What to Do When a Parent Refuses to Go to Assisted Living or a Nursing Home

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While some older adults willingly move to assisted living facilities and nursing homes — knowing they need more support and care — others dig in and refuse to leave their homes. If this is happening with a parent, “You have to identify the reason why,” says Dr. Susan Leonard, assistant clinical professor of medicine at UCLA Medical Center.  “Older people value their independence,” Leonard says, and when they lose their ability to take care of themselves, they may not want to face it. It may cause them to lose hope, she says.

It will likely take time — and multiple conversations — for you to show them that things are changing and that they need to accept help. Talk with them and let them know you’re worried that they’re not eating properly, or keeping the house clean, or if they’re falling more often (bruises on the limbs can be a sign of this). These are all signs that they need additional care — probably an assisted living facility. If they have vision and hearing loss combined with arthritis, diabetes, Parkinson’s or other chronic condition, discuss your concerns about their health and the need for a bit more care. Talk with them about the benefits of living in a place where they don’t have to worry about cleaning, grocery shopping, and cooking.

Start slowly with care at home

If a parent still won’t budge, Leonard suggests easing into it. “Maybe begin with caregiving at home first,” she says. Hire a home health aid or nurse a few hours a week and increase it as needed. Get a parent used to a trusted but non-family member helping out.

Amy Goyer, AARP’s Family and Caregiving expert and the author of the book Juggling Life, Work, and Caregiving, recommends talking with your loved one about other changes that need to happen to reduce the risk of injury if a parent wants to stay in their own home. Suggest getting someone to help with transportation (if their driving is becoming difficult or there have been accidents), and moving their bed to first floor.

“Or set up meal delivery. Almost anything can be done in this age of so many home- and community-based services. I’m a strong advocate of aging in the home,” says Goyer, who cares for her 92-year-old father, who has Alzheimer’s, in her own home.

When it’s no longer safe at home

If things are more serious, if your loved one has had a fall, for example, and there’s been a hospitalization and surgery, then explain that it may not be safe for them to return to their own home (especially if they live alone) and that they need to stay at a nursing home or rehabilitation center where medical support and help with bathing and dressing is necessary as they’re healing. Explain that it’s not necessarily permanent.

Another approach is to plan in advance with a parent before they become sicker. For example, if a parent has cancer and is still able to live at home but may need more medical support down the road, do research now and find assisted living facilities or nursing homes together online. Then set up a tour and meet the staff.

“Some places will allow a temporary visit. A parent can do it almost as a trial run. That may be a way to ease into it,” Leonard says.

Acknowledge that change is hard

A move may be especially hard to process for someone with dementia. “Any change can be very aggravating for the individual. It causes behavioral disturbances. Usually initiating a transition is hardest, but it gets better with time,” Leonard says.

Most of all, be aware that when a parent moves, leaving behind a home full of memories and often beloved belongings, they may go through a grieving process. “It’s important to let them go through all those emotions and to try to not minimize it. Let them be frustrated and angry. Let them be sad,” Leonard says.

That means that you have to acknowledge the difficulty of the move as well.  “When you try to dismiss it and say ‘it’ll be fine,’ then they are more likely to try to fight it. They have to process it, to have it click in their mind that this is my reality. It’s better to say, this is the reality. It’s change. It’s going to be hard but we have to focus on your health and safety,’” Leonard says.

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