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Knowledge of the following will assist you in choosing the right level care:

•              Specifics about their physical and mental condition

•              Facts about their ability to handle normal activities of daily living (ADL’s)

•              Facts about their ability to handle instrumental activities of daily living (IADL’s)

•              An understanding of their cognitive (thinking) limitations/capabilities

•              Specifics about their financial situation (including what insurance they may have)

•              Legal documents such as Durable Powers of Attorney, Health Care Directives, etc.

Geriatric Care Managers are an option to assist you in doing an objective assessment of your loved ones needs. 

•              Geriatric Care Managers have backgrounds as Registered Nurses, Licensed Clinical Social Workers, or have advanced training in Gerontology. 

•              They understand the various care options that may best serve your loved one. 

•              They can also continue to follow your loved one wherever they go to assess situations and recommend changes in the care plan as needed. 

•              There are fees for these services. 

To contact a Geriatric Care Manager, contact the Long Term Care Ombudsman Program Information Center (314-918-8222) or contact the National Association of Professional Care Managers at www.caremanager.org.

Your Loved Ones Physician has critical information and should be able to provide information about your loved one’s medical condition. 

•              What diagnosed conditions are there

•              What medications are there

•              What is the physician’s prognosis (professional judgment) about their future medical needs?  (NOTE: Due to HIPAA regulations regarding confidentiality of medical information, your loved one will have to give permission to the doctor to release this information. 

•              Is there a history of mental illness and is it currently being treated with medications

•              Do they have a dementia that is affecting their ability to make judgments (i.e. Alzheimer’s Disease, Parkinson’s Disease)?  If so, what is the prognosis for the future (i.e. will their condition continue to get worse?).

•              Take the advice and counsel of the physician under consideration.  But also make your own assessment of your loved ones condition

•              Include your loved one, if possible, in assessing their own needs also

•              This also is a good time to make sure that your loved one has completed a durable power of attorney document naming a trusted relative or friend as their “agent in fact.”  This person could then request the medical information from the physician. 

Activities of Daily Living (ADL’s)

Observe and assess:  Can your loved do the following?

•              bath and maintain a good state of cleanliness

•              dress themselves

•              get to the toilet on their own

•              control their bowels and bladder

•              feed themselves

•              transfer from their bed to a chair, use a walker, etc. without assistance

If they are not able to handle most activities of daily living, it is not likely that they will function well living alone. 

Instrumental Activities of Daily Living (IADL’s)

Similar to ADL’s, assess whether your loved one can:

•              use the telephone

•              do their own laundry

•              keep their home reasonably clean

•              manage their person finances

•              go shopping for essentials

•              cook for themselves

•              take medications in the right dosage and at the right time each day

•              Living alone requires that they be able to handle most of these activities on their own.  However, in some situations, they may be able to function somewhat independently if they have some assistance from families and friends.

Taking medications properly is an extremely important.  If your loved one can’t handle this task consistently and correctly, this often means that they need to be in a licensed nursing facility where they will have a nurse or certified medication tech make sure that they receive their medications properly.

Cognitive Limitations/Capabilities

ADL’s and IADL’s are closely linked to a person’s ability to think clearly.  As people age, their cognitive skills do change.  However, if there are significant changes in their ability to think clearly, manage money, know what time it is, etc., this can be a warning sign that your loved one needs daily supervision.

NOTE: it is important to see changes in your loved one’s condition.  However, if mom or dad has always been a little disorganized, has difficulty in making decisions, etc., what you are observing now may just be mom or dad being their normal self. 

Look for:

•              Changes in their ability to speak in clear sentences

•              Loss of short term memory (though they may remember things from the past very clearly – this often is a sign of dementia)

•              Putting their car or house keys in the freezer instead of the normal safe place, or some other form of “odd behavior” (again this often is a sign of dementia)

•              Wandering away from their home and not realizing where they are

•              Bills not being paid, bounced checks, etc.

•              Large sums of money missing from bank accounts (a possible sign of financial exploitation)

Dementias are the most common reason for having a loved one go to a licensed nursing facility (if there is no one able to assist them at home). But there are long term care options other than nursing homes for some people.