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Planning a Move to Assisted Living or a Nursing Home

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Help someone deal with emotions over moving

The decision to move -- whether to an independent living community, assisted living community, or nursing home -- is only the beginning of what can be a long and challenging journey. Helping someone through this important transition takes research and planning. Here's a 10-step guide to smoothing her way to her new home and the next phase of her life.

1. Talk to her -- and don't forget to listen. Even though moving will often improve her quality of life, it's also likely to stir up all kinds of emotions, and even trigger what Nan Hayes, founder of, calls "transition trauma." Many older adults are filled with anxiety about what a move will mean. They may see moving as a sign of defeat and a harbinger of increasing loss of control and independence.

The listening part should come first -- find out as much as you can about her health, needs, fears, and hopes, so you can help her make the best choice possible.

After that, it's your turn to talk. Help her understand that moving can be "just as freeing as going away to college," Hayes says. The range of options has broadened tremendously since her parents' day, and as the human lifespan gets longer and longer, a late-in-life move has come to be a rite of passage just as natural as buying a starter home. If you can help her see a move as a positive transition rather than a defeat, you'll be off to a good start.

2. To reduce stress, hold off on selling the house if possible. Moving is hard enough without asking her to live in a home that a realtor is showing to prospective buyers. If she has the assets to finance a move in the short run -- or if you can lend her the deposit or entrance fee -- move first, sell later is the way to go. If she's moving to a community where she has to buy an apartment or condominium, a mortgage broker may be able to help her get a "bridge loan" to cover the down payment until she sells her home.

3. Plan on giving her extra support after the move. A move may be the best thing for her, but it's also going to be exhausting for her, physically and emotionally. A good assisted living community will offer plenty of support during the transition, but if you're able to make time for extra visits in the days or weeks after the move, it will help reassure her that the most important things in her life -- like family and friends -- aren't going to change.

4. Consider bringing in the pros. A professional Geriatric Care Manager can assess the level of care an older adult needs, find senior communities in your area, navigate the application process, and prepare for a move. These services can be especially useful if you don't live in the same state as the person who's moving and can't be there to manage the day-to-day aspects of her transition.

5. Help get her finances in order. This is crucial in order to know what kind of care she can afford and how she plans to pay for it. Also, many continuing care retirement communities and other facilities will ask for thorough documentation of her income and assets in order to be sure she'll be able to pay for her care over the long haul.

If she doesn't have an accountant who can help you pull the paperwork together, the Society of Certified Senior Advisors can refer you to a financial planner who specializes in assisting older clients.

6. Get her home appraised. If she's planning to sell her home to finance a move, today's topsy-turvy housing market makes a professional appraisal a must before assessing her financial position.

7. Talk to a doctor. Deciding what kind of community is best for her is a medical decision as well as a personal one. Her family physician may be able to evaluate her and make a recommendation. If not, ask for a referral to a geriatrician who can do a full evaluation, or go to the American Medical Association's Doctor Finder and search under "geriatrics" in your area.

8. Shop around. In most areas of the country, there's a wide range of options when it comes to eldercare communities. A good place to start is's local services directory, where you can search for nursing homes, continuing care communities, and assisted living facilities in your area. Your local Area Agency on Aging should be able to steer you to local communities. Your local Chamber of Commerce might also be able to help. Once you've narrowed down the list, tour several places -- with the person in your care -- and make sure to take time to talk to residents, eat a meal, and really get the feel of the place before making a decision.

9. Read the fine print. Yes, those long contracts can be overwhelming, but don't give in to the temptation to skim documents before signing (or asking her to do so). The contracts and agreements that come with moving into any kind of community may well spell out the parameters of the care she will -- or won't -- receive for the rest of her life, so make sure you, and she, understand exactly what you're agreeing to before putting pen to paper.

If you spot something worrisome or have questions the facility can't answer to your satisfaction, the National Academy of Elder Law Attorneys can refer you to a lawyer who can go over the paperwork with you.

10. Plan the move logistics carefully. Downsize and deal with belongings now to avoid moving day chaos. An estate liquidator can often help you with selling what she won't need, and a senior move manager can help with all the logistics. Bring in a senior move manager who specializes in transition and relocation of older adults.

Last revised: October 14, 2010

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