Updated October 9, 2019
There’s nothing more devastating than learning someone you love has cancer. After the initial shock of their diagnosis, you have many important decisions ahead of you as a caregiver. One of the most important decisions is where your loved one will receive treatment and begin the recovery process. Naturally, you want the best care possible during and after treatment.
While many individuals get treatment and recover at home, assisted living is another option, particularly for seniors. We’ll discuss how to choose the right setting, when assisted living might be best, and how to find the right facility for your loved one.
Deciding on the Right Setting for Care
Understand the Cancer Diagnosis
The first step in deciding on the best setting is understanding the cancer diagnosis. It’s important to speak with your family member’s entire healthcare team. This could include the primary care doctor and members of the oncology, pathology, radiology, and palliative care teams.
The American Cancer Society offers a useful set of questions for those newly diagnosed. We’ve summarized questions that have the most relevance to your decision on where you loved one should live – either temporarily or permanently.
- What stage is the cancer in and what does that mean for treatment options?
- Is this cancer treatable, based on what you know now?
- Are additional tests needed before you decide on treatment?
- What are the treatment options?
- How long will treatment last?
- Where will treatment occur?
- What are the side effects of treatment?
- What can we do to reduce the side effects?
- Will there be regular tests during the treatment, such as blood tests or imaging scans? How often?
- Will we need to prepare a special diet before or during treatment?
- How might this diagnosis affect any existing conditions or diseases?
Consider the Age Factor
Cancer in the elderly presents a greater challenge. Complicating factors include compromised balance, strength, and healing as well as bone loss, depression, cognitive losses, and dementia. These factors can complicate how cancer treatment is delivered and how well elderly patients can tolerate it. This means the risks of surgery and chemotherapy may often outweigh potential benefits in older adults.
It’s important to discuss how your loved one’s age might affect the treatment plan and any pain management strategies. Speak frankly with their healthcare team to understand how your loved one’s age-related complications might affect whether they decide to proceed with treatment. This will help you make the best decision. Are you preparing for treatment and recovery or pain management and hospice? It’s hard to ask those questions, but they will help you create a safe and comfortable environment for your loved one.
Evaluate Your Home Setting
With a better understanding of what to expect, think through the following questions.
- Can we meet their physical and mental needs at home during this time?
- Are we prepared if the condition gets worse?
- Are we able and willing to manage their medication, medical equipment, or treatments at home?
- Should they be home alone? Would there be someone available to help them at all times of the day?
- Do their symptoms require 24/7 attention?
- Are we worried about falls in the home?
- If your home is on two levels, will we need to get a hospital bed for the lower level?
- Is there enough room in the living space for needed medical equipment?
You may read through the questions above and decide that your loved one can safely remain at home during the early stages of cancer. If you can’t provide the care needed, you could get supplemental support through a home care agency. An in-home caregiver could make meals, help with medications, and keep your loved one comfortable. The healthcare team and family should re-assess regularly to determine if an assisted living facility could offer more comprehensive care than at home.
When Assisted Living Can Help
When Assisted Living Makes Sense
One of the most important benefits of assisted living for elderly cancer patients is a safe environment. You can have peace of mind knowing your loved one is getting healthy meals, has a clean and tidy living space, and has emotional support. No more worrying about if they’ll fall going to the bathroom at night or if they’re able to take care of personal hygiene. It’s also important to note that for individuals who require a lot of home care (having a caregiver present most of the time), the cost of an assisted living facility can be less over time.
Think about the long-term needs of your loved one. If the cancer is likely treatable, but the process of recovery will make it difficult for them to manage the tasks of daily living, an assisted living facility might be best, especially if they have other conditions or age-related issues that make living at home more challenging.
An assisted living facility might also be appropriate for someone who has decided not to pursue cancer treatment. Hospice care providers can come to both an individual’s home or their assisted living apartment to provide pain management and emotional support. Often, the staff at the assisted living facility can help you facilitate the arrangements. However, there are a handful of states that do not allow hospice care in assisted living facilities, so be sure to ask.
Scenarios That Might Not Be Appropriate
If the cancer diagnosis could lead to the need for serious medical care, it’s important to note that assisted living facilities do not provide medical care. They can help ensure your loved one is taking their medications as prescribed and has transportation to medical appointments. Many facilities also have a visiting doctor. But if your loved one needs 24/7 monitoring and care, a nursing home may be a better choice. Many treatments for cancer can be performed right at the nursing home. Most facilities can administer medication, IV chemotherapy, antibiotics, subcutaneous injections, and intramuscular injections.
More and more, there are facilities with both assisted living and nursing home facilities on one campus. This allows residents to shift over to nursing home care as their needs increase. If the cancer could go either way, it’s reassuring to know that your loved one is already in a facility that can handle their changing care needs. Some nursing care homes have a skilled nursing unit, specifically designed for patients who require more medical care. This might be needed if your loved one has cancer surgery. They could be released to the skilled nursing unit immediately following hospitalization and then transferred to the assisted living or nursing home as they recover.
Choosing an Assisted Living Community
Where to Begin
As a starting point, keep a list of standard questions so you can compare answers across all your contenders. AARP provides a printable resource Caregiver Checklist for Evaluating Assisted Living Facilities. Their checklist covers everything from safety to resident rights to fees. Be sure to add your own questions as they pertain to the specific needs and preferences of your senior, such as whether pets are permitted, if couples can live together, how they welcome LBGT residents, and if they have bilingual staff.
Check out online overviews and reviews on third-party sites. While the website may appear perfect, it's vital to get feedback from individuals who have experienced their services first-hand. Ask your doctor, family, friends, neighbors and clergy about their experiences. Ask a hospital's discharge planner or social worker for recommendations, especially if your senior was recently in the hospital.
Tour several facilities once you've narrowed down your list. We recommend making multiple visits. For your first visit, make an appointment with the admissions director to tour on a weekday. Late morning and mid-day hours are usually the best times to get a feeling for the day-to-day operations.
Cancer Care Questions
Choosing an assisted living community specifically for cancer care can be a little more complex and require more research. Consider these additional questions as you look at assisted living facilities:
- Will your loved one will need specialized care in the future? Even if they don't need these services now, it might be make sense to choose a facility that can respond to their changing needs over time. That way, you can avoid the expense and disruption of moving.
- Is there always a nurse on duty at your facility? Since assisted living facilities are regulated state by state, be sure to understand the requirements, as well as what they can provide/treat.
- When does a physician visit the residents? What does he/she do? How is information communicated to their primary care physician?
- Is hospice care permitted?
- Are there additional costs for transportation? This is especially important if your loved one will need frequent trips to the hospital for treatment, if a family member cannot take them during the day.
- What are your procedures for responding to an emergency medical incident? You want to make sure you loved one is promptly transferred to a hospital if needed.
Remember, there is no magical right decision. The best decision is the one that will put your loved one in the optimal position to thrive. Cancer is unique for everyone, so whatever living situation provides the best quality of life is the right one for their individual journey.