As featured in North Hawaii News August 11, 2015
When it comes to planning for our later years, most people don’t really consider all the options available in case they become cognitively impaired. Understanding these care options helps you to guide the decisions you would want for yourself in case life takes an unexpected turn. Many people do not expect they may lose competency or their own good judgment, yet the statistics show that there are over five million older adults in that category.
According to the Alzheimer’s Association, by 2025 the number of individuals currently diagnosed with dementia will increase by 40 percent. If those 2.1 million people who are likely to be affected within the next decade were currently setting realistic goals and clarifying their desires to both themselves and their loved ones, their proactive planning would make the difficult decisions their loved ones will need to make in the near future much less overwhelming.
I would like to offer some options to consider when you think about all of the different paths that may be available to you should you have any cognitive decline. I had mentioned that most people want to live at home as long as possible. We work hard to create a home and life for ourselves that brings us joy. Being in your own home, or living with a close relative, is usually the ultimate goal. If this goal is also a realistic option, please consider some of these possible scenarios.
For better or for worse, right? Many spouses fill in where their partner may be starting to have gaps. Often, family will wait for mom or dad to ask for help, but that request never comes because they feel it is their duty and do not want to burden their children. The caregiving spouse does not realize that without asking for help they may be at risk of being unable to provide any care for their loved one.
Did you realize that it is often the healthier spouse who passes away before the one they are caregiving for? Please do some research on the topic and learn about the danger involved in having a spouse, who is older themselves, providing the bulk of caregiving responsibilities for an extended period of time. Prolonged elevated stress hormones and physical breakdown are two high risk factors that may lead to their demise.
If there is not a spouse to provide care, sometimes a grandchild with no other major responsibilities moves in. The rest of the family think this is a great option because this younger relative can keep an eye on their grandparent. Next thing you know they are receiving shelter and food for free, the laundry is piled up and there’s nobody there to make sure medications or well balanced meals are made available on a consistent basis. I suggest creating a formal contract that explains the specific duties they are signing up for when moving in. This can be helpful if the time should come to change the situation. There must be an exit strategy that is clearly discussed before any relative moves in. I also suggest the family pitching in to get that relative some training in caregiving. Love is a good starting point, but not the only tool you need in that caregiving belt!
At other times you will see a very responsible child take a relative in. They may be raising their own family and become “sandwiched” in between caring for the younger generation and caring for their parent. Their marriage and health may start to fray at the edges due to the increased responsibility of making sure your needs are met. This dynamic may work well for some adult children and their parents, yet they still need to be sure to maintain a healthy balanced lifestyle and have outside support.
All of the above scenarios are those in which an individual stays at home. There are a variety of services available to assist with in home care.
When choosing between options, there are a few things to consider. With a private caregiver you may find it is more affordable at $12 to $20 per hour. You do want to do your due diligence, though, and run a background check and speak with references. You must also consider that if you have one person lined up to provide care, they may have a family emergency or illness that leaves your loved one without care.
With a home health agency, you may have a higher cost of over $20 per hour, but you also have backup aides, screened employees and an HR department which monitors physicals, TB clearances and also provides workman’s compensation if needed. You also usually have a Registered Nurse providing the intake process and monitoring the needs of your loved one as needed.
Adult Day Care provides respite for the daytime and gives an older adult an opportunity to socialize with their peers. You pay for the day, which breaks down to less than the private caregiver per hour, and lunch and activities are provided. This is a nice option for individuals who may be at risk of depression due to loneliness or lack of physical stimulation.
I suggest that you think over the above “home based care” options and have conversations with your loved ones about which you feel most comfortable with. It may very well be in your best interest, and theirs, to have paid professionals assisting you with your care.
Now is the time to make some decisions about which of those options you’d prefer for them to consider. Ultimately it comes down to faith in the services available and the family members who will be making those choices. Giving them an outline will help them immensely should the time ever come.