Choosing a Care Facility or Home

Aunt Florence was recently widowed, and wanted to stay in the home she’d shared for more than a decade with her second husband.  It was isolated and more than two hours drive from her two nephews.

Her own children had disowned her at her remarriage, and they would not even discuss their mother’s care with their cousins. Then there was another really BIG problem:  Florence was clearly suffering from dementia with significant memory loss and paranoia.

In theory, the solution was simple enough—find a senior care facility for Florence.  She insisted however, on staying in her own home.  When she fell and broke her hip, there was no question of her living on her own. The family needed help choosing a care facility or home quickly.

How to Choose a Senior Care Facility or Home

Are you facing a similar dilemma, trying to decide whether to move your loved one, and if so to what type of facility?  Here are some suggestions to help you sort out the choices.  They come from Stages of Senior Care: Your Step-by-Step Guide to Making the Best Decisions by Paul and Lori Hogan, founders of Home Instead Senior Care.

You are probably trying to make choices between an assisted living facility (ALF) or a nursing facility. Generally, people in an ALF require some, but not a lot of assistance.  In a nursing facility, people like Aunt Florence need more supervision and medical assistance.

ALF residents have a greater degree of independence than in a nursing home.  For the most part, they live in small apartment-like units and are free to set their own personal schedules as they decide.

In both types of facilities, patients are not allowed to be in charge of their own medications.  Those are handled by the staff whether or not the patients are capable of handling them own their own.  This even applies to supplements like vitamins.

Both settings offer opportunities for social interaction and plenty of activities to help keep residents’ minds active.  It’s a benefit of moving your loved one away from an isolated existence at home.  Safety is another reason for choosing a care facility over staying at home.  Falls, like Florence’s, and other emergencies  are all reasons to consider moving your loved one out of his or her home.

Cost is an obvious issue.  Be sure to ask at the facility you’re considering what is included in the monthly fee, and most importantly what is not.  Does your loved one (or you) have the financial resources to stay in a care facility over a long period of time?

Are you prepared for the downside, such as anger and resentment on the part of your loved one at being moved, perhaps against his or her wishes?  An ALF with its small apartments and nursing facility with one-half of a two-bed room don’t allow your loved one to bring many possessions with them.

In theory, it’s a good idea to have your loved one’s approval to move him or her to one of these types of facilities, but in reality you may never receive it.  Perhaps the better question to ask is about your ability to continue to provide care and keep your loved one safe and comfortable in the home.  Try to see the issue from the perspective of your health and well-being as well as their comfort and safety.

Finally, be sure to spend time picking the right facility.  Visit more than once and spend time observing how the staff members interact with their patients.  Note sights, sounds and smells.  Keep in mind that there is a wide range in quality of either type of facility.


  1. Thanks for the post. I didn’t really know what the difference was between nursing homes and assisted living facilities. That helps me to better understand what would be better for my loved one. I like that assisted living offers a bit of independence. I think that can be really good for them.

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