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Reducing the Stress of a Transition to Assisted Living

By Julie Hayes | 10/11/2019

The decision to move a loved one to assisted living can be one of the hardest a caregiver can make. However, if we are caring for a loved one with a chronic disease, particularly Alzheimer’s Disease or another form of dementia, it may become necessary to consider assisted living placement if we lack the time, resources or support to continue caring for a loved one at home.

Shifting a loved one’s care to an assisted living facility may seem as if it will relieve many of the stresses of caregiving such as anxiety, depression or feeling overburdened. However, studies show that assisted living placement can instead change the type of stressors a caregiver experiences rather than eliminate them. In fact, the level of stress we feel is likely to remain at the same level, or potentially increase, following an assisted living placement (Whitlatch CJ, Schur D, Noelker LS, Ejaz FK, Looman WJ. The stress process of family caregiving in institutional settings. Gerontologist. 2001;41:462–473). 

There are many sources of stress that may accompany an assisted living placement, such as:

  • Arranging placement. In one study, responders reported numerous sources of anxiety when arranging placement, such as:
    • Finding a location where a loved one could feel safe and comfortable
    • Assuring ideal quality of care
    • Managing forms and paperwork
    • Being placed on waiting lists
    • Finding a facility on a limited timeframe (Zarit, S. H., & Whitlatch, C. J. (1992). Institutional placement: Phases of the transition. The Gerontologist, 32(5), 665-672).
  • Providing continual care. Most caregivers continue to remain involved in a loved one’s care after placement by:
    • Visiting regularly 
    • Assisting with a loved one’s day-to-day activities in the facility
    • Communicating with facility staff
    • Handling care arrangements such as insurance, finances and medication
  • Dealing with feelings of guilt. Even if a loved one is open to living in a facility, we may still feel that we have let them down or have not done enough for them as a caregiver.
  • Handling a loved one’s emotions. While many older adults will adapt to the assisted living environment, others may become unhappy or upset by the change. If a loved one has dementia, they may also become confused or act out due to the unfamiliar environment.
  • Dealing with conflicting opinions from family and friends. It may happen that not all of our loved one’s family and friends will agree with our decision to move them to a facility. This can be especially stressful when those who are unfamiliar with a loved one’s condition, or do not interact with them often, try to minimize a loved one’s needs or our own caregiving efforts.
  • Handling the financial burden. According to the National Center for Assisted Living’s 2018 report, assisted living costs can average to about $48,048 a year.
  • Working together with staff. It’s natural to want to have a say in a loved one’s care, and it can sometimes feel frustrating if the facility staff isn’t assisting or interacting with a loved one the way we want. We may also feel stressed when a facility has staff turnover and the person who originally cared for a loved one changes unexpectedly.

As we help a loved one transition to assisted living care, it is important to prepare ourselves for these potential stressors so we can plan to meet the needs of our new role while still caring for our own mental, emotional and physical well-being. To start, having a conversation with a loved one about their care preferences can help us determine their feelings or concerns about assisted living, the kind of environment they would feel most comfortable in and how involved they would like us to be in their continued care. This can help us make arrangements in their best interest, and to reduce feelings of stress, uncertainty and guilt.

If we are still feeling stressed, the good news is that we are not without help and resources to support us through the transition, including:

  • Placement management services. These services can provide referrals to assisted living based on our needs and the needs of a loved one, and support us both through the challenging process of finding the right facility for a loved one. Use National Care Planning Council’s locator to find services in your area.
  • Pre-transition counseling programs. Many nursing homes and assisted living facilities offer special programs to help a loved one adjust to life in the facility before moving there, and provide counselors to discuss concerns and answer any questions we may have.
  • Caregiver coaching programs. These programs, such as Benjamin Rose Institute on Aging’s WeCare, can provide support and guidance to caregivers while connecting them to community resources for further help. 
  • Mediation services. If the decision to place a loved one in assisted living is causing family conflict, we should not be afraid to reach out to local mediation services to help us reach a resolution. Some mediators even specialize in eldercare issues and can offer informed perspectives on assisted living care.

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Choosing an Assisted Living Facility

Secondary Caregiving: Providing Care to a Loved One in Assisted Living