Assisted living without local family

[Anonymous]

My mom lives alone in a senior independent living building in a city where she has many friends but no family. We are beginning the process of getting a higher level of care for her. For right now we are bringing caregivers into her apartment but wondering if assisted living makes sense.

One option would be to bring her to an assisted living facility in my area, but there are lots of reasons why that isn’t a great choice. I am wondering if people have kept their aging parent in a distant city and how that worked out for them.

[Anonymous]

“Assisted living” is a term of art. Typically higher level of care than alone at home (with gradations) but below a skilled nursing/rehab facility. What do you want from the “assisted living” facility that she’s not getting at home. There are good assisted living facilities but they seem less regulated than skilled facilities and the ones we looked at all seemed quite willing to dump our person on the sidewalk if they were ever perceived as a problem.

[Anonymous]

When you have a elderly parent in assisted living, memory care or nursing home, it’s best to have family or other trusted people nearby so that they can visit regularly, check up on things, and be an advocate if needed. This is especially important when the elderly parent is cognitively impaired.

[Anonymous]

My mom is in a good one in our hometown; the family takes turns visiting, but the center handles things like getting her medical care, keeping track of her various needs, etc. So while she wishes we lived closer to her, she doesn't want to move, and her needs are met

[Anonymous]

You can hire a geriatric to advocate for her, keep track of medical issues, take her to appointments and communicate with you with her permission. It's expensive, but they know the system better. Usually they keep a big binder with all medical information and add to it accordingly. They tend to know the right questions to ask as medical appointments and what can and cannot be requested at AL.

Keep in mind if you move her near you, so much is up in the air and what will happen with your life as you know it. I do know cases where it was a relief and it was easier to include mom and visit and mom remained gentle and kind.

My mother became very needy and volatile and she was no peach before aging. Siblings seemed to think their job was to call me with commandments. Even when an emergency happened with a sister visiting, she still thought I should be there too. It didn't matter that I handled dozens of emergencies ALONE, the expectation turned into I should drop everything for mom at all times and my health/spouse/kids/job/sanity didn't matter. So even moving mom near, we ended hiring out. Let me tell you, what i did for free is worth A LOT of $$$$. Nobody thanked me for the years of coordinating care and being emergency contact I did, but wow did they complain when someone had to be paid to do it.

[Anonymous]

Continuing care community.

[Anonymous]

Anonymous wrote:Continuing care community.

Worth a shot, but many of them want residents to move in when they're still able to manage living independently

[Anonymous]

No matter how good the facility, you need a roster of visitors. The people who get the best care not only have strong advocates (paid or family member), but staff never knows when a visitor might pop up.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Continuing care community.

Worth a shot, but many of them want residents to move in when they're still able to manage living independently

Accurate! That is why convincing your parents to move into a CCRC while still healthy is key. It's a lifesaver, especially if no family lives near them. My parents did it 5+ years ago and it has been the best thing. Still in Independent living in mid 80s.

[Anonymous]

There are people who work as “Geriatric Care Managers,” who can probably provide the kind of distance supervision you’re looking for, but they are not inexpensive.

Depending on personal preference, getting a local church or other affinity organization into the picture might provide local eyes and ears.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Continuing care community.

Worth a shot, but many of them want residents to move in when they're still able to manage living independently

OP here, the facility where my mom lives now has both independent living, and assisted living. It doesn't have skilled nursing. So, one option is to move her within the same facility.

[Anonymous]

My grandmother lived in assisted living in Florida. I think one son and his wife lived locally but don't know how often they visited. Everyone else lived in NY. It was fine.

[Anonymous]

Obviously, what your parents want should rule.
If you can arrange a roster of vistors, living far away shouldn't be a deal breaker, if you can make phone calls/FaceTime meaningful. Frankly, that would make your in-person visits special.

[Anonymous]

My mother has Alzheimer's and is in Assisted Living several states away. We have one elderly family member in the area who is cognitively with it, but cannot really visit due to their own physical limitations. I fly down and rent a car every 6-8 weeks. I am in regular touch with the staff when I'm not there and am always ready to jump on a plane as needed. My mom has several friends there but this continues to drop off the longer she is in Assisted living. I often think about moving her closer to me but she does not want the cold and re-establishing doctors and her care systems would be a challenge. She likes her facility (as much as one can) and her room. It's hard going back and forth, but I can afford it and have a flexible enough job that it's possible. If she was close by I think I'd be running out to see her and deal with little problems constantly. All of the staff and her doctors are aware of the situation, and when I'm in town I spend a lot of time connecting with staff to see how she is doing. I schedule her dr's appointments when I can be in town. It's not easy, but she is as comfortable and happy as she can be and that's important to me. We have multiple direct flights to her city each day which helps because I often have to jump on a plane on short notice, or I go one a one way ticket and wait to see how things are going before leaving. Flexibility is crucial in this setup!

[Anonymous]

Anonymous wrote:Obviously, what your parents want should rule.
If you can arrange a roster of vistors, living far away shouldn't be a deal breaker, if you can make phone calls/FaceTime meaningful. Frankly, that would make your in-person visits special.

If you have her in assisted living in my experience it's safer and more socially engaging, though there is an adjustment period where you may feel awful for pushing it. It's much easier when they are agree right off the bat. It's not all sunshine and roses, they see people get ill and lose friends, but there are so many social activities and they always have people to eat with and people who will notice if they don't show up for a meal. I found it's also easier to have others visit the AL. When they age in place, my experience has been there is more hesitancy because the person is more likely to be needy-not as much social interaction with peers and it can be depressing. Visiting AL is less stressful because you can go sit in a garden area, the person has peers greeting them and isn't complaining about being lonely (though may complain about peers/foot/staff) and it's easier to make an excuse to leave.

Also, I found it helpful to be so grateful to anyone who visited even once. I personally found it unrealistic to schedule "a roster of visitors." If friends want to visit they will, same with family. You can't really dictate it, even with your own siblings. People will offer to help, but keep expectations low. If you parent is very pleasant, you probably won't even need to think about this because people will enjoy visiting. It's more if the parent becomes more difficult/agitated or even if the parent is nice, but childlike and needy. Sometimes their friends don't want to be reminded of what their own future may hold and they know they only have so much time left and don't want to spend it being brought down.