What’s best for Mom? – Home vs. Assisted Living
The politically correct view, and often is the right move, is for Mom to stay in the home as long as physically possible. The government strongly encourages this, as well as the family pocketbook. However, it isn’t always the best option, even when the senior is physically able.
Two major reasons supporting the in-home option are the cost and “The Promise.”
The cost of assisted living in 2020 nationally averaged almost $4,300 per month.* It is indisputable in many cases – “We just can’t afford it now.” But what is “The Promise”?
In many families, “The Promise” is:
“Mom; I will never put you in assisted living. You will always live with family when you are no longer able to live alone.”
And too many families view that as being written in stone, despite what may actually be best for Mom.
Let me tell you about my family’s experience.
My Mom had always heard and assumed “The Promise” meant stay at home. In our case, once necessary to move, she moved in with my sister, an RN with 10 years of hospice experience (Medicaid clients only). And she knew Mom wasn’t going to see any of it – not if she had anything to say about it.
My sister had an ideal house. Mom had her own bedroom, own bath, 3 small dogs, 3 cats and an understanding, supportive son-in-law (my sister’s husband). But things change.
After a year, my sister’s physical health took a big turn downward. She could no longer assist Mom in her daily life and still meet the high expectations of care she had set for herself. My sister lived an hour away from our hometown and my Mom’s social network couldn’t drive to visit. My Mom, very unusual for her, became despondent. She wanted her outside social life back.
To understand my 88-year old Mom better, l will relate my most recent phone call. Because she is an avid baseball fan of the Detroit Tigers, I suggested my next visit could be somewhere near the start of the season. Without missing a beat, she responded with, “We could go to opening day.”
“Uh,oh,” I shouldn’t have said that. Opening Day in Detroit is utter chaos. Trying to back-off, I indicate that Opening Day is too big of a party and I was thinking more of the second or third week.
Mom’s response was, “I am a party girl.”
My response, “It will be too crowded. Too much pushing and shoving.”
Mom’s response, “I can push with the best of them. Besides, I have a walker to help push.”
My Mom’s answers are made in a humorous vein. But you get the idea. She wants to be where there’s activity happening and she wants to be a part of it.
The point? My Mom thrives on social activity and being an hour away from her network, she was not getting it living at my sister’s home. So, what then is the spirit of “The Promise?”
To me, it does not mean, “You will always live here.”
It implicitly means that you promise to give your parent the best possible care within reason.
Our family decided the best option was assisted living back in our hometown. Trust me – this option was not as easily reached as it sounds. My Mom not being financially flush, we discussed what we kids could throw in monthly. Then, we found out about the VA Aid and Attendance Benefit. The VA benefit made the move feasible and within budget.**
In retrospect, it has been a great move. Transportation to her church (she went daily before her moving in with my sister). Bingo available both at the assisted living and away. In addition there is hall bowling, balloon volleyball, meals with friends, movies, exercise classes, regular visitors, and much more. Last year, she was elected and crowned “Valentine’s Queen” at her community – yes, my Mom is a party girl!
“The Promise” has not been broken. My Mom is happier, more independent and as her needs increase, the care is already in place. Staying “in-place” in a too large a home, is NOT always the best option for everybody.
*Genworth – https://www.genworth.com/aging-and-you/finances/cost-of-care.html
**VA Aid and Attendance Benefit – https://www.va.gov/pension/aid-attendance-housebound/