How to Choose Assisted Living for Someone with Disabilities

Here’s a startling statistic: by 2020, the number of seniors is projected to outnumber children worldwide. By 2050, one-fifth of the total U.S. population will be 65+. Those 85 or older will be the fastest-growing segment over the next few decades.

For many elders, life on a day-to-day basis is challenging. More than half of the “oldest old” (those 85+) are dealing with at least four chronic diseases, and 25 percent have more than six.

As the senior wave grays the globe, there is a corresponding surge in the number of elderly people who need assistance with their ADLs (Activities of Daily Living). But how do you know whether someone is “disabled” — and if their plan to age in place is no longer viable?

Defining “Disability”

Disability changes the landscape of senior living options. Below are the primary parameters researchers with the U.S. Department of Health & Human Services use to define “disability” in the elderly. Consider these points a guide to help determine if your loved one may be disabled, or becoming disabled:

  1. Ability to manage 5 core ADLs: bathing, dressing, using the toilet, transferring from bed to chair, and feeding oneself.
  2. Ability to manage daily life tasks, known as Instrumental Activities of Daily Living, or IADLs. IADLs include:
    1. preparing meals
    2. taking medications properly
    3. grocery shopping
    4. housework
    5. managing money.

Many elderly individuals do not require assistance in core ADLs, but cannot perform these IADLs without occasional or ongoing help.

  1. Cognitive functioning. Some seniors, including those with Alzheimer’s disease, may be physically capable of performing ADL and/or IADL activities, but should not be allowed to perform them independently because of their cognitive impairments, which impede their ability to handle these tasks safely and accurately. In other words: if a senior with dementia is cooking her own meals, she may leave the stove on and accidentally set the house on fire.
  2. Impaired in an ADL, but able to perform the task with the aid of an assistive device, e.g., getting to the bathroom with the aid of a walker, or climbing into the bathtub with the aid of a grab bar.

Measuring disability is therefore not a straightforward matter. Some elders require the active assistance of another person to perform an activity; they absolutely can’t do it on their own. Others may be able to perform an activity with difficulty, but just need someone nearby in case they require assistance.

The most common approach, per the Department of Health & Human Services, is to define someone as disabled in an ADL if he or she requires the help of another person to perform the activity. Thus, elders who can manage on their own with assistive devices are generally not considered to be disabled.

How to Select the Right Assisted Living Facility

An Assisted Living community may be the answer for a senior with disabilities, because it can provide the degree of help needed, allowing the resident to maintain as much independence as possible. A residential care home might be another good option, especially if the home specializes in serving seniors with disabilities and is equipped to provide the level of care your loved one needs. The smaller, homey atmosphere can be very soothing for someone with dementia or other cognitive impairment.

When considering an assisted living facility or residential care home for an elder with disabilities, be sure to address the following ten questions:

  • Is the facility clean and odor-free?
  • Are the residents well groomed?
  • Do residents seem happy?
  • Are caregivers and employees engaged with the residents? Do they seem to like their work?
  • Are caregivers trained to meet the special needs of people with the disabilities my loved one has?
  • Who administers medication and attends to urgent medical needs?
  • What types of training do caregivers and other employees receive?
  • Ask to see a resident’s room or apartment. Is the space clean, and in good condition?
  • Are the common areas — kitchen, laundry, bathrooms, guest rooms — clean and well maintained?
  • Are family members and residents encouraged to stay connected?

Financial Help for Elders and the Disabled

A non-profit organization known as Elderly or Disabled Living (EDL) is a housing help service that assists seniors or people who are disabled (an applicant doesn’t need to be both) with paying a portion of their bills. Because it is a private charity, there are no waitlists or special requirements. ElderlyorDisabledLiving.com is open to all U.S. citizens on an equal basis. An applicant may only receive financial assistance once per year, and is welcome to reapply at any time if they are not selected.

 

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