This VERY comprehensive article is designed for a person’s elderly parents but guess what…us Baby Boomers need to be aware of these resources as well so I want to pass this article along to you! It helped me – I hope it’s a great resource for you as well.
If your loved one no longer has a voice in which to defend or advocate for herself, who better to do so than you?
In this post I will assume that your loved one, e.g., parent, grandparent, spouse, or sibling, lives in a long-term care (LTC) facility. Oftentimes by the time our parent has entered a facility, we are so relieved that someone else has taken over the caregiving, we willingly take a back seat and let the professionals do their job. By all means, reward yourself with the freedom that less active caregiving of your loved one has afforded you, but don’t leave your caregiving role behind.
I know it’s hard to hear what I’m about to say – especially since you finally turned over your parent’s caregiving to someone else – but I want to encourage you to NOT assume that the care being provided (or withheld) is in your loved one’s best interests. It’s easy to have a perhaps unwarranted laid-back attitude because:
- mom is being taken care of by trained professionals who wouldn’t be doing this job if they didn’t love it; and/or
- mom is living in a ritzy/expensive place so it must be the best option for her; and/or
- this place couldn’t possibly have any problems as witnessed by the waiting list we had to climb to get her accepted.
I wish all of the above points were reason enough to become somewhat removed from the picture but the truth of the matter is that none of the above have any bearing on the quality of care being provided to your mom. Let’s take each point separately.
- Without a doubt, there are caregivers and management staff that truly do love what they do and this attitude is demonstrated in the compassionate way in which they care for your loved one. However, in 2007, studies showed that staff turnover rates ranged from 50 percent to well over 300 percent a year! There’s a reason why caregiver turnover is so high. This job is TOUGH and the pay is unconscionably low. A 2004 U.S. Dept. of Health and Human Services report addresses the front line long-term care workforce challenges which have only increased in the past several years. This report is worth your while to read. Learning is power – right?
- Champagne and chandelier facilities are just that – beautiful buildings on their face, but not necessarily representative of the care being provided. Don’t get me wrong, I’m aware that stellar higher-end senior housing companies exit, but it’s important that we not be lulled into thinking that glitz equals great. Sometimes what I call “generic” buildings oftentimes provide as good or better care.
- The waiting lists that so frequently exist for LTC facilities – especially for dementia care – are representative of the demand for space that, as of 2011, is not adequate for the burgeoning influx of Baby Boomers needing care. So a waiting list does not necessarily represent quality.
So here are some pointers for you that I hope encourage your continued involvement in your loved one’s care.
SPEAK UP. You don’t have to be a squeaky wheel to get the grease.
- Be persistent yet respectful.
- Take the time to be a part of your loved one’s care meetings/conferences with staff to discern their reasons for the care being provided.
- Be present: in person if you live nearby or by phone if you are a long distance family caregiver. Trust me, if the caregivers know that you care and are going to be an active family participant, you’ll get their attention, and so will your loved one.
OBSERVE. When visiting your loved one, observe her behavior and demeanor; her cleanliness and her appearance. How does it differ from visit to visit? Is her room tidy, clean and uncluttered? One way to observe staff members in action is to accompany your mom on facility outings. Observe the staff’s interaction with the residents. Do they speak respectfully to them? Are they patient with them? Do the residents enjoy their outings or do you get the impression that these outings are forced upon them? All of these impressions are important towards discerning what goes on in your absence.
ADVOCACY RESOURCES. Do your part in acquiring the tools needed to better understand the resident rights guaranteed by law that your loved one should be receiving as a long-term care facility resident. Each state in this country has a LTC Ombudsman program. Get acquainted with their mission of advocating on behalf of vulnerable adults and contact your local program to receive help in assuring optimal care for your loved one.
The most comfortable decisions you can make in life are well-informed ones. Whether you are choosing a vehicle, the vacation of a lifetime, or a potential residence, doing so is made easier when you’re armed with essential information. Oftentimes when inundated with too many choices, we exclaim that we would rather have fewer options from which to choose. “Give me two choices and I’ll be able to decide – six or more? Forgetaboutit!” There is one time, however, when you will welcome a diversity of options: selecting appropriate care in your Senior years.
Identifying the person in need of care.
This quest upon which you are embarking may be your own personal quest. You know staying in your current home might prove dangerous to you – and therefore inadvisable – in the years to come. Or perhaps you just want to retire from doing house repairs and weekend yard work –and who doesn’t? Whatever the reason, you’re considering your options for when you might be less able to take care of your daily needs.
Another scenario is that your spouse, parent or sibling is in need of some sort of long-term care resultant from a debilitating condition such as cognitive decline, mobility restrictions and/or advancing age, so you’re trying to discern how best to address the care needs associated with their condition.
There are two primary care options from which to choose:
- Aging in Place – This blog posting addresses the option of staying put and making adjustments that modify a residence to suit your needs or that of your loved one. Also included in this option is the potential for hiring in-home care. Both of these options allow a person to remain in their home for as long as possible.
- Long-term care (LTC) housing options. In a future posting I will address the available categories of long-term care (LTC) housing and will provide resources that should be helpful towards choosing a replacement for your current residential situation.
Both options have Pros and Cons involved with them. But only you know what best fits your personal situation.
Aging in Place: I don’t even want to think about moving!
Aging in Place refers to living where you have lived for many years using products, services and conveniences to enable you to remain where you are. To successfully age in place without moving you will most likely need to accommodate the physical and cognitive changes that may accompany aging.
Structural changes. Both the inside and outside of the home could eventually require some structural adjustments to accommodate a person’s current – and future – needs.
- If you live in a two-story house and your primary bedroom and bathroom are upstairs, does your bottom floor afford a bedroom/bathroom alternative?
- Are you financially prepared for the costs of making the inside of your home more accessible, e.g. wider doors for wheelchairs or walkers; lowered counters to accommodate same; showers that can accommodate someone confined to a mobility aid?
- Does the outside of your home allow for the addition of ramps and railings for easier access to the residence?
- If one of you has cognitive decline and is prone to wandering outside of the house – what measures, if any, will assure this resident’s safety?
- If you need care assistance during the day, are you comfortable having a health care provider in the home? The costs and logistics of hiring and scheduling staff to come into your home can prove to be overwhelming and oftentimes more expensive than if a person moved into a residential community that readily offers the needed care.
How expensive is in-home care these days? Caveat: I will not be addressing financing sources such as long-term care insurance, Medicare, Medicaid and the like. My intent in these articles is simply to provide an overview of care options and potential costs.
The U.S. Department of Health and Human Services gives a 2009 run-down on costs for care options both in the home and in a long-term care residential setting. I know that in Washington State, where I reside, the average Home Health Aide hourly rate is $22; the average monthly cost of an Assisted Living (AL) facility is $2870; and the average daily cost of a semi-private room in a nursing home is $225 which is approximately $6700/month.
Focusing on Home Health Aide/In-home care: based on the average hourly rate of $22, one could expect to pay close to $528 per day if based on an hourly rate. Keep in mind, however, that most staffing agencies offer a monthly rate which will be less than the hourly rate. But even with that “discounted” rate, in-home care can be very cost prohibitive. A great many of us may not have access to that amount of cash and if the need extends out to several years – now it’s really adding up.
So why even think of remaining in one’s own home if it’s so %#^%($ expensive?
All of the above is not to suggest that Aging in Place is not doable. Many people around the nation are successfully aging in place so why shouldn’t you have a crack at it? Consider this alternative: some people start out Aging in Place and then transition into a long-term care housing situation when finances, or circumstances, warrant such a move.
The articles, Avoiding the pitfalls of selecting senior housing, and Selecting a senior housing community – easy for some, not for the rest of us, provide some tips for your selection process.
I’m a Baby Boomer – are you one too?
No doubt you have already faced some challenges in your 21st Century age grouping called: Baby Boomers. I think you’ll agree, however, that along with those challenges we’ve also experienced delightful times that can only be experienced by us Boomers fortunate to have grown up in the 1960’s and 1970’s.
My hope in starting this blog is that you and I will be able to provide some sort of content that benefits our age group, but not our age group only. Let’s face it, our children and/or our grandchildren need some sort of resource that adds to their understanding of what we’re going through. They too will enter a Baby Boomer-Like age grouping when they reach our age so perhaps we’re doing them a favor by getting their feet wet in this wacky aging world in which we live.
Some of this blog’s content will be humorous; some of it will be inordinately sad. My hope is that one way or another, we’ll all be better off because we’ve entered this “Baby Boomers and More” blog site.