When to step in, help aging loved ones

For more than a year, Alice Mazmanian has been happy at Silverado Senior Living in Costa Mesa. At least, Mazmanian, who suffers from Alzheimer's disease, seems happy — and that's what counts to her family.

"She just couldn't stay at home anymore," her son, Victor, said about his 83-year-old mother. He also acknowledges that his mother's battle with dementia has profoundly altered his future.

Once he was the proud third-generation head of the family's trash-removal business, then a mortgage banker. Today, he is a paid consultant to families needing to care for a loved one with Alzheimer's, and he also volunteers at churches, where he conducts support groups helping caregivers cope with the challenges of elder care — particularly Alzheimer's.

"The need is so great," he said. "So many, many people are caught up in care-giving. The story never seems to end."

The signals

Holiday gatherings often are the time when adult children notice a change in their parents' lifestyle. Often the change is a red flag signaling it's time to step in and, perhaps, take over.

"We're talking changes in the parents' appearance or the home's appearance," said Laurie Dobies of La Habra Home Instead Senior Care, which provides trained caregivers and companionship for seniors.

"Maybe it's clutter or spoiled food in the refrigerator. Maybe they can't stand long enough to prepare a meal or they're afraid of falling.

"Common-sense things aren't being done, and that's a signal the parent needs help."

So there's the signal. But how to respond?

"Everyone usually starts by talking about nursing homes because, at one time, that's all that was around," Dobies said. "But now there are so many, many options."

Often, some help with housework, shopping or personal care may be all an aging parent needs. Others have health issues but may remain in their home with caregivers who remind them when to take medications and provide some other assistance. Still others may have to move out of their homes into assisted living for required care and supervision.

Resistance

Most seniors resist leaving their homes, Dobies says.

Maureen Gardiner, 72, says she will never leave her Laguna Niguel home. Gardiner was diagnosed with Alzheimer's two years ago, but her decline has been very rapid, says her daughter, Sara Kelly.

"She's always been fiercely independent," Kelly said. "It's so important for her to stay at home; we decided to try to make that possible until, frankly, she doesn't recognize who she is anymore."

Two caregivers stay with Gardiner 24/7. Jennifer Nguyen oversees their efforts, visiting a couple of times a week and reporting regularly to Kelly.

Home care is less expensive than assisted living, but still offers "peace of mind for the children who know their parent is safe," Dobies said.

"A lot of home care is simply companionship," she said.

Countering senior resistance to assistance can be challenging, says Suzanne Mintz, president and CEO of the National Family Caregivers Association.

"Family caregivers must recognize that their parents are adults and — unless there are cognitive or emotional problems — they can make their own decisions. We do not and should not become our parents' parents. We must remember we will always be their children."

See the website caregiverstress.com for a discussion of home-care options.

Assisted living

Despite best efforts, however, assisted living often is the safest option for a parent.

Whether you are choosing a large assisted-living community or a small residential-care home, the initial move from independent to community lifestyle is a big adjustment, says Erwin T. Allado, CEO of SeniorCareHomes.com.

And finding a home for a parent who lives outside your area definitely requires homework.

Allado offers seven tips to help make the right choice:

Take your time: Research available facilities in your area. Note that vacancies change rapidly. Try to give the facility two to three weeks' advance notice.

Know your options: Get at least two or three living arrangements to compare and consider what you like the most or the least about each. Are they a match for your needs in terms of care, location and budget? Talk to the senior-care adviser at each home.

Talk to residents: Are they sociable? Will your parent interact with them?

Talk to the owner and staff: Do they seem like they care about their clients? How do they interact with residents and family members?

Check references: Get testimonials from residents and family members.

Get the facts: How long have they been in business? Do they have any major citations from state licensing agencies?

Look around: Is the home clean? Does it smell good or bad? Do they celebrate client events like birthdays? Do they post a menu and schedule of activities? Does the staff care about residents?

"Care-giving is a growing concern in this country," Allado said. An estimated 66 percent of the population will need to give, receive or arrange for care, according to a survey by the National Family Caregivers Association.

"Our goal is to help smooth out caregiver decisions and stress," Allado said.