When it’s time to make the move

“Parents don’t want to be a burden to their children,” said geriatric care manager Nancy Wexler, author of “Mama Can’t Remember Anymore.” “But they also made their children promise to never put them in a nursing home. Before the children will consider placing their parent, they need to know they can’t make the parent happy, the parent’s illness is unchangeable and they have done everything they possibly could.”

When elderly parents can no longer live independently, families usually do their best to keep the senior citizens home with them. However, there often comes a time when the burden of care outweighs the benefits to either the parents or the adult offspring, said Dr. Dan Osterweil, author of “Medical Care in the Nursing Home” and medical director of S+AGE, a specialized senior care program at Encino Hospital.

“If the care giver feels emotionally overburdened or depressed, cannot continue his or her life, and is getting somatic diseases, such as ulcers or hypertension, at that point a move has to be made,” Osterweil said.

But what move? A nursing home is no longer the only choice. Home health care may provide enough assistance to allow the senior citizen to stay in familiar, comfortable surroundings. Adult day-care programs, offered at many senior centers and hospitals, give family members a much-needed break, while the senior participates in a variety of social and recreational activities. Licensed board-and-care homes and retirement hotels offer homey, social atmospheres for senior citizens who are not bedridden.

Choosing the best option for a loved one can be difficult. “Homes don’t display their amenities the way hotels do,” said Osterweil. “You can’t go in and look for a three- or four-star place.” But by doing a little detective work, you can evaluate the care a facility provides. Here are some suggestions from geriatric experts:

* Look around: Does the facility look like an institution, or is it a home environment? Are patients subdued, lying in beds or motionless in chairs? Are patients fed or brought to the dining room during mealtime, or are they left lying in bed? Are people dressed in the morning?

* Listen: Talk to the administrator and head nurse to determine their philosophy of patient care. Do the nurses speak your language? Find other family members visiting their loved ones and ask them about the care. Are patients yelling and screaming? This may indicate that their needs are not being met.

* Smell: The facility should smell clean, with no urine odor.

* Consider professional help: Senior centers and private geriatric care managers help ease the transition by helping families make the right choice in living arrangements and assisting with referrals and placement.

Choosing the most appropriate facility for your parent takes time, cautions licensed clinical social worker Dorie Gradwohl, director of Valley Storefront Jewish Family Services, a senior center in North Hollywood. “You can’t just pop somebody in and hope for the best,” she said.

After your parent is placed, continue to stay involved. “The elderly parent will enjoy visits and outings,” said Osterweil. “Keep a frequent visiting schedule. Install a phone at the bedside and call regularly. If someone has dementia, it doesn’t mean you close the door on that person. It means you do what you can to keep them active and alleviate the burden of care on their loved one.”