Some decisions do not come easy. To stay in the family home or downsize may create disagreement among family members. Lots of information is available but stress, worry and the time to choose the right place can take their toll.

The three most common challenges faced by seniors are dealing with changes occurring in their lives, being able to redefine who they are under those circumstances and maintaining autonomy, according to Miriam Oliensis-Torres, president of Geriatric Support – Pathway Care, a private consultation and care management service company.

“The happiest and most successful are people are those who can make their way through the process and have a new, normal life. Sometimes it may be a couple who has reached a stalemate in their lives. He wants to change and move out. She doesn’t want to talk about it. Or it could be a senior who wants to plan ahead due to health challenges or a family member who has concerns,” she said.

Changes can be physical, psychological

“Changes may be physical, mood changes, depression, or memory losses. Seniors and their families may be struggling internally. Recognizing and adapting to the changes going on are important. Changes can be handled as transition rather than crisis –‘How do I know when to seek help?’ and signs that things aren’t going great,” she said.

According to Oliensis-Torres, the timeframe is flexible.

“To Move or Not to Move” will be presented by Oliensis-Torres from 6 to 7 p.m. on Thursday, June 10 at Lake Country Landing, 2255 Stonehedge Trail, Oconomowoc, sponsored by Lake Country Campus at Summit Commons. The facility is just south of I-94 and east on Highway 67. For reservations, call (262) 567-4912.

“In the beginning, it’s figuring what’s going on and giving help. No matter who makes the initial contact, the client is the one who needs help and the entire family is involved in the process. They want a consultation to know they are on the right track and that may be for an hour. There may be brief, intermittent callbacks or a regular, ongoing basis for years. The majority of those who seek our services are in their 80s and 90s but we work with younger people who have health issues also. The range is from 30s to over 100,” said Oliensis-Torres.

Family members may have concerns

The family may have concerns as they watch what is going on and wonder how to accept the changes in family members, whether or not, how or how not to say or do something so that they are not over-reacting or under-reacting to what is happening.

“Imagine – I have a concern about somebody, (mother) in my family. I think she needs help. She doesn’t (think she does). My siblings and I don’t agree. We want to do the right thing but we don’t know what the right thing is. We usually then will go to the home and meet the person in their home environment – just get to know them. By talking with them, we get a picture of what’s going on  – their health, mood, how they manage things in the house, how they see things, what they think is going well, what they’re worried about, how things are different for them than a few years ago. On the first or a follow-up meeting we will talk about things that might be better. Maybe they need a different doctor. Do they need some help in the house with steps, laundry, lawn or snow upkeep, grocery shopping, medication, finances, legal things?”

Special evaluation may be needed

“Are there memory changes? What are the causes? Can it be made better? (We may) suggest a special evaluation. In memory loss, the hardest time is early on when the person can still do a lot of things. There may be subtle changes in insight, awareness, bad decisions that are not thought through. The impairment is subtle and they may not adapt to it. It is a lot of work – how to deal with the challenges and decisions to be made and how to get that care. We follow up with the older adult and also the family – give feedback about what’s going on. We can differentiate immediate need and long- term needs. Sometimes families get in a panic. We help them realize needs that exist now without causing upheaval and provide guidance as needs occur.”

Move done ‘with her,’ not ‘to her’

Oliensis-Torres tells of one 94-year-old woman who lived in the same apartment for 50 years with the same sagging mattress.

“We asked her what she wanted a new place to be like. She wanted ‘nice people to help me, someone to give me medication, nice people to eat with, and if there were music that would be wonderful.’ The move wasn’t done to her; it was done with her. We recommend that if people aren’t sure, they try it out for a while. If we’ve done a good job of getting to know them, then it works out. It changes the voice that people have in the decisions that are made,” she said.

First move often the hardest

The first move is the hardest move for those who have lived in their home for many years, according to Oliensis-Torres, who noted it takes time to make a successful transition, to let go of what was and find out what the new normal is.

Belongings have sentimental value, history, memories. Identify treasures. Women tend to take knickknacks, artwork, family pictures. Men, she said, want their computer and tools even if they may never use that drill again.

To “stay in a home as long as able” may not be possible without a great deal of expense. To get the care they need some people decide they want to move on. It is a lifestyle choice. They may not want to shovel snow or deal with winter. Singles who may feel isolated are more likely to leave home. For some, it is a financial decision. They don’t want the burden of owning their home.

Oliensis-Torres recommends that people have a safety net of some sort – friends, neighbors, relatives, agencies. For others, it is senior housing with services on site if they need it.

Every family is different

“Every situation is different because every family is different. Every person on staff has dealt with issues personally so they know what it’s like. We can provide care if the family lives out of town, are involved but too busy, or if there are family conflicts.

A move is not the end of the story. In one family, the mom had a medical event and went to the hospital and then a nursing home and would not be able to go back to her own home. The daughter wanted to help and hire someone just to look at places. But a son who lived out of town was in charge of the money and the woman spent three months (at $200 a day at the time) in a nursing home not suited to her needs. Eventually, they had a consultant match the woman to a place that better fit her needs. For a few hundred dollars more, a consultant could have found the right place for her in the beginning.

Many of the people served would not be eligible for services through a public agency. Billing is on an incremental hourly basis and is usually not covered by insurance.

Oliensis-Torres, a clinical social worker and certified geriatric care manager, birthed the company 22 years ago (at the same time she was expecting her second child). The social workers and others in their group work for the client and are not affiliated with any health care network. Their care is based on development of relationships rather than specific tasks.