Greenville Senior AdvisorHow do we know a parent can no longer live alone safely?
Common signs are repeated falls, missed or doubled medications, spoiled food or weight loss, unpaid bills, getting lost while driving, poor hygiene, wandering, and a parent who is lonely and withdrawn; one sign may be manageable, but several together usually mean the current arrangement is not safe.
Keep a simple log for two or three weeks: what happened, when, and what help was needed. Patterns at night point toward a setting with overnight staff; patterns around medications or meals may be solved with daytime help.
What are the options short of moving?
Options include hourly help from a DPH-licensed in-home care provider, adult day care on weekdays, home-delivered meals, a medical alert system, home modifications, and for Medicaid-eligible adults at nursing facility level of care, the Community Choices waiver or PACE-Upstate in Greenville, Pickens and Anderson counties.
DPH licenses 17 adult day care facilities in the four counties, with licensed capacity for 1,058 participants in all. The Area Agency on Aging (Appalachian COG at 864-242-9733, or Upper Savannah COG for Laurens County) can assess what help is available and screen for programs. A combination of adult day care and evening help often keeps a parent home for another year or more.
When is assisted living the right move?
Assisted living makes sense when help is needed at unpredictable times, particularly at night, when a parent is isolated, when medications need to be given rather than reminded, or when the family's caregiving cannot be sustained; a South Carolina CRCF keeps staff awake and dressed around the clock.
DPH's data lists 68 licensed CRCFs in the four counties with 3,996 licensed beds; 7 of them are small community residences run by county disabilities boards or the Department of Mental Health, leaving 61 senior-serving CRCFs, 33 of them in Greenville County. Visit at least three, at different times of day, and ask each for its admission agreement and most recent DPH inspection report.
How do we talk with a parent who does not want to move?
Start with the parent's own goals, such as staying independent, not being a burden, or being near grandchildren, and frame each option as a way to protect those goals; involve their doctor, and offer a short respite stay as a trial rather than a permanent decision.
Many CRCFs offer short respite stays, and the Community Choices waiver includes respite in a CRCF for participants. A parent who has tried a building for two weeks makes a very different decision from one who has only seen a brochure.
What legal paperwork should be in place?
A durable power of attorney for finances and a health care power of attorney, plus an up-to-date will and a list of accounts, insurance policies and doctors, should be in place while the parent can still sign them.
Without a power of attorney, a family may need to go to the county probate court for a guardianship or conservatorship, which takes time and money. An elder law attorney can prepare the documents together.
At a glance
| Option | Best fit when | |
|---|---|---|
| In-home care | Help is needed at predictable hours and nights are safe | — |
| Adult day care | A parent is alone during the workday | — |
| PACE-Upstate | Needs are high, Medicaid-eligible, Greenville/Pickens/Anderson | — |
| CRCF (assisted living) | Help is needed at night or unpredictably | — |
Sources include S.C. Code Regs. 60-84, DPH Healthcare Quality and SCDHHS pages and bulletins, CareScout, CMS and VA rate tables as cited above; see our editorial standards.
