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Carol Bradley Bursack, Published May 25 2013

Minding our Elders: Choosing assisted living facility challenging

DEAR CAROL: My mom has mild Alzheimer’s disease and really shouldn’t live alone anymore. I’ve been helping her look at assisted living facilities and we’ve narrowed our choices to two. One is nicer than the other, but more expensive. We feel Mom can pay for approximately five years at the nicest AL, but if she lives longer than that she’d have to move because of money issues. If she took the less nice one now, she could stay longer. How do people make these decisions when so much is unknown? – Nichole

DEAR NICHOLE: As you indicated, we can’t know what will happen in the future. We can plan, but we have to be prepared to make adjustments in our plans – sometimes major adjustments.

You are wise to take this step while your mom can still take part in choosing a home and before her disease progresses to the point where she is frightened by changes in routine or environment. Unless your mom has a strong preference, I think I’d base the decision on how much difference there is between the two facilities. If the less desirable assisted living center is significantly deficient, then I’d go with the nicer one. If there isn’t a lot of difference, and all other things are equal, I’d take the lower priced facility because that could mean your mom may not have to move when her money begins to run down.

An important thing to consider, though, is whether or not the facilities have memory care units. It doesn’t sound like your mom needs that type of comprehensive care yet, so she probably wouldn’t start in a memory unit. However, if the facility has a designated dementia/memory unit, an eventual move to that kind of specialized care within the same facility may be less traumatic for her than moving to a completely different ALF. The less a person with dementia has to move the better, because moving to an unfamiliar home, or even a different room, can be upsetting.

Remember, too, that if your mom has other significant health issues she may eventually need to move from assisted living to a nursing home. What I’m saying is that no matter how well you plan, your mom may have to move from the room or facility that you choose now to a more advanced care option.

Whatever decision you make, don’t blame yourself if down the road you wish that you’d made a different decision. That’s one of the hazards of caregiving. We have to do the best we can with the information and assets we have available at the time.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.