When you are caring for someone at home when should you consider having them live in a long-term care facility? The executive summary: it depends. It depends on so many factors but I will break them down for you.

Making decisions about long-term care

Your relative:

If your loved one is wandering and has been found more than once by police or a kind stranger, the time to move them is yesterday. Your environment is not safe and what you have tried has not worked.

When your relative’s needs require a registered nurse to deal with their health more than once a day it is time to move them. If you are not able to give them their meds at appropriate times or if it is too complicated for you to administer it is best to let professionals do so.

Frequent falls may be an indication that your house is not appropriate for them or you cannot supervise them as often as needed. Check with their health care provider as well.

If you cannot maintain their hygiene and cannot find someone else to do so on a regular basis, you are not only compromising their health but their dignity as well.


If you are physically OR mentally unable to care for your relative it is time to move them. Constant exhaustion that interferes with your caregiver duties, hostility, or crying jags are good indications.

If you are on the border of being physically or verbally abusive (or already are) it is in both of your best interests to move to a facility.

Stimulation is also an important consideration. If the person you are caring for is getting little to no stimulation (TV doesn’t count) then you need either day care or a facility. Think of the person’s quality of life when considering this. You may want to try respite care as a baby step.

The environment:

If you live in a home that is causing problems it is time to move, either both of you or just the person you are caring for. Stairs, inadequate outdoor space, or inadequate bathroom facilities are all reasons to consider a move.

Long-term care facilities in your area

Are they good quality? Is the only acceptable one more than 20 minutes away? What is the availability?

The bottom line:

You may be feeling guilty, especially if the person asked you not to move them to long-term care when they were well. Certainly discuss this with them if they are able. Like any major life decision, there are pros and cons. However, this decision is not permanent. You have the ability to switch facilities or even take that person home again, although these changes should be minimized if possible. When you are physically and mentally ready, and the person you care for needs more than you can do, it is time to consider long-term care.