Bob, 83, has been living on his own since his wife died eight years ago. Now his children are seeing signs that he might need help. He has been forgetting to take his medicine. He fell while going down his front steps. He even left the stove on a few times.

The family felt that moving Bob to an assisted living facility would be best for his health and safety. But they struggled with the best way to approach their dad.

Geriatric case managers help families in this situation every day. Assisted living may conjure up troubled feelings in older adults of losing control or facing the last chapter of one's life. Moving can be especially hard for those who have been living in the same home or community for decades. Add having to face the painful reality that you are no longer able to live independently.

Don't put it off

You may face resistance, but don't put off broaching the subject of assisted living if you think a loved one needs help. Geriatric specialists offer these tips for starting a discussion:

• Listen to the objections your loved one may have. Let him or her know you understand those feelings.
• Point out the advantages of moving to an assisted living facility, but also acknowledge it may be hard to make the move and adjust.
• Assure the senior that he is still in the driver's seat. Let him know he'll be involved in all decisions.
• Ask the elder about health and wellness concerns as well as location (closer to you?) or activity preferences.
• Arrange for visits to several facilities. This will give your loved one a feel for the differences and a sense of where she would be happiest.

Preparing for the move

You've chosen an assisted living facility your loved one is fairly comfortable with. But as packing begins, you may find that anxiety sets in. The elder may also begin grieving about the life and memories he or she is leaving behind. It might help to:

• Get a floor plan for the room. Ask the senior to show you where he or she wants things to go.
• Explain that the room is their space. They will have privacy when desired.
• Make time for your loved one to share memories. Sorting through belongings can be emotional.
• Get a program schedule from the residence. Help the elder to choose some interesting activities to attend the first two weeks.

Get a list of everything that will be provided by the assisted living facility so you don't pack things you don't need. Have the older adult pick out favorite items to bring, such as family photos or items of sentimental value. Also check with the facility to see if the senior's prescriptions need to get transferred. 

Moving day

It's often best to do the moving yourself while the senior enjoys the day elsewhere. Perhaps he or she may want to visit a late spouse's grave or go to a favorite lunch spot. Seeing their new room only after it is set up with all their treasured things may feel more welcoming.

Also try to call and visit often the first few weeks after the move. Listen and be understanding if your loved one complains or talks about missing his old home.

Encourage the senior not to stay in the room all day, too. If possible, arrange a weekly outing with a family member that the elder can look forward to. This might be attending church or watching a grandchild's school play.

Then, be patient. In two to six months, most seniors adjust to their new home. Staff at the residence can provide assistance if there are still adjustment problems.

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