Increasing support needs and options
The following options represent increasing care. Do not present them to your parents as multiple choice, because they are more about what the fit is for a particular stage of their lives. It is likely they'll go through more than one of these at various times in their final years of life.
- Aging in place. Staying in the current home, often with modifications and in-home help. Many people prefer this; see the home safety and household help pages. Know that even with great plans, this option may close due to your parent's needs, your availability, and the community resources. In my community, in-home help is hard to acquire and maintain, so even with a plan in place there are never enough back-ups to ensure continuous care at home.
- Independent living. Community living for active older adults, with amenities and social life but little or no personal care. This can be a great first step for folks who are downsizing from the home where they raised you. By making this step before age 70, they are making things easier for themselves (and you) after age 70. Independent living communities remind me of off-campus college housing, and ideally they'll be close to grocery, restaurants, and medical offices.
- Assisted living (AL). Private apartments plus help with daily tasks, meals, medications, and 24-hour staff, for people who need some support but not full nursing care. Predictably, this is going to cost a lot more than independent living. Friends whose parents are in AL have told me they pay privately for a helper to visit with their family in AL, to supplement and support the paid staff.
- Memory care (MC). Specialized, secured assisted living for people living with dementia, with staff trained for those needs. This is sometimes but not always offered as a progressive step within an assisted living facility. That is a nice set-up, as one spouse living in AL can visit the other who has transitioned to MC in the same facility. It is also less disruptive for both your parents and you if you can continue to work with a familiar facility and its routines even while your parent moves from staying in one room to another.
- Nursing homes. Licensed facilities providing 24-hour skilled nursing and personal care for people with significant medical or care needs. These are an important part of the the care continuum, and they're what scares your parents. They don't want to see themselves as being sick enough to need this care. But if they do need it, getting care from a nursing home allows families to visit and love on them rather than feeling overwhelmed by caring for them at home alone.