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Have you recently moved an older relative to an assisted living facility? Are you still in the process of making that decision? Decision time, while not easy, is just the first step. It may be a yes or no answer, to move or not to move. But the next step is how everyone adjusts to the move if "yes" is the answer.

It can be a very emotional time when a family member leaves the home where they lived with their spouse, where they raised their children, and where neighbors were their friends. Most people want to stay in their own home as long as possible.  They often have the unrealistic feeling that "I can take care of myself for the rest of my life." To decrease the emotional impact of a move it is important to start these conversations early, well before the decision to move has to be made. Unfortunately, the majority of families make these decisions while in the middle of the crisis. 

Is your family member a willing participant to the move? Sometimes the older person has no trouble accepting this needed change and they are able to focus on a positive view of the future. Moving to an assisted living facility may bring a sense of relief as daily chores are handled by staff, i.e. cooking, cleaning, laundry, making their bed. There is no more yard work to do or the need to maintain a home.

Others are not so willing to accept the need to leave their home. When the older adult is resistant it is suggested that the adult child when discussing the need to move, make it their problem. "Mom/dad we are so worried about your safety that...........................". It is best not to say , "You need to do this.............." which could result in increased resistance. 

Adjustment difficulties are many and varied. Dealing with the loss of independence has a major impact on the older adult.

  • Not being able to get in your car to go to the store, movies, or out to dinner, making an impromptu visit to family or friends, can affect adjustment.
  • The need to downsize their home, giving away, selling or throwing out possessions may prevent an easy transition.
  • When the person can't see family or neighbors on a regular basis there may be feelings of abandonment. "No one cares."
  • You family member may have hosted all or many of the holidays and is having difficulty turning over this responsibility to others.
  • the new assisted living resident is often overheard verbalizing their feelings that they don't want to live with old people while acknowledging that they are probably in the same age group.

The decision to move a family member to a safer environment may be necessary due to physical deficits or frailty. Planning the move should involve a discussion with all family members. While there may not be any resistance to the move it does not mean there are no feelings of sadness or sense of loss. Just let your parent know you are empathetic with their feelings. You, too, wish it could be different.

If the move is permanent either planned or sudden, adjustment can be made smoother with a few small,  simple steps in place.Encourage the older adult to participate in the decisions about downsizing. What items to take. What to throw away. What special things to give to family and friends. Being part of the decision making process is essential. It provides the individual with some sense of control over their lives. It offers a new sense of independence.

Rituals can also be a very important part of the transition process. Saying good-bye is sad. Creating a farewell event along with a special welcome at the facility can help with positive feelings. One possibility would be to invite neighbors for coffee and........ before the move. Provide family and friends with the new address and ask them to send a note or card. It's nice to start getting mail in a new place.

Finally, as the caregiver when discussing a proposed move you may have feelings of guilt, feel trapped in this no-win situation or feel as if you are walking on eggs. First and foremost focus on the benefits to your loved one's health and well-being. Safety is always the primary concern. Are they now in a safer environment? If the answer is yes, holding on to those feelings may have negative impact on everyone's adjustment. After helping with the move while it is necessary to keep in touch, it is best to limit the length of a visit and frequency. Hand holding or spending too much time with your family member can possibly inhibit adjustment to the necessary move. 

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