Making the decision – for and with older parents – to transition into residential care is fraught with challenges. The move to long-term care is often preceded by a sudden health crisis, a deterioration of an existing condition, and the inability for care to be provided at home any longer. Choosing which home is right for the older person is a complicated process with multiple factors to consider: What type of care is right for my older parent and how might their care requirements change over time? What is the cost and how will we finance it? How will the home cater to my parent's individual interests and needs? Will the staff love and care for my parent? And after all that consideration, do they even have a vacancy? Adult children and their older parents are challenged by all these questions and many more, and all within the context of pervasive negative stereotypes about what care will actually be like.

The focus of this chapter is on older parents who have lived in their own homes and who are now transitioning into long-term residential care. It considers a range of trajectories into care that older people might take, including falls or sudden health crises, more gradual declines in cognition, and loneliness and bereavement. Participants for my studies were sampled based on them having a parent move into a residential care home, so although alternative arrangements for care such as moving in with children or moving to sheltered housing were discussed in family conversations, they were decided against amongst this research population. We will hear the voices of adult children and their decision-making processes, as well as the voices of older adults whose voices have typically not been heard or are often not taken into account when planning transitions to care.

Care options

In the UK there are a wide variety of long-term care (LTC) options for older people. The most common include the following: Retirement communities, which tend to accommodate retirees who all live in the same area. These communities of older residents often have a sense of collectivity and mutual interests, and the housing arrangement provides them with a sense of autonomy and at the same time a sense of mutual support, safety, and security.