Part 2: Signs You Should Consider a LTCC

By CarePatrol of Northern DE & South Chester County

Senior care is a large and growing concern. The leading edge of the baby boom generation is in their mid-seventies. Dementia cases are exploding, putting tremendous stress on families desperately trying to care for a loved one. In 2026, as boomers start to enter their 80s, those in need of the safety of a care community will begin a massive surge that will last for nearly 20 years. Right now, approximately 10,000 people per day are turning 65 so that Silver Tsunami is coming to LTCCs.

The vast majority of us - over 90% - want to remain in our home as we grow older, a concept called ‘aging in place’. That is a natural response tied to every person’s desire to remain free, independent and self-sufficient. Sadly, that desire can fly in the face of reality. Are meds being taken properly? Are there trip and fall risks like steps, throw rugs, cords and other hazards? Are bills being paid in a timely manner? How about home repairs and maintenance? Nutrition? How are tasks like grocery shopping being done? So much needs to be done when living at home ...

Consider the point at which a senior becomes a prisoner in their own home, determined to remain there no matter the cost, one slip or fall away from a nursing home? What is the ultimate price they are willing to pay to remain “free” and “independent”? And what potentially wonderful things are they foregoing in order to pay that price?

There are home modifications that can be done as seniors age. Grab bars, ramps, stair lifts, alarm pendants and wristbands, removal of hazards and much more should be considered and implemented. Help can also be brought in for a variety of reasons but it gets expensive - very expensive. Just like moving to a bigger house can solve the problem of a growing family during that stage of your life, moving to a LTCC that is already set up to address safety and care concerns (and much more) can be less expensive and more effective. It also allows you to face each day from a different perspective. Instead of What do I need to do today?, the question becomes What do I want to do today?

Safety and health should always be the major considerations of any assessment of a senior’s living condition. Falls and medication mistakes are major concerns but overall health goes way beyond that. Overall health includes mental, spiritual and emotional pieces. Are seniors being mentally challenged for brain exercise? Do they have opportunities for recreation, socialization and physical exercise? Are they being spiritually fed - a critically important aspect of aging?

Living alone at home can lead to more rapid mental and physical decline. 28% of older adults - nearly 14 million - live alone. Research by the National Institute On Aging (a branch of the NIH) shows that older adults need social interaction. What is not fully understood is the link, if any, between isolation and loneliness because the two do not always come as a pair. Isolated people are not always lonely and vice versa but depression, often linked to loneliness, can have an enormous effect on any senior’s outlook, drastically affecting their mental and physical health. From NIA’s April 23, 2019 research report on social isolation and loneliness:

Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease and even death.

People who find themselves unexpectedly alone due to the death of a spouse or partner, separation from friends or family, retirement, loss of mobility, and lack of transportation are at particular risk.

Conversely, people who engage in meaningful, productive activities with others tend to live longer, boost their mood, and have a sense of purpose. These activities seem to help maintain their well-being and may improve their cognitive function, studies show.

Seniors benefit from participating in social activities and interacting with other people. Sadly, opportunities for socialization while living at home become fewer and further between. Old friends have their own mobility issues or they may have moved or even passed away. When this happens to an isolated senior, thoughts shift to self, generating negative thoughts and feelings that can lead to depression. The senior becomes trapped inside two cages - their home and their own mind.

In LTCCs, social interaction is not only possible but strongly encouraged and facilitated. Games, field trips, activities, happy hours, entertainment and much more are readily available, creating an environment that can shift a senior’s outlook in a positive direction.

So what are some of the signs to look for when assessing a senior? The key is being aware of what they are and watching objectively. Some can be simple fixes like a pill box or a few hours of week of in-home care. Others are not so easy to fix: 

Become Increasingly Concerned

The more you see, the more concerned you should become:

• Forgetting medications, taking more than prescribed, sharing
• Diagnosis of an identifiable dementia like Alzheimers
• Spoiled food not thrown away
• Dirty house, extreme clutter, dirty laundry
• Missing important appointments, especially doctor’s
• Unexplained bruising or skin tears that linger, inviting infection
• Trouble getting up from sitting
• Walking, balance and mobility issues
• Uncertainty and/or confusion with once-familiar tasks
• Unneeded repairs, purchases or changes in activities
• Infrequent showering or bathing
• Stacks of unopened mail, late payment notices

Become Urgently Concerned

These are flashing ‘DANGER’ signs:

• Wandering without knowing where they are or how to get home
• Frequent medication mistakes, especially for disease
• Unsafe behavior (leaving the stove on, front door unlocked, etc.)
• Physical abuse of spouse, caregiver or self-neglect
• Lack of adequate fluids or nutrition
• Increased falls
• Signs of depression

If you see these signs in yourself or a loved one, the time for difficult choices is coming soon.

Next: Can I stay at home with family caregivers?