How does anybody know when independent living should give way to assisted living? What are the indicators that an older adult - or their adult children - can use to reasonably determine if alternative arrangements should be considered? There is no firm litmus test. Each individual is different and each setting is unique. The need often arises only gradually - sometimes imperceptibly. Consideration should be given to:

• Medications
• Living Habits
• Food & Groceries
• Daily Business
• Social Contact
• Solicitations
• Calls to Family Members and/or Health Care Providers

A decision can involve several different individuals. Pay attention to which people the older adult most trusts. Here's a sample list:

• Older Adult
• Spouse
• Adult Children
• Relatives
• Caregivers
• Neighbors
• Pastor
• Friends
• Social worker
• Case manager
• Doctor

It is difficult to balance an individual's desire for independence and their right to make their own choices against their ultimate safety and well-being. Any choice will likely take time. It may be helpful to start here and then move on to serious discussions about the pros and cons of various living alternatives and the many competing values.

Feel free to contact the ADRC (Aging and Disability Resource Center) staff. We would be delighted to discuss with you your the unique situation, considerations, options, strengths and drawbacks, costs, and other issues. We can talk on the phone or we can make an appointment for you to come in for a visit. Call the ADRC at (253) 798-4600 or (800) 562-0332.

• Are prescriptions not being refilled, resulting in failure to take medication when scheduled?
• Has taking medication become difficult due to poor memory or confusion? Evidence may include pills taken together that shouldn't be, different pills mixed together in a pill box or an oversupply or undersupply of pills.
• Have conditions previously under control become more serious because medication is not being taken correctly?

• Has there been a change in living habits such as a change in dress or appearance, or a decline in personal hygiene not related to physical disability? Is dress appropriate for the weather?
• Have housekeeping habits changed so that a normally neat and orderly home is now cluttered and not cleaned regularly?
• Are pets that were normally well cared for suddenly not being fed or cared for as they had been in the past?
• Does sleeping in a recliner often take the place of sleeping in bed?
• Does sitting all day replace other forms of physical activity/exercise?

• Based on past food habits, are the cupboards frequently empty or being filled with unusual foods?
• Is the food in the refrigerator often spoiled or kept long beyond the 'use by' date?

• Is the mail being picked up and opened regularly or is it remaining uncollected and/or unopened?
• Are credit cards or checkbook being misused or not balanced as well as in the past?
• Is there an increase in occasions when there is pronounced confusion, disorientation, or an inability to communicate clearly?
  

• Has the amount of social contact changed dramatically, so that there are few public outings or limited social visits with close friends?
• Has the ability to drive deteriorated? Is there a fear of driving or a recent history of multiple minor accidents that is leading to isolation?
• Is there a regular (daily) check-in system by phone or in person?
  

• Is there a sudden increase in ordering unnecessary items through mail or televised advertisements?
• Are the number of prize notifications, awards, special offers, and other potentially fraudulent proposals increasing.
• Are there serious risks of identity theft coming through the mail or telephone?
  

• Has there been a marked increase in panic calls to family or medical providers without apparent need?
• Have unnecessary calls been made to 911?
• Are episodes of loss of balance and falls becoming more frequent?