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Nursing Homes – How To Make An Informed Decision


Many of us find ourselves in the ‘sandwich’ generation, so described because while we may still be parenting our own almost grown children we are also faced with the responsibility of caring for our parents. While for most of us it is an honor to help our parents find the very best lifestyle and living arrangements available it can still be a challenge to help our parents continue to enjoy independence and dignity while ensuring their safety and their health.

This subject is close to home for me. My mother was hospitalized this week due to a fainting episode, the origin of which is not yet diagnosed. This isn’t the first time she has had a fainting/falling incident. She has been living on her own in another state where she has her entire network of friends. She now is of the opinion that she needs to be close to her family, here in Orange County. However, she wants her independence and her own space. By fall we will have all three children in college.

Orange County, California is one of the most magnificent places to live whether you are 1 or 100, so it is no surprise that the OC also offers a variety of living arrangements for the feistiest senior, like my mom, as well as for those who may need various degrees of assistance.

In starting the process of finding the best place for my mom, we first had to determine, what level of care does she need? Handling this can be sticky, because it can surely cause hurt feelings and a feeling of the loss of independence, dignity and control on her part.

There are several options available. There are independent living apartment-style arrangements in an activity filled senior setting with meals provided. Then there are various degrees of assisted living where seniors retain their own living space and have whatever combination of other daily living assistance and monitoring is appropriate.

Generally your seniors will require living arrangements in an assisted living facility when they are unable to independently perform what is termed ‘Activities of Daily Living’ which include: eating, bathing, dressing, toileting, and transferring. While these terms sound very clinical they are a critical measure of a senior’s ability to live independently, because they have been found to be ‘significant predictors’ of admissions to nursing homes; use of paid care; use of hospital services; and living arrangements, according to the U.S. Department of Health and Human Services. Deciding what level of care is required will drive your search of living arrangements, as not all living arrangements may have the assistance that a particular senior needs.

That brings up another question you might want to consider when helping your parent[s] pick their living arrangements. Even if your parent[s] is fully able to prepare meals; take their medications on time; and do light housekeeping, you may want to try and estimate how long they will be able to care for themselves independently, as you may want to help your parent[s] choose living arrangements that offer additional care when needed. Keeping this in mind may be helpful, as it seems the older we get the less we like change. So picking living arrangements where there can be a smooth transition from independent living to assisted living might be a great option to consider. This is my mom’s choice. She doesn’t like change.

Many senior living/assisted living arrangements offer the independent living choice at a more reasonable fee, and then the parent can add services needed for an additional fee, but without having to totally move and change their surroundings. My mom likes this idea.

Another consideration for you may be whether or not your parent[s] will be able to keep their own furniture or at least some of it. One of the most upsetting parts of leaving the family home to go to another living arrangement includes having to leave everything that is familiar to your parent[s]. Many living arrangements offer not only the ability to have some familiar furniture and collectibles, but also allow a small pet, which can be a great comfort for a parent[s] who is physically able to care for one. My mom doesn’t have any pets, but bringing some of her furniture with her is a high priority for her.

The next question, of course, is the safety of the living arrangements, and whether they are licensed and if they have had complaints or lawsuits filed against them. In California, you can access the California Department of Community Care Licensing Services or please check the California Department of Social Services for a list by region, including all phone numbers and addresses.

Additionally, the Department of Social Services has just released its first Adult & Senior Care Update this April 2007. For your information, you may want to call the State-wide Senior Care Program Office for in depth questions as to suitability and safety. Their information is as follows: Ben Partington, Program Administrator; Lori Peterson, Staff Services Manager; 744 P Street, MS 10-90, Sacramento, CA 95814, and the phone number is: 916-657-2592.

Another consideration, depending on the extent of care and the health of your parent, is how close are the hospitals in the area to the sites under consideration? And, even though your parent may not need emergency care right now-how soon might they? When my wife’s mother recently had a stroke, one of the reasons she recovered so well was because she was so close to the hospital at the time of the stroke.

Next, you will likely want to think about convenience-for you. I am. Studies show that elderly people thrive more and are less likely to be victims of any kind of abuse when they are visited often by family. So, it only makes sense, all things being equal, to pick living arrangements that will allow for frequent visits. We are looking at facilities within a 15 minute drive.

For those who are considering living arrangements for their parent[s] in Orange County, I really like the Orange County Department of Aging site. At this site you can search for licensed living facilities, offering a wide range of services from independent to assisted living to 24/7 care, by entering the desired zip code, name of city, or even the name of a specific senior living facility. What I really like is that each result gives you a link for a map to its location. Once you have chosen several locations you can investigate further by a visit to each location of your choice. Take your time and investigate! Help your parent[s] find a place that will feel like home and will be safe for them. Find a place that is convenient to the family.

Here we are helping mom choose an independent living facility and helping the children choose their colleges. All three children will be in new colleges this fall. One is just starting. One is transferring from a two year to a four year college. And one has finished undergrad and starts law school.

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