What are the best care options for a 92-year-old female widow with concerns about living in a house with stairs, considering moving with her daughter or to an assisted living facility?

From the Guidelines

For a 92-year-old female widow concerned about stairs in her home, the best care option would likely be an assisted living facility, as it offers professional care, safety features, and social opportunities, thereby enhancing her quality of life and reducing the risk of falls and related morbidity. When considering the patient's living situation, it is crucial to evaluate her needs and construct a tailored care plan, as social difficulties may impair her quality of life and increase the risk of functional dependency 1. Assisted living facilities can provide the necessary support for older adults, including medication management, meal preparation, and assistance with daily activities. In contrast, moving in with her daughter could provide family support, but it is essential to consider the daughter's home accessibility, work schedule, and the potential impact on their relationship.

Before deciding, the family should assess the widow's health needs, including a mobility assessment by a physical therapist, as falls are a significant concern in older adults, and interventions such as exercise and physical therapy can be effective in preventing falls 1. The family should also consider the widow's financial resources, as Medicare generally does not cover assisted living. A trial stay at an assisted living facility or a gradual transition to the daughter's home could help determine the best fit. The ultimate goal should be finding an environment that balances safety, independence, and quality of life for this elderly widow.

Some key factors to consider when evaluating the patient's risk for falls include her age, history of falls, mobility problems, and performance on the timed Get-Up-and-Go test 1. The patient's living situation, including the presence of stairs, should also be taken into account when developing a care plan. By prioritizing the patient's safety, independence, and quality of life, the best care option can be determined, and her risk of falls and related morbidity can be minimized.

The patient's care plan should be tailored to her individual needs, taking into account her health status, functional abilities, and social support network 1. This may involve a multidisciplinary approach, including input from healthcare professionals, social workers, and family members. By working together, the best care option can be determined, and the patient can receive the support and services she needs to maintain her quality of life and reduce her risk of falls and related morbidity.

From the Research

Care Options for a 92-year-old Female Widow

The patient is considering moving with her daughter or to an assisted living facility due to concerns about living in a house with stairs. When advising this patient, several factors should be taken into account:

• The patient's medical conditions and ability to manage her health care 2
• The physical environment of her current home and potential new living situations 3
• The patient's social circumstances and support system 2
• The availability of financial resources to support a change in living situation 2

Assisted Living Facilities

Assisted living facilities can provide assistance with daily tasks and promote a sense of community for older adults. However, the quality of care and services provided can vary widely 4. When considering an assisted living facility, it is essential to evaluate the facility's:

• Staffing and training 4
• Regulations and policies 4
• Ability to provide medication management and other medical services 5
• Care culture and philosophy 3

Living with Family

Living with family can provide emotional support and a sense of belonging for older adults. However, it is crucial to consider the:

• Ability of the family member to provide care and support 2
• Potential impact on the family member's lifestyle and well-being 2
• Need for additional support services, such as home health care or adult day care 2

Promoting a Sense of Home

Regardless of the living situation, promoting a sense of home is critical for the patient's well-being. This can be achieved by:

• Personalizing the living space 3
• Maintaining autonomy and ties with the community 3
• Participating in domestic and recreational activities 3
• Fostering family relationships 3