How do you know when loved ones are ready for assisted living?

Use these guidelines to help spot the telltale warning signs of aging and illness.

Rosalyn Carter once said: “There are only four kinds of people in the world–those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers.” In light of the longer lives we all now enjoy, it’s very probable that many of us, at one time or another, will have to provide support for an aging parent or relative.

Families are often slow to recognize that a beloved family member needs help with their everyday activities. Nor are they prepared for the financial burdens involved. But both the emotional and financial costs of caring for the elderly can be even greater if the signs of illness are not caught until later, rather than sooner.

Who’s at risk?

An estimated 7 million older adults are having difficulty performing everyday activities and will need assisted living services this year, according to the National Academy on an Aging Society. That figure is expected to rise to 12 million by 2030.

Another study, by the U.S. Department of Health and Human Services, indicates that 65-year-olds face at least a 40% risk of entering a nursing home. According to the 2010 MetLife Market Survey of Nursing Home and Home Care Costs, the average annual cost of a semiprivate room in a U.S. nursing home is $74,825. The American Council of Life Insurers estimates that the annual cost of nursing home care will rise to as much as $200,000 in less than 30 years.

Anticipating the need for assisted living helps defray costs. Answering the following questions will indicate whether a loved one has retained the ability to live independently or whether intervention is necessary.

Independent Living Test


  • Are prescriptions not being refilled, resulting in failure to take medication when scheduled?
  • Has taking medication become difficult due to poor memory or confusion? Evidence may include: pills taken together that shouldn’t be, different pills mixed together in a pill box, or an over- or under-supply of pills.
  • Have conditions previously under control become acute because medication is not being taken correctly?

Food and groceries:

  • Based on past food habits, are the cupboards frequently empty or being filled with unusual foods?
  • Is the food in the refrigerator often spoiled or kept long beyond the “use by” date?

Daily business:

  • Is the mail being picked up and opened regularly, or is it remaining uncollected and/ or unopened?
  • Are credit cards or checkbooks being misused or not balanced as well as in the past?

Social contact:

  • Has the amount of social contact changed dramatically, so that there are few public outings or limited social visits with close friends?
  • Has the ability to drive deteriorated? Is there a fear of driving or a recent history of multiple minor accidents that is leading to isolation?

Living habits:

  • Has there been a change in living habits, manifested in dress or appearance, or a decline in personal hygiene not related to physical disability?
  • Is dress appropriate for the weather?
  • Have housekeeping habits changed so that a normally neat and orderly home is now cluttered and not cleaned regularly?
  • Are pets that were normally well cared for suddenly not being fed or cared for as they had been in the past?


  • Is there a sudden increase in ordering unnecessary items through mail or televised advertisements?

Calls to family members or health care providers:

  • Has there been a marked increase in panicked calls to family or medical providers without apparent need?
  • Have unnecessary calls been made to 911?

Think ahead

While it may be difficult to think of a parent or family member as needing assistance, it may be a greater disservice not to get them the care they need as early as possible. There are a number of resources available for those who are caring for an aging relative. These are just a few:

When planning your retirement, visualize your life all the way through and establish appropriate assumptions for each phase, including a final phase that may require several years of living assistance or nursing care. The bottom line is whether you are still working or already retired, you now need more than ever to have a sound financial plan to cover your retirement income needs.

Reesa Manning is a Senior Financial Advisor at Integrated Wealth Management, specializing in retirement and income planning. For more information, call Reesa at (760) 834-7200, or [email protected]. Integrated Wealth Management is a Registered Investment Adviser.

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