Which way should we go?

Age in Place at Home or Move to Senior Living? What’s Right For You is All That Matters

Matt Perrin

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Should Mom age in place at home or move to an assisted living community?

The question was my caregiving version of the chicken or the egg. A fundamental and philosophical question forced on us by Alzheimer’s a few years ago. We didn’t have a say in the matter but this much was clear: Mom needed to live in a more supportive environment — for her safety and quality of life — and our options were few.

Two options, neither good (in Mom’s mind)

Either Mom would move in with us or move into an assisted living community. Thinking objectively to myself about the choices available to us was horrible and talking about them with Mom was worse. It required venturing down the guilt riddled mental rabbit hole that was my mind at the time and showed me visceral anger from Mom that I had never seen. In her mind, she would lose her independence either way.

I distinctly remember the feeling of unique and deep sadness for our reality as well as the excruciating guilt from the knowledge that I’d be the person to take her independence away no matter how desperately she was guarding it. Yet, mandated by Alzheimer’s, our options remained clear: move in with us and age in place in our home or move into assisted living.

When we first arrived at this unfortunate fork in life’s road, my strong preference was to move Mom in with us. It just felt right. Thinking back, I’m not really sure why. My best guess is that anything different felt like abandonment.

But I wish I knew then what I know now. Transitioning a loved one to assisted living does not mean you are abandoning them. It wouldn’t have made that time period easier per se, but I would have enjoyed a bit more peace of mind along the way.

Down to one

In the end, Mom refused to move in with us. She “didn’t want to be a burden” no matter how much we insisted she wouldn’t be. Further it was abundantly clear that she didn’t want to leave Cape Cod because that’s where her life was. So we quickly went from two options down to one. For a minute, I thought that would make the transition easier but I was wrong. It was still tumultuous.

For months prior to taking action, the mere thought of the topic felt like a broken promise to Mom. I was piling heap after heap of guilt on myself for something I hadn’t even done yet. Didn’t matter that I was considering it for all the right reasons — her safety and general quality of life.

When the time came, moving day felt like unimaginable betrayal and left a mark like no other.

How could I do that to Mom?

She’ll never forgive me.

Am I making a mistake?

How could I do that!?!

Yet that was then and this is now. I’ve learned a bunch in the time since. Most importantly, I’ve learned that I did not betray Mom by moving her to assisted living. Quite the opposite actually. I see that now.

I helped her!

It was the right move for Mom and she’s thrived in spite of Alzheimer’s continuing its assault on her. Once we figured out what we could afford (and how), the decision for Mom (and our family) centered on social benefit. Because Mom’s always been a classic social butterfly.

Not universal

Thankfully it worked for Mom. But here’s the thing about the ‘age in place at home vs. senior living’ question. There is no universal right or wrong answer.

There’s only the right answer for your loved one (and family). What’s best for your spouse or parent or grandparent is all that matters. What’s right for your family is right. Nothing else matters.

In our case

Our family is living proof that there’s no universal correct or incorrect answer to the question. We tried assisted living for my father-in-law Steve too. It didn’t work.

It was no fault of the assisted living community. Not the staff or the location or the building or the other residents. The building was nice. Location was great. Staff was kind. Other residents were welcoming. It was all good — except for the fit for Steve. Instead of thriving he plateaued.

Like Mom, Steve’s always been a social person. He still is, even in the face of Lewy Body. It’s just that Lewy now makes it so he needs his social fix in a more hands-on setting, highly tailored to him. And the best setting for that, is with his family.

Our home is now his as well. He’s aging in place here and living his best life in spite of Lewy Body’s unrelenting advance. It’s been a year and a half since he moved in and when we look back, it’s clear that we made the right decision. It wouldn’t be the right call for Mom but it’s best for Steve to be here.

Lots of data (and opinion)

For a variety of reasons, the ‘age in place at home vs. senior living’ question is bantered about often on the internet. The senior living industry has their take. The home care industry has theirs too. There’s an ample amount of public opinion out there. And some great data too, like this AARP Research Report from 2018 that said 76% of Americans aged 50+ prefer to stay in their current residence but only 46% expect to be able to.

When I read data like that or opinions on the question, I’m reminded of the following from the infamous Mike Tyson.

Everyone has a plan until they get punched in the mouth

In our case, it was Alzheimer’s and Lewy Body Dementia throwing the punches and forcing the question: should Mom and Steve age in place at home or move to an assisted living community?

Age in place at home or move to senior living?

The answer comes down to the person in need of care and the family. Rather than a preconceived opinion on what’s right and what’s wrong, it comes down to answering questions like this. Uniquely and specifically as they relate to you.

What are their needs today?

What do we expect them to be in the future?

How soon do we expect the needs to change?

What makes Mom/Steve tick?

What gives them joy?

How much support do they need? Want?

What are the family implications of staying? Going?

What resources do we have available?

With or without said resources, what are the options?

When these questions are answered, you will have at least a rough roadmap to what’s right for your loved one. And your family as a whole. And that’s all that matters.

Because there’s no universal right or wrong answer to the ‘age in place at home vs. senior living’ question.

There’s only what’s right for you.

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Matt Perrin

Surrounded by Alzheimer’s and Lewy Body Dementia. Founder of Ro & Steve. Working my way through life and dementia caregiving.