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How to Tell When It's Time for Assisted Living

As the song says, there’s no place like home for the holidays. There’s something special about going home at this time of year and finding comfort in the traditions and memories of childhood. When it’s time to leave, however, you may be taking a few gnawing concerns with you.

It’s not uncommon to notice changes in our parents as they age and health declines. If you’re among the thousands of Americans with aging parents still living on their own, you may find yourself wondering how to determine if home is still the best option for them.

It can be emotionally taxing to see someone you love unable to fully take care of themselves when they used to be the one taking care of you. Those feelings can be amplified by the reality that there’s only so much you can do to take care of an aging parent until it becomes overbearing and inhibits your ability to live a normal life and be there for others who depend on you.

Senior care professionals use an evaluation developed by Sidney Katz, MD and his research team first published in 1963. The Activities of Daily Living (ADL) measures independence based on a set of basic activities, ranging from the most complex bathing activity to the least complex feeding activity. Each activity has equal value of importance in Katz’s scale. A number—one if you can complete the task, or zero if you can’t—is assigned to each category. Once that is done, you add up the numbers. The higher the score, the more independent a patient is able to live.

Other types of more broad activities are evaluated to get a deeper understanding of the type of care a senior may need. These activities are called instrumental activities of daily living, or IADLs. These include activities like:

  • Paying the bills
  • Cleaning the house
  • Cooking food for yourself
  • Being able to transport yourself outside of the house
  • Socializing 

While senior care professionals use tools like these, there are important observations that you can make that will help you determine if you and your aging family member should consider a senior care community. “Changes in our parents’ cognition and health often develop slowly over time, but it’s important to be aware of these changes and how it’s affecting the way they live,” said Eric Bernard, Director of Operations for the Assisted Living division of Elderwood, a leading senior care provider.

There are several signs that it could be time to consider Assisted Living.

Worsening Medical Conditions

As our parents age, the likelihood they develop a chronic medical condition increases dramatically. The AARP reported that more than 70 million people (aged 50 and older) have at least one chronic medical condition, and these can be debilitating issues like Alzheimer’s disease or heart disease. When seniors with conditions like this get older, they need more and more medical attention and are less capable of taking care of themselves.

Money Problems

Seniors may have less of an ability to keep up with all their financial responsibilities. Bills that pile-up because seniors either don’t have the motivation to pay them or they simply can’t are important warning signs. Diseases like dementia also affect seniors’ ability to think abstractly and handle numbers on a complex level. This can lead to difficulties when doing taxes or taking care of multiple bills at one time. Seniors can also often be susceptible to financial scams, whether it be from telemarketers or their own family members. These scams can put seniors in debilitating financial spaces, which can prevent them from taking care of themselves—if they live in their own home or not.

Hygiene and Frailty

While a loved one may have some level of ability to take care of him or herself, a big sign it may be time for assisted living is the lack of motivation for doing so. Some signs of poor hygiene include messy grooming habits and a bad odor, which could indicate they aren’t bathing as often as they should or doing laundry. Seniors can also start to become frail as they age, meaning they look skinnier or thinner than usual. This can be caused by poor nutrition, or something more serious like a medical problem that hasn’t been addressed yet.


Senior isolation is a serious problem. More than 11 million seniors live alone, according to the U.S. Census, and isolation can affect seniors’ overall health. When seniors isolate themselves, that means they decrease how often they participate in things their hobbies, social interactions with family and friends, or just simply leaving the house at all. Isolation can lead to depression and other health issues. It can also accelerate cognitive decline.

What is an Assisted Living Community?

Assisted living facilities offer 24-hour support and may include various levels of healthcare support and personal care. Usually, residents in assisted living don’t need as much care as those in nursing homes.  Assisted living offers seniors the ability to get assistance with certain care and tasks while still maintaining the independence and socialization they need in an apartment like setting with many amenities. In many instances, depending on the licensure of the facility, residents can age in place - never having to move away from their assisted living residence. 

Assisted living residents often do many activities on their own, but not enough to where they can comfortably and safely live alone anymore. Residents usually have their own living space and are still allowed to socialize with other residents freely. Meals are provided to residents, but some facilities allow patients to cook for themselves (if they are able).

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