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Helping Your Elderly Parents
Transition to In-Home Care
By Dana Carr
When parents are elderly and begin to have difficulty caring for themselves,
one of the best gifts a concerned child can give them is the gift of a
paid, in-home caregiver. The elderly may already have a lifetime of possessions
and they may not want another new memento, technological gadget, or specialty
food gift. Instead, what they really may need is assistance coping with
health, housekeeping, or mobility issues.
How do you know when it's time to consider in-home assistance for your
elderly parents? Try watching for these possible warning signs:
- Personal Hygiene Changes such as a failure to bathe on a daily
basis, wearing the same clothes all the time, or sleeping in their clothes.
- Passive Responses such as, "Why should I bathe/change my clothes?
I don't go anywhere!"
- A Dusty Home that was formerly very neat or the house not being
cleaned on a regular basis.
- A Lack of Food in the refrigerator or placing to-go orders
on a regular basis may signal difficulty driving, a fear of driving,
or a physical inability to lift the groceries out of the car.
- Tiredness and constant complaints could be a possible sign
of depression or loneliness.
- Forgetfulnesssuch as leaving food cooking on the stove, leaving
the faucet on, not taking mediations as prescribed, the phone left off
the hook or bills left unpaid.
Once you decide to seek a caregiver, take these steps to ensure you hire
the right person and manage the working relationship effectively.
Discuss Before Hiring
Your elderly parents should be part of the discussion regarding in-home
care. A tremendous amount of fear may exist once they realize they are
not functioning well on their own. Your parents may fear losing their
freedom or their home. Always approach this topic with compassion.
Most often the elderly can't imagine how an in-home caregiver can possibly
help them. To ease the transition, suggest they "try out" the caregiver
by having them assign basic housekeeping chores, such as laundry, changing
bed linens, and general cleaning duties. The caregiver can also run errands
such as grocery shopping or accompanying your parents to doctor appointments.
In some instances, the caregiver can simply be a companion to drive the
elderly to the movies or church. Often, the caregiver is a senior as well,
so your parents may find much in common with their caregiver.
Manage the Caregiver Relationship
List the duties you and your elderly parent expect the caregiver to
perform and clearly communicate the duties and the timing with the caregiver.
Clearly explain your expectations and set boundaries for the caregiver’s
personal phone calls, breaks, etc.
However personal the caregiver relationship becomes, make sure all family
members and the caregiver understand that the paid worker is not a family
member. The caregiver should NOT have access to credit or ATM cards. Nor
should the worker be paid in cash.
Pay close attention to your parents’ feelings. If your or your
parents feel uncomfortable or incompatible with the caregiver, take action
immediately. Either do not hire the person or discontinue his/her use
if you’ve already hired the person.
Finally, remember in-home assistance is not the beginning of the end.
Rather it’s an active step to prolong your elder parents’
ability to live in their lifelong home for as long as possible. Hiring
an in-home caregiver is a proactive step that can help the elderly continue
to lead healthy, active and happy lives.
Dana Carr is the owner of California-based Carr & Associates,
a carebroker who helps families find the right caregiver.
Relocating Options
- Age Restricted "Retirement Communities"
A senior community can be like any other neighborhood or community
except restricted to people usually 55 or over, or 62 and over. Differences
in minimum age is usually established when the original community
entitlement and funding is obtained. Those with a 55+ restriction
require one resident to be 55+. Other residents must be over 18, but
are permitted to be younger than 55. In a 62+ community all residents
must meet the age requirement. HUD regulations used to require amenities,
activities and services that cater to seniors to be provided or available.
Although no longer required by law, to be competitive and attractive
to a retirement lifestyle, age restricted communities are continuing
to offer amenities, activities and services that cater to residents.
Retirement Communities are oriented toward an active lifestyle,
or "younger thinking" seniors. They might offer golf, tennis, swimming
pool and spa, exercise rooms and a variety of clubs and interest groups.
- "Seniors Only" Apartments
Some older seniors sell their homes of many years and move to an
apartment. This frees up equity that can then supplement income through
interest or dividends earned through investment of the capital. The
move also frees seniors from home maintenance and grounds-keeper chores.
For others living in a large complex of all seniors also affords a
greater sense of security than living in a private home.
- Modular Home Communities
Modular Home Communities have full time residents or ones who reside
only part of the year with them. Part time residents may be "snowbirds"
coming for three months or a bit longer. The lots and the mobile units
(which are not really very mobile) may be leased to, or owned
by, the residents.
- ECHO Housing (Elder Cottage Housing
Opportunity)
Elder Cottage Housing Opportunity, Accessory Units, Granny Flats
refer to a housing opportunity where seniors occupy a second family
living unit or apartment with a separate entrance, on a single family
lot, with another family. Generally they are permitted by the jurisdiction
to foster affordable housing, or aid families with elderly parents
unable to live completely alone. The owner of the home and lot may
be a senior, or the "renting" party may be seniors.
- Shared Housing
Seniors can share their home, or share the home of another. The
roommate need not also be a senior. Professional organizations which
specialize in these arrrangements match the two parties based on needs
on one side with abilities to provide on the other side. They screen
before matching and follow up afterwards to help the match work out.
Most organizations who do this are non-profit and supported from
sources other than those seeking their help.
Seniors who share their home, are Aging In
Place, and should understand the planning that will help to do
it successfully.
- Continuing Care Retirement Communities (CCRCs)
Continuing Care Retirement Communities (CCRCs) or communities
offering Life Care are designed to offer active seniors an independent
lifestyle and a private home from which to enjoy it, regardless of
future medical needs. They may require buy-in, or an up-front
annuity purchase followed by monthly payments covering services, amenities
and needed medical. The buy-in may be refundable in part, or not
at all.
They provide the availability of multiple levels of care, without
the uncertainty of wondering where you will live.
- Congregate Housing
Congregate communities offer independent living in private separate
apartments, and the opportunity to share activities of daily living
with other residents as one chooses. They may offer rental or ownership
units.
- Assisted Living
Assisted Living (or Residential Care For the Elderly/RCFE) offers
help with non-medical aspects of daily activities in an atmosphere
of separate, private living units. It can be likened to Congregate
living for residents less able to function independently in all aspects
of their daily lives. In some states licensing is required.
- Board and Care, Residential Care or Foster
Care
Board and Care is usually offered in what may appear as a converted
home. It provides a homelike setting with supervision and care for
4-10 residents (Foster care, available in some states is limited
to 2 residents).
- Skilled Nursing Facilities
Skilled Nursing Facilities may be freestanding, or part of a seniors
community offering any or all of the following:
Congregate
Assisted Living
Continuum of Care
It may specialize in Short Term or acute nursing care, intermediate
or long term skilled nursing care.
- Alzheimer's Facilities
Early stage Alzheimer's patients may be accommodated in a Congregate
or Independent wing of a multi-level campus. Many Assisted Living
Communities will accept and successfully house early stage residents.
As the disease progresses patients develop argumentative behavior,
"sundowning" and wandering habits. Generally the communities
best equipped to deal effectively with this middle stage patient are
Alzheimer' Communities.
- Senior Day Care
Senior Day care varies from "custodial care" with programs for stimulation
and rehabilitation to day care providing medical care and procedures.
- Senior Short Term Housing (Vacations and
Snowbirding)
Senior Short Term Vacation Housing offers the chance to try before
you buy. It allows one to take advantage of a senior community in
a distant location. People too frail for the rigors of hotels and
restaurants for multiple days, can vacation at a slower pace with
needed care available to them.
800.869.9549
email
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LifeStyles is your guide to senior housing and care.
Search our online database of all state licensed senior communities
and care agencies nationwide, or order a free print guide
for the area you are interested in.
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Compare your home's costs against what
a Senior Congregate, Assisted Living or Continuing Care Retirement Community
offers in convenience and services by putting the cost of each of the
following items in the column for "Aging in Your Home" or the column
for the alternative living choice - i.e. "Assisted Living". Then total
each column and compare costs. Assisted or group retirement living may
not be much more expensive than staying where you are. Or, perhaps you
will find it's more expensive.
After you have a handle on cost differences,
look at social, stress and medical advantages or disadvantages. Only
then are you ready to visit places that are alternative possibilities.
- Mortgage and Association Fees
- Taxes
- Maintenance of outside, gardening
- Repairs
- Fire, theft and liability Insurance
- Electricity and gas
- Water, sewer and trash pickup
- Telephone and cable
- Meals
- Transportation
- Car ownership (ownership, maintenance,
repairs, insurance)
- Insurance
- Housekeeping
- Laundry
- Linen service
- Cleaning
- Comraderie with privacy
- Supplemental Medicare Insurance
- Long Term Care Insurance
Offers local eldercare office numbers throughout the United States
to help with location of facilities and services for seniors.
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