“Promise you won’t…”
Posted By Maryann Porosky On MAY 30,2017
Filial bonds run deep. Even if you've had a troubled relationship with your parent, when he or she is in need of elder care, that connection from childhood reemerges, often with a desire to give back. In modern times, however, providing the full range of elder care yourself may not be realistic.
A fear of nursing homes
In our society, nursing homes are considered a last resort. As such, a parent may ask you to promise that you will never reach for that care option. At Caring Choices, we know that's a difficult promise to make! Even if your heart wants to say yes, who knows what circumstances may arise. If your relative needs 24/7 access to medically trained personnel, as a family member, you are not likely to have those skills nor that kind of availability. Few people can afford to pay privately for a live-in registered nurse. A nursing home may, in fact, be the best care option, short term or long term.
Quality of care
Perhaps it's best to look at this from a different perspective: quality of care. One definition of quality care is "doing the right thing, at the right time, in the right way, and having the best possible outcome." Keep your sights set on quality of care and you can remain flexible.
Knowing the options
It used to be that nursing homes were the only option if a person could not continue living at home. There are now several options between staying at home and needing 24/7 access to medical attention. A few examples:
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Home care. If the person you care for does not need medical attention, but simply help with cooking, cleaning, bathing, transportation, and companionship, a home care company can provide excellent assistance. These paid caregivers are not generally medically licensed, but they often have some training about common elder care issues. They are frequently called to this work because of a deep caring and respect for older adults.
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Home health. It may be that the person you care for needs intermittent help from medically trained individuals to improve, or at least not lose, basic abilities. For instance, physical therapy after a hip operation or a nurse to supervise the healing of the incision after surgery. If your loved one has a short-term need and limited ability to leave the house, Medicare will pay for a home health specialist to make periodic home visits, thus reducing the need to stay in a nursing home.
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Home infusion. This service is available for people who need IV therapy but are otherwise able to live at home. Again, rather than stay in a nursing home, Medicare will pay to have a Picc line inserted in your relative's arm and to rent a portable medical device that administers the medication intravenously. Specialists can then come to the house now and then to monitor the progress of the treatment and ensure there are no complications.
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Assisted living (aka dorm life for seniors). Some individuals can no longer cook their own meals, clean the house, drive, etc. Private-pay home care may not be financially feasible. Assisted living offers a very social alternative. Each resident has their own apartment, but meals are eaten together in a central dining room. Van transportation is available for standard errands, and laundry and housekeeping services are typically provided as part of the price of the monthly rent. Often there are organized activities in a central gathering room, but they are completely optional. Special arrangements can be made if more intimate, nonmedical assistance is needed (e.g., bathing, toileting, feeding). Assisted living is not paid for by Medicare.
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Board and care homes. Like assisted living, a board and care home provides nonmedical support, but usually on a smaller scale. It might be a house with 6-12 residents. There's more of a family feel than in assisted living. And intimate care is readily available, such as help with incontinence, bathing, and feeding. Because they are nonmedical in their support, the cost of a board and care home is not covered by Medicare.
If your parent asks you to promise
Check out the "Promise you won't" article in our monthly newsletter for family caregivers. It provides tips for responding honestly and with caring. Not that you should launch into all the details of the options above. We offer this information simply so you can genuinely offer reassurance that should the time come, you will work with your parent to find the right balance of quality care.
Finding the right care
There are so many options to choose from. Those mentioned are just a sampling. Many can be paired together to create just the right amount of support. Within each option, you'll want to investigate eligibility requirements, financial costs, what Medicare does and doesn't cover, and the general personality of the service company or facility. It's important to get a good fit, but not easy to know all the nuances unless you work in the field. As the north New Jersey expert in aging well, we know the local resources and can save you time and the distress of making an unwise choice. Give us a call at 973-627-4087. Together we can find the best solution for your unique situation.
973.627.4087
