When Should I Consider Assisted Living?
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If you’re the loved one or caregiver of someone with Parkinson’s disease (PD), you may have to make the difficult decision of when to place your loved one in an assisted living or skilled nursing facility. This decision is challenging both emotionally and practically, but the most important factor is your loved one’s safety and well being. As PD progresses, the individual with PD may need more assistance than you or other loved ones can provide at home.

Considerations for assisted living

While every individual and situation is different, here are some signs and considerations that can help you determine when it’s time for assisted living:

  • Frequent falls – Is your loved one falling often? People with PD are at a greater risk for falls due to symptoms like balance issues, stiff muscles, and freezing episodes. Falls can be mild or result in significant damage, causing increased disability and reduced quality of life.1
  • Medications – Is your loved one remembering to take their medication at the right time? It is important to take PD medications on a regular dosing schedule to get effective symptom relief.
  • Noticeable weight loss – Does your loved one feel thinner when you hug them? Are their clothes loose, or are they cinching in their belt? Good nutrition is important for overall health and for helping manage symptoms of PD, and the timing of meals can impact medication schedules and the effectiveness of medications.2
  • Hygiene – Is your loved one having difficulties bathing and dressing themselves?3

If your loved one lives alone, there are some additional signs that you might notice that can signal cognitive decline or physical limitations:

  • Mail piling up – Are there piles of unopened mail? Lots of mail piled around and unopened bills may be signs of cognitive trouble.
  • Social isolation – Is your loved one getting together with friends and family for visits? Do they have someone who checks in on them regularly?
  • Kitchen disorganization – Are there spoiled foods in the fridge? Multiples of the same item, like ketchup? Is the kitchen clean?
  • Lack of housekeeping – Are there spills that haven’t been cleaned up, piles of clutter, thick layers of dust, or mold and grime in the bathroom?
  • Neglect of plants or pets – If your loved one is a former plant lover, have their plants died or disappeared? Is their pet well fed (not overfed) and groomed? 3

It is also important to realize and acknowledge that it may be time for assisted living or a skilled nursing care facility when you, the caregiver, is exhausted and unable to continue to provide all the assistance your loved one needs.

Important things to know about assisted living

Assisted living facilities are not equipped to provide medical care, which your loved one with PD may need. You may be able to hire extra help, or the facility may charge additional for help with dressing or eating.

Doctors who see people at assisted living facilities are contracted, not employees. If you need to talk to them, make an appointment rather than hanging around the facility and asking them questions.

Medications for PD are complex, and as a person ages, they may receive additional prescriptions for other conditions. It’s important for medication management to be overseen by a neurologist who is a movement disorders specialist, as they are trained in understanding the different medications for PD and potential interactions with other drugs.4

view references
  1. Parkinson’s Disease Foundation. Accessed online on 8/11/17 at http://www.pdf.org/en/fall09_fall_prevention.
  2. Barichella M, Cereda E, Pezzoli G. Major nutritional issues in the management of Parkinson's disease. Mov Disord. 2009 Oct 15;24(13):1881-92.
  3. com. Accessed online on 8/11/17 at https://www.caring.com/articles/signs-its-time-for-assisted-living.
  4. New York Times. Accessed online on 8/11/17 at https://newoldage.blogs.nytimes.com/2008/10/20/10-things-to-know-about-assisted-living/.
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