When mom or dad need a little help: convincing an elderly loved one to move from a life of independence to an assisted-living facility can be a tough challenge for both families and seniors. Advanced planning and communication can be the keys to making the best choice possible for all concerned.

For Mabel Dible, a resident in the Concordia Lutheran Services' Oertle assisted-living facility in Cabot, Pennsylvania, the decision came after a fall. "My sister lived here for a number of years and I enjoyed visiting her," she says "Even after my husband died I still wanted to stay in my home. But in July of 1999 I fell and bloke my ]lip. I went from the hospital to therapy to here, and I love it."

Assisted-living facilities combine housing with personalized health-care services. They promote independence while providing assistance and care within a warm, homelike residential setting. Staff is available 24/7 to meet both scheduled and unscheduled needs. Such communities are designed for those who are at a point in their life where it's too difficult or dangerous to live alone, where residents require some assistance but don't need to be in an institutional setting such as a nursing home. Tenants usually receive help with bathing, dressing, medication reminders, and meals.

The early start to the day was the only thing that took Mabel Dible by surprise. "I wasn't used to getting up that early for breakfast," she says, "but I got used to it quickly. I do enjoy the chapel services that we have here, and it breaks my heart when I miss one."

Getting everyone on board with the idea of taking advantage of an assisted living facility is best accomplished while loved ones are still in good health. A potential resident that's used to the idea beforehand will find it easier to move into this new chapter of his or her life when the time comes.

MAKING THE TRANSITION

Guiding families and seniors through this life-changing decision is Audrey Tristani's job. She's a social services coordinator for Concordia Lutheran Ministries, and has worked there for 10 years, helping to facilitate the transition of countless seniors into one of their programs. "Currently Concordia houses 178 assisted living residents, and offers live levels of care," she explains.

Tristani believes that the actual choosing of a facility is the most crucial aspect for seniors in making a successful transition. "For the senior, it's important to determine what's important to them and what they can afford, what services are offered, and what services they would like such as chaplain availability, activities, beauty shop, or laundry facilities. Thinking about it before being faced with a fast decision can relieve some of the pressure." She advises seniors and their families to visit a few facilities to determine what the senior's preferences and expectations are for his or her new life.

"Things like the size of the rooms and what they can bring with them--pictures, personal items, clothes; these are concerns seniors have and are questions we hear most often," she explains.

Tristani also says that total honesty is a must. She has witnessed families destroyed by entering into this decision without it. "The family must talk openly and honestly with their parents and never make promises that they'll never put a loved one in a facility, because we just don't know what life has in store for any of us.

"Allowing seniors to make as many decisions as possible is important when it comes time to transition them. Let them decide what they want to bring and what they want to happen to their belongings."

Being up front with each other is important, but it's crucial for caregivers. "Be honest with the facility about the resident's needs and behavior," says Tristani. "The most important thing is that their needs are met in a safe environment."

SUPPORT IS THE KEY

Transitioning the resident is all about support. Provide as much as possible. Visit often, send cards, letters, and photos. Ask grandchildren or other family members to visit, call, or send cards.

Karen McCarrier, facility director of Concordia at the Orchard in Butler, Pennsylvania, believes the role of family is crucial to a successful transition. "One fear many residents have is that they will be cut off from the outside world," she says. "Visits, especially at the beginning by friends and family, give the residents the confidence they need to make and grow new friendships. Seeing that friendships can blossom at any age is one of the joys of my job."

Many assisted-living facilities provide entertainment and activities with a twofold purpose. Activity, movement, and stimulation are healthy for body and mind. Outings and events also provide time for residents to meet one another and develop relationships.

Mabel participates weekly in a favorite activity. "On Mondays and Wednesdays we play bingo, and I provide and donate some of the plush toys used for prizes," she says with a smile. "I've also given plush toys to the children in the day-care center next door. I think people are pretty happy I'm here."

Tristani understands the powerful potential of an active lifestyle. "Families need to encourage their loved one to participate in activities and meet other residents. If the resident suffers from dementia, it's better not to visit often at first until a routine is established and he or she is adjusted. If possible, prepare the room before the resident arrives so that it looks like 'their' place when he or she arrives."

ATTITUDE IS CRUCIAL

The attitude of the new arrival is also important. Tristani has seen residents move into facilities and not join in and participate but merely exist. But, she has also witnessed countless others grow and blossom during their later years. "There's a process of grieving the loss of independence and freedom when you realize you have to depend on others," she says. "Families need to understand and validate those feelings of loss for the resident."

"We've had residents who came in angry and bitter. That tends to affect their ability to grow here," facility director McCarrier states. "When friends and family abandon the resident, they seem to retreat into themselves and don't take advantage of all we have to offer."

Concordia and other assisted-living facilities address the transitioning of residents by introducing new residents to the staff and neighbors. Tristani explains, "We give them a tour and orient them to the meal times and surroundings. We help them to develop a daily routine. We have daily routines all our life, and it's important to establish one here. A social services coordinator is available to help in the adjustment by answering questions, listening to a resident's feelings, and offering suggestions."

Being in an assisted-living facility doesn't mean a person is no longer useful. "Some residents find contentment in helping others. We have men and women who read to blind neighbors and help others take a seat or put on a sweater. It seems that as long as a person feels needed and helpful they tend to transition well," says McCarrier.

GUILT

"One issue that affects the loved ones who are making arrangements for the senior to move into assisted living is guilt," reports Steven Tack of Kittanning, Pennsylvania, and administrator of Chicora Medical Center. He says guilt should not be taken lightly and can be avoided. "Thirty of my 37 years have been spent in the healthcare industry," he states. "I basically grew up surrounded by our family's assisted-living business. No one ever really wants to spend time in an assisted-living facility, but we have to face the fact that there's a real possibility that one day it may become a necessity.

"Often the guilt will manifest itself through family members never being content with the care given their loved one in a residence. They feel that since they can't or couldn't do it themselves, nothing is good enough."

In some cases, a restored relationship is gained by transferring care to an assisted living facility. "Being a caregiver changes relationships. All the energy a loved one puts into meeting the physical needs of his or her family member can now be put back into restoring their proper relationship," reports Tack. "I've had people say, 'I got to be my mother's daughter again when I stopped being her caregiver.'"

Each assisted-living facility has a personality all its own. Researching them in person and connecting with residents who are happy there is a great way to begin the search. "An assisted-living facility is not the end," says Tristani. "It's the opportunity for a new beginning and a new chapter in life."

Important Checklist for Selecting an Assisted-living Facility for Your Loved One

* Is the management experienced?

* Is there a genuine concern and respect for the residents?

* Are residents and families happy and satisfied?

* Is staff friendly and caring?

* What's the staff to resident ratio?

* Is the community clean and comfortable?

* Is it a place children would like to visit?

* Are meals appealing and well balanced?

* What health and wellness services are available?

* Is the location convenient to friends and family?

* What activities are planned for residents?

* Will the prospective resident like these activities?

* Will the prospective resident enjoy the daily life as compared to the other options?

* Do services and quality of living meet your standards?

* Is the value comparable to cost?

* What are the residency criteria?

* Considering all ... will assisted living improve the quality of life for a resident?

(www.benchmarkquality.com)

Connie Pilston Shoemaker is a freelance writer and home schooling mom of three living in a suburb of Pittsburgh, Pennsylvania. She writes weekly for her local newspaper covering human interest stories.