One of the most sensitive decisions to make for you and your family is when to move to a nursing home. It may have been difficult to find care for aging seniors that deal with your needs, and you may be glad at your assisted living facility with no decision to make a move.

But other conditions can dictate a move from assisted living to a nursing home, such as failing health or the need for 24-hour caregiving. In these circumstances, assisted living can be restricted and need you to move to a nursing home.

If you or your loved one are uncertain as to the necessity for such a move, here are some reasons you may want to examine.

Are you ready to move from assisted living to a nursing home?

In some cases, the assisted living community will decide and order you to move. In that situation, you can appeal against your case.

Otherwise, the level of care you want can’t be prepared by assisted living. Although assisted living staff can do a lot, they can’t do everything to protect you.

Once you have used up all of your choices, it might be time to move. If you’ve decided you’re prepared to move, but not ready for a nursing home, seek a guide on alternatives to assisted living.

Signs you might be ready to move

It is a fine line deciding when it is not safe to stay in assisted living anymore. Even with other encouraging care coming into assisted living, it can be difficult to manage that care. There are signs when it might be time to move.

In and out of the hospital

If you frequently go to a hospital, it might be better to be in a nursing home. Going frequently to the hospital is difficult and, although essential at the time, doesn’t always result in better outcomes.

Some of the reasons a person is hospitalized regularly are repetitive infections, exacerbating of chronic medical conditions, recurrent surgeries, or inability to rehabilitate. In cases like these, nursing home care can help stabilize someone without the pressure of repeated hospital stays. Many nursing homes are like hospitals with the equipment and personnel imperative to cure someone safely and efficiently.

Severe Alzheimer’s

End-stage Alzheimer’s or severe neurological problems are difficult to control in assisted living or at home. Even in memory care, some treatments and practical conditions are better managed in a nursing home.

As Alzheimer’s worsens, the ability to function physically and mentally declines. These are some of the common symptoms you may notice in people with dementia:

• Hostile behaviour towards other residents
• Self-harm behaviour
• Considerable confusion and disorientation
• Declining care and wandering
• Maximum assistance with bathing, grooming, dressing, and eating

Nursing homes are able to manage these issues. They have the ability and skill to supervise, handle, and help people with dementia.

Complicated medical needs

Assisted living communities are not equipped to manage complicated medical conditions. Even with time-limited home health, some medical issues need extra care and oversight.

For example, you may want to move to a nursing home if you need some of the following medical needs:

• IV fluids or antibiotics
• Infections
• Diabetes
• Chronic Obstructive Pulmonary Disease (COPD)
• Injections
• Other heart and lung conditions
• Cancer
• Mobility issues like difficulty walking or transferring
• Wound care
• Respiratory care
• Two-person assistance

Many assisted living communities will not admit someone who needs two staff members to assist with walking and transferring. Once you require this level of help, some assisted living communities will suggest nursing care. Stand and lift devices are also not permitted.

The main reason for this law is that several states command that a resident needs to be able to move out of assisted living with minimal help during an emergency.

For other communities, the staff is not accessible to do two-person assists. You can imagine what it would be like if many of the residents needed this level of assistance. It would be unmaintainable and unsafe.

“Round-the-clock” nursing care

“Round-the-clock” nursing care means 24-hour nursing care. Assisted living communities have nurses on staff, but they are not able or equipped to deal with someone 24 hours a day.

Nurses in assisted living do more coordination of care and general evaluation of medical conditions and medication management. They also do the initial assessment for admission to assisted living. Nurses in nursing homes have many duties, starting with monitoring the medical care and condition of residents.

They are also needed to bring together this care with other physicians, certified nursing assistants (CNAs), and plan said care in consultation with family members.

They must also deal with specific medical requirements such as the following:

• Starting IVs
• Administering oxygen
• Skin assessments
• Pain management
• Obtaining lab specimens
• Blood sugar checks
• Monitoring vital signs
• Swallowing issues or dietary restrictions

Swallowing problems are prevalent in people with Alzheimer’s and other neurological problems. Once a speech assessment is conducted, a modified diet is often suggested. These diets are specific, and those with swallowing problems often need one-on-one monitoring. This type of supervision is barely probable in assisted living. Nursing homes have determined dining areas for residents who have swallowing issues.

Becoming bed bound

Confinement to a bed is the result of several various conditions and needs deep staff involvement. Conditions that lead to becoming bed bound are mobility problems, infections, general weakness, pneumonia and broken bones, among others.

The longer someone is bed bound, the weaker they become. Taking care of someone who is bedbound involves some of the duties:

• Toileting
• Assisting with eating
• Frequent turning to prevent bedsores
• Bathing, dressing, and grooming
• Stretching to prevent contractures
• Restricted financial resources to support assisted care

Unfortunately, some people are not financially capable of paying for home care or assisted living. Just because someone doesn’t have financial resources doesn’t mean they can go to a nursing home. Nursing homes need that specific conditions met—namely, that there is a nursing need.

If finances are restricted, then nursing home care may be the best option. They will have the care they need.

The idea is that with sufficient medical support in assisted living, some may do well in that environment at a lower cost than that in a nursing home.

You are on hospice care

Assisted living inhabitants can be in hospice care. What many people don’t know is that being placed in hospice is nowhere near 24 hours a day.

Under specific circumstances, a patient might need “continuous care” for a short time to get chronic symptoms under control. A person can be in hospice and also need more care than what hospice can provide.

In these situations, some families choose nursing home placement with hospice. With both supports, you will have both the nursing home and hospice team handling your care.