Charleston Senior AdvisorHow do I know a parent can no longer live alone safely?
Watch for repeated falls, missed or doubled medications, spoiled food and weight loss, unpaid bills or scam calls, getting lost while driving, a stove or door left on, and withdrawal from friends; two or three of these together usually mean a change is needed.
Keep a dated list for a few weeks. A record of what actually happened is more persuasive, and fairer, than a general sense that things are slipping. A primary care visit with a cognitive screening is often the right first step.
What are the options short of moving?
Licensed in-home care for a few hours a day, adult day care on weekdays, home-delivered meals, a medical alert device, and home safety changes such as grab bars and better lighting; for eligible Medicaid members, Community Choices or BoldAge PACE can pay for much of this.
The three counties have 10 DPH-licensed adult day care centers, licensed for 658 participants in all. BoldAge PACE, which serves all three counties from North Charleston, combines medical care, a day center and home support for people who meet nursing facility level of care. The Trident Area Agency on Aging (843-554-2275) can arrange meals and caregiver support.
When is assisted living the better answer?
When help is needed at unpredictable hours, nights are no longer safe, home care hours keep climbing past about 40 a week, or loneliness is doing as much harm as the physical decline.
DPH's data shows 60 licensed CRCFs in the three counties with 3,452 licensed beds; 4 are small community residences run by the county disabilities board, which leaves 56 that serve older adults, 42 of them in Charleston County. Start with location: a building near the child who will visit most usually works better than the most impressive building across the harbor. Then use the directory to check each candidate's license, Alzheimer's flag and enforcement record before touring.
How do we talk with a parent about moving?
Talk early, privately and in terms of what the parent wants to protect, such as independence, staying near church or friends, or not burdening anyone, and offer choices rather than a decision already made.
Bring the list of incidents, not accusations. Suggest a short respite stay as a trial. If the parent has dementia and cannot weigh the decision, the person holding health care power of attorney decides, ideally with the doctor's input.
Side by side
| Staying home can work when | A move is usually needed when | |
|---|---|---|
| Nights | Nights are safe and quiet | Wandering or falls happen at night |
| Hours of help | Under about 20 hours a week | Over about 40 hours a week |
| Medications | A pill organizer and reminders suffice | Doses are missed or doubled despite help |
| Social life | Friends, church or a day program fill the week | Days pass without seeing anyone |
Sources: S.C. Code Regs. 60-84, DPH Healthcare Quality, SCDHHS bulletins and charts, CareScout, CMS and VA rate tables, as cited in each answer. See our editorial standards.
