How to Navigate the Transition from Nursing Home to Assisted Living

When my grandmother was in a nursing home, she really struggled to enjoy her time there. She resented being taken away from her home, where she’d lived for most of her life. My grandmother was a very creative and highly intelligent woman who wanted to live out the rest of her days on her own terms, in her own way—and in her own home. Aside from her children, her home was the last remaining connection she had to her late husband.

i-homecareWhen my grandmother was in a nursing home, she really struggled to enjoy her time there. She resented being taken away from her home, where she’d lived for most of her life. My grandmother was a very creative and highly intelligent woman who wanted to live out the rest of her days on her own terms, in her own way—and in her own home. Aside from her children, her home was the last remaining connection she had to her late husband.
As the years went by, I watched her health slowly deteriorate as she grew more depressed. It was the best my family could do for her at the time. There weren’t any quality programs nearby that offered assistance for aging in place. And we didn’t know anyone personally who had aged in place successfully—it just seemed expected that everyone moved into nursing homes at a certain age.

When you lack real life examples and surrounding support, it can be hard to trust new approaches. I’ve always wondered how her final years might’ve gone had she been able to live at home; how much happier she might have been. From time to time I’ve also wondered: did she really need to be in a nursing home in the first place?

Benefits & Challenges of Aging in Place

There’s no doubt that nursing homes provide an invaluable service. But do all nursing home residents actually need to be there, or are some able to transition to aging in place? A 2011 AARP article states that up to 12% of nursing home residents are categorized as low-need patients. In 2010, a Cornell University study revealed that over 50% of low-need patients “could transition back into the community with the right social supports.” It’s possible that—with that support—many seniors might actually be able to live more independently by aging in place.
While nursing homes are wonderful places for older adults who need round-the-clock care, they’re not necessarily the ideal place for people who are able to live on their own with just a bit of outside help. If your loved one is a low-need patient living in a nursing home, it could be that aging in place can offer them a greater sense of independence, and increase their overall happiness. It’s estimated that 90% of older people want to age in place. Continuing to live at home or in a community is, understandably, important to your loved one.
With the right support, aging in place can offer numerous benefits to both caregivers and their loved ones. In addition to helping the older adult feel happier and healthier, aging in place means that family and friends can visit more often. Most family members and caregivers feel more emotionally grounded when they know their loved one is at home. Of course, the benefits only occur if you have proper assistance to make sure your loved one is being cared for— otherwise, it’s too stressful (and potentially harmful) for all involved. Especially when transitioning from a nursing home, most older adults will need assistance from outside their home to stay healthy and safe.
That’s where programs like the ones provided by the Institute on Aging come in. If your loved one is aging in place, proper services will make all the difference: home care and support, social day programs, and health services allow your loved one to feel safe and secure while remaining relatively independent. For example, you can hire a caregiver to come into the home on a regular basis to ensure they are receiving proper medical care, or undergo training to equip yourself to become their caregiver. You can also accompany your loved one to social programs held by local organizations: you get to spend more quality time together, and your loved one will be far more engaged with life.

Steps to Take When Considering Leaving a Nursing Home

Of course, if your loved one happens to be one of the low-need patients currently living in a nursing home—and doesn’t need to be—the transition back to an assisted living community or aging in place can be tricky to navigate. There are challenges for both sides: the patient as well as the family and/or caretaker will all be affected by the move. Below, we’ve listed two key steps to take when considering a move. While each individual’s situation will vary somewhat, these general guidelines will hopefully help you approach this complex decision with a greater sense of clarity.  

1. Determine whether they qualify as low-need.

Can your loved one safely adapt to life outside a nursing home?

  • Consider that older adults who are immobile or dealing with particularly complicated illnesses are unlikely to qualify to move from their nursing home. If your loved one needs ongoing specialist care or assisted living, aging in place is probably not the right choice.
  • Reach out to the nursing home staff and doctors to get a professional opinion on whether they feel your older adult is eligible for this type of move. Conversely, talk to staff at your local assisted living facility to hear their take on your situation.
  • Check in with your loved one to find out what they think about a move. Consider having a professional therapist speak with them. This creates a safe space for your loved one to share how they really feel—including any fear and anxiety—and what they truly want.

2. Establish whether they will have sufficient support away from the nursing home.

Is there enough service and care available for your loved one beyond the nursing home?

  • Ask family members what they can offer in terms of in-house support. If they can’t provide enough support, figure out how much they can do (financially or otherwise). Check whether proper medical care is easily accessible.
  • Explore assisted living facilities in your area. Visit them in person and inquire about their services and fees. Look into community programs that offer social activities and healthcare for aging adults living at home.
  • Network with folks who are part of an assisted living or aging in place community—both older adults and their caretakers. Ask questions and listen to their thoughts. They might end up being your biggest allies and sources of ongoing information and support.

The unifying theme here is to seek as much information as possible. Arming yourself with practical facts will help you and your family rule out options and see which ones might hold promise. Aside from info-gathering, talking to people who’ve been in your situation can decrease emotional stress. Consider reaching out to online forums as well. Taking action and reaching out for support will reduce anxiety for both you and your loved one. And remember, there’s no right or wrong here—the best choice is the one that respects both the older adult’s and your family’s circumstances and desires. If you want more details about assisted living and aging in place, don’t hesitate to get in touch with us here at Institute on Aging.

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Institute on Aging

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Three and a half years ago, Maggie Fang started her journey as an Assessment Specialist in the Support at Home Program at IOA. Her excellent people skills enabled her to manage a caseload of older adults and individuals with disabilities, helping them receive homecare to age in place. Maggie was selected to pioneer the Temporary Respite Caregiver Support program, and we are delighted to have such a skilled and dedicated individual leading our newest program at IOA. Thank you, Maggie, for your exceptional work! 

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