12th July, 2018

Author: Prasita Nair, Head of Clinical Operations, Epoch Elder care


In the 21st century ‘assisted living’ or ‘retirement homes’  for the elderly are no more alien words; but there are a lot of thoughts, emotions and big decisions behind these simple words. 


Typically we start looking for a home for seniors when day to day life for them becomes a struggle, they need more and more help in their daily routine or they have developed a medical condition which requires professional care. It is part of our culture and conditioning to look after our old parents and understandably there has been some taboo and discomfort around the topic of homes for the elderly.   When the time comes to make a choice, it has never been easy. Even though it may be the best care option and a step that will improve the quality of their life,  the feeling of guilt and societal pressures may force one to re-think their decision. 


However, things are changing rapidly and more and more people are opting for professional care and homes for the elderly although it is a big decision. One of the essential steps which are part of the decision-making process is, to begin with, an open and honest discussion with the parent, if they are in a frame of mind to do so and what apprehensions can be addressed. With seniors with dementia, this discussion needs to be well thought about and should never be initiated without consulting an expert or the team from the homes.  Several other topics may require more attention like choosing the kind of residential place, type of care needed, finances, transition, changes in lifestyle etc.
Things to keep in mind while moving an elderly parent to an assisted living or retirement home:

  1. Location of the place: One of the points to consider is the location. Ideally, the home needs to be in a peaceful place, in a quiet neighbourhood. It should also be close to a hospital, so emergency care can be sought easily.  The home should be spacious for them to walk inside as well as outside. Good ventilation and lots of sunlight is another important factor. It would be always the best option if the elderly can visit the place by themselves and can share their concerns or approval before the decision making.
  2. Planning finances: Good homes often come at a price - it can either be in the form of a hefty upfront deposit or the service fee in itself. It is important to discuss with the family members concerned- all siblings, spouse etc so that the responsibility of the decision is shared. If the elderly want to pay the expenses by themselves then one needs to ensure that each and everything should be explained clearly to them so that there is no confusion and expectations are aligned. This can be a financially draining experience and one must plan for it. For elderly suffering from dementia, it is not advisable to involve them in the planning so as to avoid a stressful situation leading to further deterioration.
  3. Medical history & assessment: In homes which offer assisted living, typically a medical assessment is done by the nursing team, which includes history taking of elderly, reviewing all medical documents which include their latest review prescriptions, blood tests, investigations. Either way, it is important to handover all medical details as well as details of any existing insurance plan, which can be used during hospitalization. All medication records need to be explained. It is better to have a written history prepared beforehand the assessment so no small details are left out. 
  4. Handover and information: One of the most important aspects is to give as much information as possible regarding the elderly so that a detailed care plan can be made.  This would make the move-in process very smooth and help the elderly face minimal changes in the transition. Some of the important hand over points are:
  • Favourite food and preferences
  • Leisure time and social activities, spiritual and religious needs
  • Daily routine preferences
  • Past hobbies or interests like favourite music, book, movie, actor etc
  • Details on childhood- where were they born, where did they complete their schooling etc

Transition story for seniors with dementia: Since dementia robs you of your decision-making capabilities, developing a story and rationale for why they are moving out of their home is critical.  It is very important that everyone involved in the transition – all family members & staff – are in sync & consistently convey the same message to the elderly. Detailed history, the smallest details about their daily routine and preferences as well as customising their new room like their existing one are all inputs which are critical to the move.
It takes a couple of months for any elderly to settle down in their new home, but once they start getting involved in the activities specially personalized for them or simply following the daily routine, they can be more engaged, active and happy.  Interaction with the team, facility nurses, care attendants as well as other residents gives them a sense of well being and make them socially more active perhaps which they may have been and missed in the past. 


At Epoch we follow person-centred care to help the individual to accept the home and feel similar to what they felt in their own home and do the things which they used to do before. Small steps taken by the team at the home as well as family members can make the move a smooth, comfortable process and the decision a right one.