When is it best to transition someone to assisted living?

1 answer | Last updated: Sep 17, 2016
A fellow caregiver asked...

Is it better to transfer a person to a nursing home while they still kind of know what's going on and could make the adjustment or wait until they really don't have a sense of "reality" and hope that they don't really realize what's happening? My sister & I care for our 87 year old mother who has dementia. Mom attends adult day services during the day while we work but the problem times are more at night. The dementia compounded by 2 sleep disorders can mean that she sleeps all night or can be p 15-20 times in one night! She thinks there's people in the room or something has to be done etc. She also talks long into the night. Mom's been with us for almost 6 years and we've both developed health issues and are pretty burned out. She has NO short term memory and is easily confused. We would like for Mom to stay with us but it's getting more difficult to get her up in the a.m. and agree to going to Daybreak. Then she keeps us up half the night so we're not getting rest. I looked into having someone come in for the overnight hours but the cost is almost as much as a nursing home per month! Any suggestions would be appreciated.


Expert Answers

Brenda Avadian, brings knowledge, hope, and joy to family caregivers for loved ones with Alzheimer's and dementia. She cared for her father with Alzheimer's and helps families one-on-one and in groups. She is the author of eight books, including the pioneering memoir "Where's my shoes?" My Father's Walk through Alzheimer's and the Finding the JOY in Alzheimer's series. She presents vivid, compelling, and funny keynotes to both professional and family caregiving audiences.

When to transition someone to assisted living depends on you and your sister.

Although, you've cared for her for six years, it sounds like you're both getting exhausted.

The answer to your question then depends on how often your mother has those nights when she gets up frequently versus the nights she sleeps.

Also, the adult day care center can provide you with some guidance since they see and interact with her, daily.

Care Options for Your Mom

  • You and your sister can take turns getting up to help your mom when she needs help.

    If she doesn't need help each time she gets up, you can catch up on your rest.

  • You can hire in-home help one night a week.

    This will take the pressure off of you while not costing as much. I suggest breaking up the week and hiring help on Wednesday if you work Monday through Friday. Alternating each week to two nights a week (Sunday and Wednesday or Tuesday and Thursday) will still cost you less than a nursing home.

  • You can try out assisted living for a week while you take a respite.

    This will give you time to catch up on your rest and even feel re-energized. You may even consider a board and care for a more home-like touch with only five or six residents.

Trying these options one at a time will ease the pain (guilt) both of you may feel as long-term caregivers for your mom. It will also help you to ease the transition into long-term care for your mom.

If you wait too long, the care facility may not accept her. This is a possibility.

Bottom Line: Your mom may surprise you and thrive in assisted living.