It’s a situation many people are familiar with. An elderly mother passes away suddenly, leaving her husband, who suffers from mild dementia, home alone. Their adult children are now left facing decisions they may never have considered.
Inevitably, many of us will face the question of how to take care of a loved one when living independently is no longer an option. Whether the situation comes on gradually or quickly, the feeling of confusion and being overwhelmed is the same. Making the right choice moving forward is critical to the individual’s quality of life and overall health as well as the family dynamic.
Fortunately, there are alternatives. For many families, one key question is whether to consider moving their loved one to a nursing home or assisted living facility, or to support them at home or perhaps in a shared living arrangement with a relative.
An important consideration is the level of care the individual needs. One way to measure that is to use what is termed Activities of Daily Living or ADLs. These include medication management, eating, personal hygiene, continence, and mobility. It can be difficult to assess a loved one this way, but you don’t want to rely on simply asking him/her. Careful observation is the key.
If you’re looking at outside care resources, understanding the differences between facilities will be important. People often use the terms “assisted living” and “nursing home” interchangeably, but they are quite different.
Assisted living arrangements. Assisted living arrangements work best for individuals who are largely independent but may need some assistance. Examples might be housekeeping or some personal care. Generally, residents live in a dedicated living space like an apartment with their own bathroom and kitchen facilities. Pricing is based on the level of assistance needed and can vary during a resident’s stay.
Nursing homes. Nursing homes are intended to provide a higher level of care. Residents usually require greater assistance with their ADLs and may also need more medical care management. Rooms are often shared and the set up may look more like a hospital setting because of how residents are housed and the visibility of medical staff. While nursing homes are intended to provide a higher level of care, cases of abuse and neglect in nursing home facilities are becoming more and more common, especially for those who may be spending a good deal of time alone. To choose the proper nursing home, research is critical using resources such as the online compare tool from Medicare.gov.
At home support. Any examination of outside facilities should also include some consideration of at-home options. Studies have shown the vast majority of seniors would prefer to stay at home. The reasons are many, including the comfort of home and the connection of community, as well as the emotional and physical stress of a major move later in life. With the rapid growth of home health care, flexible assistance is available for many daily and weekly tasks including housework, meals, medication, transportation, errands, as well as for ADLs.
If needs permit, arranging for at-home support may be less disruptive and more workable for individuals and their families. Recognizing the advantages and cost-effectiveness of home healthcare options, the Centers for Medicare and Medicaid Services (CMS) recently expanded its reimbursement policy to cover skilled home care. It may even be possible for a family member to be reimbursed for home care.
The time to consider options is before circumstances force your hand. If you have a loved one who is requiring more support or depends on another for care needs, weighing alternatives now could greatly lessen the uncertainty and stress later.
And finally, regardless of what you and your loved one chooses, it is important that you and other family members and friends remain vigilant regarding your loved one’s care. If you don’t believe he/she is getting the proper care, speak up. Talk to a supervisor or director. Demand a transfer to an emergency room if the situation warrants. Ask for a transfer to another nursing facility. Be an advocate for your loved one – they will be depending on you.