!
Know going in that your loved one may still say no to assisted living, even after you’ve taken all the steps outlined above. If your loved one is of sound mind, you cannot force the issue. However, you might benefit from help from professionals who work with situations like these every day. Elder Care Coordinator Sue Hendricks urges clients to seize the opportunity to experience the quality of life that assisted living can offer.
At Burzynski Elder Law, we specialize in helping older adults and their family caregivers navigate the challenges of aging. If you would like to learn more, call us 239-434-8557. We can help you begin your road to better planning.