Caregiving for senior family members involves deciding what's the most appropriate and affordable care available. The information and choices can be confusing, even overwhelming. What's appropriate and affordable may not be clear, and the choices may seem too few. Three general options for families stand out, but the specific choices may still not be simple.
At-Home Caregiving
The first choice for many families is to take care of their loved ones in a home setting. This preference may pose the biggest challenge for several reasons. Foremost, frankly, is guilt. It comes in big, strong doses. "I should take care of my mother and father because they took care of me growing up." A variation on that line of thinking goes something like "What will people think if I put my momma and daddy in a nursing home?" That’s a shaky foundation for the rigors and demands of caregiving. Why?
First, many of us are not gifted, tempered or trained to be caregivers, in spite of our preferences. The demands of caregiving can be enormous, in particular when round-the-clock care is required. The physical and emotional energies of caregivers are often drained away quickly with few realistic prospects for complete renewal.
Second, home care often involves other people like siblings, spouses, and children because their lives are touched as well. Everyone is impacted in some way or other. Support from them may be uneven, at best. So, family issues may need to be dealt with regularly in addition to the daily challenges of caregiving at home. For insight about dealing with some of these challenges, see my Suite101.com articles on caregiving.
Caregiving relief and assistance may be available through state and local governmental agencies, or from privately owned services. Local service centers for senior citizens and family physicians may be able to help sort through these kinds of options.
Adult Foster Care Services
Home settings are the norm for adult foster care, although there's some variety in this category. "Adult foster day care" allows your loved one to go out of his home to another site for daytime activities. This choice is particularly helpful when the family caregiver has to work outside the home. Basically, it's like daycare for children. It's a safe place that can give the assurance of skilled oversight as well as providing a respite of sorts for the primary caregiver.
Full-time adult foster care homes usually have a limited number of residents. The range and limits, often in the range of 6-20, are determined by state licensing rules and regulations. The “home" setting is usually less institutional in appearance. Although adult foster care is more costly than home care, it's less expensive than nursing home care because the support and care services offered are limited. For example, there is less likely to be licensed nursing available on site. And, recreational activities may be limited as well.
Nursing Home Living
Advanced and more comprehensive care can be provided by nursing homes. These kinds of facilities are usually more costly, in part because a greater range of services is necessary to meet the needs of residents. Resident- or on-call doctors and nurses are a part of staffing that may also include nurse aides, physical therapists, dietitians and managers for social and recreational activities.
Nursing homes become the preference when physical and/or mental capabilities have diminished to a point that at-home living or adult foster care are no longer practical. That’s especially so for residents with dementia. Nursing homes are better geared and staffed to deal with the typical changes in the memory, thinking and behavioral issues related to Alzheimer’s Disease.
Calculating the Caaregiving Costs
The price for each of the levels of senior care varies widely, and is sometimes limited by the assets of the patient. That is, with too much money in savings, for example, a senior may not be eligible for assistanced housing programs such as Medicaid. That’s another whole area of consideration for families when trying to determine what sort of care makes the most sense.
Part of the cost calculation, although impossible to determine in monetary terms, is the price that individuals and families will pay emotionally and physically when attempting to provide in-home care. It’s not a casual factor and should not be treated that way.
Overall, the process of determining the most appropriate and affordable care is frequently made more difficult by families that simply avoid the issue as long as possible. In such cases, options can be limited by circumstances in ways that add significantly to decision-making difficulties. Begin thinking about realistic options early in the senior years, including loved ones in the discussions when possible, and outlining possibilities well before harder choices become inevitable.
For Further Reading:
Caregiving: Dealing Successfuly With Family Issues
Caregiving: Giving Care to Senior Caregivers
