After you learn your elderly parent has a problem with memory or self care, what’s the best way to handle it? There are plenty of options depending on the situation.

Dr. Jessica Israel, the corporate chair of geriatrics and palliative medicine for Robert Wood Johnson Barnabas Health, said it’s important to be aware of the options because “as people get older, the risk and prevalence of memory issues become higher.”

“You should consider [whether] your mom or dad [are] able to safely and with good quality live the way they were living before," she said.

“Noticing a problem doesn’t mean this is the end of the world and my mom is going to wind up in a nursing home, or I’m going to have to quit my job to take care of her. It means that there’s something that needs attention.”

Mary Catherine Lundquist, the program director of the Rutgers University Behavioral Health Care COPSA Institute for Alzheimer’s Disease and Related Disorders, said the question people have to ask is "how safe is my loved one being home alone by themselves?"

“Once you have a diagnosis, then you can start to get services to help fill in what a person can’t do for themselves,” she said.

An elderly relative may go to bed at night and never have an issue but sometimes that’s not the case.

“If it’s somebody that has significant memory problems, chances are you don’t want them to be home alone at all," she said.

She noted if the elderly relative is cognitively intact and they just need a little assistance with cooking or with bathing or doing the laundry, “then you might be able to get away with just hiring a home health aide.”

Another option would be social adult or medical adult day programs. All New Jersey counties and many towns have their own senior centers but these facilities are for people who don’t need to be monitored or assisted with taking their medications.

“These are actual centers where people can go and participate in activities, get a hot meal. They might have a nurse at the program. They might take day trips, as well, and there’s an extra level of supervision. It’s more than just going to a senior center.”

A live-in aide would be someone who is there 24-7. But if the relative is not comfortable at home, or you don’t think it’s appropriate, you may need to consider an assisted-living arrangement.

“You have your own apartment. You can go and take your meals with a general group or you can cook your meals in your own apartment if you want to. There are also activities,” she said about assisted-living facilities.

Full-memory care is for people who need help bathing, eating and going to the restroom.

Continuing-care retirement communities offer graduated living arrangements depending on the needs of the elderly relative with the option to move into a nursing home if necessary.

“Sometimes that’s a good option for couples, especially if one spouse is sick. Then they can stay at the same location with one of them moving through the levels of care," Lundquist said.

The most comprehensive care situation would be a nursing home, where full-time attention is required.

She noted when considering various options the cost of different types of treatment varies widely, so it’s important to carefully look at what’s wanted and needed.

As you begin to consider what situation is best for you and your elderly relative, an excellent resource in New Jersey is your local Office on Aging, which you can reach by calling 211.

“There are some programs through the county and the state that if you income-qualify you might be able to get a home health aide for a few hours a week maybe twice a week who can help with housekeeping or do some of the meal preparation," Lundquist said.

Israel said change can be difficult because giving up one's independence is sometimes difficult.

“There’s a balance that we have to strike. We have to remember who the person is in front of us and what is going to contribute to their quality of life," she said.

Tomorrow we’ll look at what happens when there isn’t a choice, and mom or dad come to live with you.

You can contact reporter David Matthau at

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