Monday, March 26, 2012

Navigating the Senior Care Decision

One of two things is true: Mom or Dad needs care now OR they will need it in the not too distant future.

Beyond this realization, getting to the most desired outcome is based on Mom or Dad’s position on a number of variables: acceptance, preferences and financial ability.

When a family has time to plan and an open relationship based on trust and respect, solutions can come about with less stress, guilt and animosity. However, when decisions need to be made without prior conversation, due to a critical event such as a stroke or fall, adult-children struggle with the pressures of doing so regardless of Mom or Dad’s preferences. Regardless of which situation you find yourself in, navigating your way remains the same procedurally.

Acceptance

Is Mom or Dad accepting of care? A very large percentage of seniors are not. Midwest Home Care has assisted many families with these discussions and is happy to assist you. Here is a very good resource offering insight to transitioning this resistance to one of accepting assistance:
"Caring for the elderly: Dealing with resistance"

Preferences

There are four primary choices for seniors when assistance with daily living becomes necessary:

· In-home/private duty care(non-medical) is focused largely on safety, social engagement, exercise, medication reminders and household chores (Services are 1 hour a week to 24 hours/day)

· Home Health care (medical) is focused on providing specific medical visits (blood draws, IV’s, etc.), administering medication, and physical therapy among the services (Services are based on needs)

· Assisted living communities (mainly medical) – 24 hour living arrangements

· Skilled nursing facilities (mainly medical) - 24 hour living arrangements

Most seniors indicate they prefer to stay in their own homes. Private-duty agencies such as Midwest Home Care make this not only possible, but preferable. There are many benefits to receiving care at home.

These options may be blended as well to create the desired outcome and balance between medical assistance and social engagement. For example seniors can receive private-duty care while living in assisted living communities or skilled nursing facilities to create a more relationship oriented environment.

Ability to Pay for Services

The following are some financials that may help you evaluate long-term care options:

In-Home/Private-Duty Rates (2011)
Monthly
Increase
over 2010
Median
$3,840.00
0.00%
Assisted Living Facility (2011)
Monthly
Median
$3,261.00
2.39%
Nursing Facility (2011)
Monthly
Median
$5,964.00
5.10%
Statistics by www.genworth.com
All statistics based on 8 hr/day, 5 days/week

Some in-home/private duty agencies currently accept governmental financial assistance. Long-term Care Insurance
generally accepted as are benefits offered through the Veterans Administration.

Making the Choice

Before making a determination of any one option, conduct interviews, request access to trial programs such as participating in an assisted living community/skilled nursing facility ‘Activities day’ or requesting a short trial period with an in-home/private-duty agency and certainly site visits are recommended. A suggestion for ‘outside the box’ consideration that will not only save you time but, perhaps improve your interviews overall would be to invite everyone to the same table. Ask your questions once and measure the responses of each all in one sitting. Midwest Home Care is happy provide a format for this process on request.

Friday, March 2, 2012

Aging parents: When Health Fails

Each Generation Recognizes the Obligation to Care for the Elderly.
             Fulfilling the Obligation is a Whole Other Ballgame.

Fact: After age 65, an American stands a 70% chance they will need non-medical help with activities of daily living (bathing, dressing, housekeeping, toileting). (American Society on Aging)

While some adult-children will never have to concern themselves with long-term care decisions for their aging parent(s), the vast majority of them will.

Fact: 2 out of 3 families have never had these conversations about Mom or Dad’s long-term care wishes. (AARP 2011)
       
Generally speaking, 75% of adult-children making long-term care decisions are doing so as a result of a crisis; Mom or Dad is being discharged from the hospital after suffering a debilitating stroke and cannot live alone. Can they live with you?

Fact: Family caregivers live an average of 480 miles from the one they care for (Alzheimer’s Association & National Alliance for Caregiving) and they are: raising families of their own and are financial contributors to their dual income home.

The road map through the long-term care system is not easy to navigate. Why? Each family situation is unique. Family dynamics play a significant role in the negotiation; consider your relationship with Mom or Dad, your siblings and extended family. Is there a history that suggests Mom or Dad should or should not be cared for by family? Finances have a major role in determining which care options are available. Does Mom or Dad have long-term care insurance that makes private-pay in-home care an option? Or, is a nursing facility, paid for by Medicare, most affordable.

Whether you are one of the 25% making long-term care decisions in advance or find yourself one of the 75% responding to a crisis, I point you to a series of extremely well written articles that will provide sound advice in the areas of:


  • Building Positive Relationships (with aging parent(s))



  • Brothers, Sisters and Aging Parents (understanding sibling dynamics surrounding care for aging parents)



  • Helping When Health Fails (general principles to consider in charting the course of long-term care).