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When to Consider Assisted Living

Aging isn’t easy. Caring for an older adult isn’t easy either. There are the health challenges, managing medications, keeping them safe and occupying their time. Because of these stressors, at some point, most adult caretakers consider whether they should move an elder member of their family into independent or assisted living arrangements. The big question many older adults and/or adult caregivers face is when the right time is to move them to an assisted living community and how to make those plans.

What Is Assisted Living?

Assisted living communities can offer different services, but all of them give older adults the support they need to continue living as independently as possible. A study from the Centers for Disease Control and Prevention shows that 28,900 assisted living and similar resident care communities are serving more than 900,000 U.S. residents. There are over 70 facilities in Atlanta alone.

These communities offer a part of a whole range of senior living options. Typically, they provide more medical staffing and support than a senior independent living community. Yet, they are designed for adults that don’t need the constant attention they’d find in a nursing home or a hospital. The residents at an assisted living facility may need assistance due to movement issues such as arthritis, deteriorating muscles, dementia, or other chronic medical conditions, but aren’t considered sick. These residents might require is assistance with bathing, dressing, toileting, cleaning, activity or medication reminders, and other activities of daily living (ADLs).

Meals are usually included for assisted living residents and are served in a group setting that encourages residents to socialize. People in assisted living communities typically have a private apartment or a shared room. These facilities might also include amenities such as physical therapy or light exercise, activities, and entertainment. This type of setting focuses heavily on social engagement. Group activities such as exercise and discussion groups, dining, outings to shopping, entertainment and other area attractions keep residents engaged physically and cognitively. Additionally, many have beauty shops on-site and facilities on-site visits from podiatrists, audiologists, dentists and other medical professionals, making it a very convenient option for those with transportation challenges or adult children not able to accompany them for these visits

How to Know When It’s Time for Assisted Living

It’s hard to gauge when to make the transition to a senior living community. There are sometimes definitive signs, such as a fall or the inability of an older adult to take care of themselves. Yet, it really depends on the individual and their caregivers.

Instead of looking for a sign, consider the following questions as a way to give some perspective.

  1. Is the senior living a healthy life? Are they getting exercise and eating balanced meals regularly? Is there fresh food in their refrigerator?
  2. Is the senior getting around safely? Can they transport themselves to the grocery store? If they are still driving, are they doing so safely? Are there bruises or minor injuries on their arms or legs from walking accidents?
  3. Are they staying clean? This does not only means bathing regularly but also wearing clean clothing each day and not the same outfit multiple days in a row. Are they laundering their bedsheets and cleaning the house?
  4. Is the senior remembering to take their medications correctly and on time? Are they able to request and obtain refills? The older we get the more medications there are, each with singular instructions for dosages and times.
  5. How are their current health conditions being managed? Is medical care needed more frequently for medical conditions like Alzheimer’s, Parkinson’s, Diabetes, etc.. Do they need more support to remember physicians orders and understand the necessary questions to coordinate care between physicians?
  6. Are they experiencing mood swings or becoming increasingly angry? When someone begins losing their memory or other cognitive abilities, they may become more scared, depressed, aggressive, and antagonistic. This can make a caregiver’s role even harder and perhaps unsafe for the senior as well.
  7. Can they still cook for themselves? Do they sometimes forget to turn off the stove or other kitchen appliances? If so, it is also a good idea to check the refrigerator periodically to make sure they are grocery shopping regularly and able to get to the store.
  8. Are bills being paid on time and accurately?
  9. Do they have friends whom they go out with or still talk with on a regular basis? Do they have hobbies? How much of their time is empty or spent in front of the television? When seniors begin to show signs of cognitive decline, social isolation can often be a defense mechanism due to embarrassment or fear of making a “mistake.” Social isolation can also contribute to increased cognitive decline and depression.


Most adults see themselves as younger than they are. But we all have to be honest about our limitations as we grow older. This can be a fact at any age. Seniors must ask themselves the above questions honestly and caregivers must try to be unbiased. In the end, the main question is: does this person need more help than they can get living independently?

If you still need help deciding what’s best for you or a loved one, or if you are currently having the conversation about moving to a senior community, AgeWell Atlanta has care managers that can help with these decisions. AgeWell Atlanta is also connected to supportive communities that customize support levels based on the needs of the individual. Our professionals bring a great knowledge base and a third-party perspective that can guide families toward a decision.

Initiating the Transition

Many seniors don’t want to think about going into a supportive care community. Many caregivers don’t want to have that difficult conversation. However, the sooner these conversations happen, the better.

It can be much easier moving to a new location, especially after decades of independent living, if it’s a choice that’s not instigated by a traumatic experience. Moving a loved one after a major health crisis or while grieving the loss of a spouse magnifies those emotions in an already fraught situation. However, talking about these decisions while the family has the time and space to consider options rather than in crisis and needing an immediate solution can lead to better outcomes. That isn’t to say that feelings of guilt or anger can be prevented. These emotions may be reduced if when there is a crisis—an unexpected fall, hospital stay, or unmistakable sign of advancing dementia—families have already created a well thought-out action plan.

Some families find that speaking with a doctor, a financial advisor, an attorney or even a counselor who works with families facing these challenging situations very beneficial. These advisors can help in determining when the right time to move is and how such a change will be executed. These professionals also benefit from understanding how other families have handled the same issues.

Similarly, keep in mind that trying to make the decision through consensus of all family members can be challenging. Moving a loved one often means conversations about the family finances, wills, and the legal arrangements that need to happen in advance. If the senior has a condition such as Alzheimer’s, then it’s important to establish powers of attorney, living wills or advance directives. The more siblings and relatives who are involved often equates to more differing opinions. Consider who should be asked for advice and who should make the ultimate decision, not least of which is the senior.

Once the Decision is Made to Move to Assisted-Living

Many experts say it takes between 3-6 months for someone to adjust to assisted living. The first 3 to 6 weeks can be particularly emotional for both the adult children and the senior as everyone, including the community, transitions to their new roles and new routines. The best thing to do is see what the individual needs. For some, visiting often will help them adjust to the new surroundings. In others it might trigger feelings of abandonment or anger so a regular phone call might be better. Setting up the senior’s apartment with all their own furniture, photos and trinkets is also very important for continuity and comfort, particularly if the senior has cognitive impairment.

The important thing is to stay focused on why this move is important such as for safety, health, security, and sanity. Don’t lose touch of those reasons while dealing with the roller coaster of emotions during those first few months.

Become your senior’s advocate within the assisted living facility. It may take a little while for the staff to get to know your loved one. They will look to you for guidance on interests and care. Encourage your loved one to get involved, and join them for meals and activities. They will still need you.

Once everyone gets more settled in all parties will benefit from the decision. If you need help with any part of this process, contact AgeWell Atlanta. They have the contacts and resources needed for seniors, caretakers, and their families.