How to Decide If It's Time for a Nursing Home or Assisted Living Care

It's Not Always Easy to Know If or When the Time Has Come

How to Know When It's Time for Nursing Home Care

Understandably, many family members want to care for their loved one at home for as long as possible. But, what does "for as long as possible" really mean? Several caregivers have asked if there are signs to indicate when the time is right or if there are clear factors to consider in the decision of placing someone in a nursing home for more care. Their question: "How do you know when it's time?"

If you're the caregiver for a loved one with Alzheimer’s or another dementia, maybe you've wondered the same thing. Maybe you’re taking care of a family member in your home and your situation is working out really well. Or, maybe you're in that situation of wanting desperately to keep your family member at home, but you're starting to feel that the challenge of balancing everything in life might be too much at times.

Reasons Nursing Homes Are Avoided

Families often experience guilt and anxiety related to even the thought of nursing home placement. They may have made a promise years ago to their loved one that they wouldn’t ever put them in a nursing home. They might feel like it’s their duty to care for their spouse or partner in their own home.

Others may have had a bad experience (or heard of one) with a nursing home and are fearful of making that choice. They're concerned that their loved one will not be cared for as well at a facility as they are at home, or worried that placement in a facility will cause a decline in functioning and quality of life.

When Nursing Home Care Happens by Default

Occasionally, there are situations where it's clear that the time has come for nursing home care. These could include severe illness, injury, or hospitalization of the caregiver or person with dementia, or the death of the caregiver. Those sudden changes often necessitate immediate nursing home placement and sometimes individuals end up in facilities almost overnight, with very little time to research different facilities.

Signs That the Time for Nursing Home Care Is Near

Outside of those sudden changes, when is it time? What are signs to pay attention to? How do you know when you should make that move to a nursing home, or if you can continue to make things work at home?

Here are some signs that it’s time to consider nursing home care:

  • You’ve hurt your back or fallen when trying to lift or move your loved one.
  • Your loved one's Alzheimer's has progressed to the point where she tries to hurt you or exhibits other challenging behaviors, such as paranoia or frequent anger.
  • Your family member has wandered outside and become lost.
  • You’re dropping the ball with other responsibilities.
  • You display several signs of caregiver burnout. For example, perhaps you've lost your temper recently when your loved one was resisting getting dressed or was following you everywhere you went inside the house. 
  • Your own health (either physical or emotional) is declining. This may include conditions such as high blood pressure, arrhythmia, headaches, gastrointestinal problems, anxiety, and depression. 
  • Your most important relationships are significantly suffering.
  • You have surgery or another planned medical procedure coming up soon.
  • Your doctor has said that it’s time for nursing home placement.
  • Your loved one has care needs that you really can’t handle very well, despite your best efforts.
  • You've had friends or family members repeatedly express concern for you and encourage you to look into the option of a nursing home.
  • You already have tried other options and resources to keep your loved one at home and they just aren't providing enough assistance.
  • Financially, nursing home care is more feasible than paying for the amount of in-home services that would be needed to meet your loved one's care needs.

If one or more of these signs sounds familiar, it may be time to go forward with planning a move to a nursing home. Be sure to talk with others around you who are familiar with the facilities in your community and who can make a recommendation. Dropping in on facilities to visit can give you a feel for the place. Researching your options is key to choosing a good nursing home for your loved one.

A Word from Verywell

Thinking about care options for your loved one can be stressful. Although sometimes it feels like you can manage it, there may be other times where you feel like you're just not able to do it all. Some people describe feeling as if they were drowning in the responsibility and the weight of this role. Acknowledging these feelings does not take anything away from the love you have for this person.

Keep in mind that if your health or emotional well-being suffers too much, you won’t be able to be much help at all to your loved one. Planning well can help you continue to be there for your loved one, so you can keep providing the love and support that she needs during the challenge of this journey.

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Article Sources
  • Pacific Northwest Extension. Making Decisions About a Nursing Home.