Tough Choices: When It’s Time for A Skilled Nursing Facility

There are many conversations you’ll have to have in your lifetime, but one of the most difficult ones may be with your senior loved ones. As they get older, you begin to notice red flags that may point to them not being able to live at home anymore. How are you supposed to tell them you think assisted living or a skilled nursing facility is the safest option? How do you know when this next step is necessary? It’s a delicate dance, but the following tips should help.



Keep a Careful Watch

Whether you live near or far, it’s important that you, a relative, or friend check in often to watch for signs that may point to it being time to seriously consider assisted living. Does your loved one have a hard time with basic tasks such as making food, cleaning, laundry, and keeping up with bills? What about with necessities of daily living like bathing, dressing, toileting, grooming, and eating? Have they been injured or had a fall recently? In addition to the physical signs, look at the mental signs as well such as memory loss, difficulty with familiar tasks, issues remembering time and place, frequent confusion, and mood changes, all of which may point to early-onset Alzheimer’s disease.

Weigh Your Options

If you are just beginning to notice subtle signs, you may not be ready to make the jump to assisted living just yet. There are other options to consider, all of which should be carefully considered:


  • Home modifications – If your loved one is having issues such as getting in and out of the tub, senior home modifications could be the solution by installing a zero-step entry tub, grab bars, or widening doorways. The average cost of an aging-in-place remodel is $9,000, but this will depend on how much needs to be updated.
  • In-home caregivers – In-home caregivers are a possible solution as well, especially if your loved one doesn’t yet need 24/7 care. These caregivers can help with activities of daily living, administer medications, and provide companionship.
  • Moving in – If you’re able to do so, you might consider having your loved one move in with you. This means split bills and maybe some extra help around the house or with the grandkids, but the biggest factor is time. How much help do they need? Do you need to drive them around? Will you be there 24/7, or will there be periods of time (such as when you’re working) when you’ll be away?
  • Assisted living or Skilled Nursing – It may be the case that assisted living or 24 hour skilled nursing care is the logical next step, so you’ll want to include your loved one in choosing an assisted living or a skilled nursing facility. You can easily use an online search tool to filter facilities by budget, room type (private/semi-private), and features so you can narrow down the ones you’d like to visit.

Having ‘The Talk’

Although you may have already decided that assisted living or skilled nursing is the safest and most realistic choice for your loved one, you still have to have this conversation with them, and it can be difficult. Bring it up at an appropriate time such as after a minor event such as forgetting to pay bills, a non-major fall, or a time when you weren’t able to be there for them right away. Have a conversation as opposed to giving orders, and let them voice their concerns. Encourage them to come with you to at least look at facilities. The discussion is a process, and you may find it helpful to have a mediator such as a counselor to help everyone sift through their feelings, emotions, and concerns.

Discussing assisted living with your senior loved one can be a difficult subject to broach. But if you’re noticing red flags, it needs to be discussed. If assisted living is the next step, remember it is a slow process that takes time to accept.

This article was exclusively written for our Dry Harbor readers, by our dear friend Hazel Bridges of AgingWellness.