Rather than moving into a long-term care facility as they age, many older adults prefer to stay at home for as long as possible. This may be the right choice for you if you only need minor assistance with your daily activities and enjoy a close network of nearby family and friends. These guidelines explore the range of home care services available to help you maintain your independence within the comfort of your own home.
Is Global Health right for my loved one or me?
It’s natural to want to stay at home as you grow older. However, taking a step back to look at the big picture can help you decide whether staying at home for the long term truly is the right step for you. Too often, decisions to leave home are suddenly made after a sudden loss or emergency, making adjustments all the more painful and difficult. Take a look at your options, your budget, and some of the alternatives.
What can help me stay at home?
You may be used to handling everything yourself, dividing up duties with your spouse, or relying on family members for help. But as circumstances change, it’s good to be aware of all the home care services available that might be of help. What you may need depends on how much support you have, your general health, and your financial situation.
Keeping a household running smoothly takes a lot of work. If you’re finding it hard to keep up, you can look into laundry, shopping, gardening, housekeeping, and handyman services. If you’re having trouble staying on top of bills and appointments, financial and healthcare management may also be helpful.
Transportation is a key issue for older adults. Maybe you’re finding it hard to drive or don’t like to drive at night. Investigating transportation options can help you keep your independence and maintain your social network. You may want to look into local transportation such as buses, reduced fare taxis, and senior transportation options to appointments.
If your mobility is becoming limited, home modifications can go a long way towards making home more comfortable. This can include things such as grab bars in the shower, ramps to avoid or minimize the use of stairs, or even installing new bathrooms on the ground floor.
Help with activities of daily living, such as dressing, bathing, feeding, or meal preparation, is called personal care or custodial care. You can hire help with personal care, ranging from a few hours a day to live-in care. People who provide this level of care include personal care aides, home care aides, and home health aides. Home health aides might also provide limited assistance with things such as taking blood pressure or offering medication reminders.
Some health care services can be provided at home by trained professionals, such as occupational therapists, social workers, or home health nurses. Check with your insurance or health service to see what kind of coverage is available, although you may have to cover some cost out of pocket. Hospice care can also be provided at home.
Day programs, also called senior daycare, can help you keep busy with activities and socialization during the day, while providing a break for caregivers. Some day programs are primarily social, while others provide limited health services or specialize in disorders such as early stage Alzheimer’s.
Involving loved ones in Global Health services
Everyone has different family structures and support. In deciding your own options, take a look at your own family structure, culture, and the expectations you and family members might have. You may have already made alternate plans, preferring to keep family as little involved as possible. Perhaps you and your family want to work out a system where caregiving by family is your primary support for staying in the home. Or it could be that work, health issues or location of your family may not make this feasible. Your family could live far away and prefer that you live with them or move close instead, which would mean giving up a local support system.
While this conversation may not be easy, it’s better to discuss these issues earlier than to wait for an emergency when options may be more limited. An independent opinion, such as a home assessment by a geriatric case manager or consulting with other professionals, can be helpful in defusing family tensions too. You have the final decision as to where you want to live, but input from family members is also helpful. Are they worried about your safety or a health problem such as Alzheimer’s that will eventually require heavy care? Listening to concerns and keeping communication open is key.
Even if you have strong family support, be open to the idea of having other help too. Many people have an initial feeling of “not wanting strangers in the house.” But caregiving can be physically and emotionally exhausting, especially if it is primarily on one person such as a spouse. Your relationships will be healthier if you are open to the idea of getting help from more than one source.
Finding the right home care services for you
Global Health will help you figured out your needs, to evaluate what home care services are right for you.
I’m worried my loved one is not safe at home. What should I do?
Perhaps you’ve noticed that your loved one’s home has become much messier than it used to be, or that he or she is wearing stained, dirty clothes. Maybe it’s clear that your loved one hasn’t had a bath for a while. Or when you open the refrigerator, there is hardly any food inside. Or you may be worried sick about a recent fall or seeing a pan burning on the stove.
It can be frightening and painful to see a loved one who is losing the ability to care for him- or herself. Sometimes, declines can happen gradually. Or a sudden change in health, recent fall, depression, or loss of a key local support can trigger difficulty. Regardless of the reason, if you’re worried about safety or the condition of the home, it’s important to bring it up with your loved one to see what can be done.
Tips on talking to your loved one
Try to find the real reasons behind resistance:A seemingly resistant loved one could be frightened that he or she is no longer able to do tasks that were formerly so easy, or chronic untreated pain may be making it difficult. It might be more comfortable to deny it and minimize problems. Perhaps he or she is grieving the loss of a loved one, or frustrated at not being able to connect with friends. If your loved one has a hard time getting out and is losing support, he or she is also at risk for depression.
Express your concerns as your own, without accusing:A loved one might be more open to your honest expressions of concern. For example, instead of saying “It’s clear you can’t take care of yourself anymore. Something needs to be done,” try “I’ve really been worried about you. It hurts me to think that you might not be getting everything you need. What do you think we should do?”
Respect your loved one’s autonomy and involve him or her in decisions:Unless your loved one is incapacitated, the final decision about care is up to him or her. You can help by offering suggestions and ideas. For example, what home care services might bridge the gap? If you’re worried that home care might not be enough, what other options are available? You can frame it as something to try temporarily instead of trying to impose a permanent solution.
Enlist other help:Does your loved one know others who have used home care services, or have had to move? Talking to others who have had positive experiences can sometimes help remove fear of the unknown. You may want to consider having a meeting with your loved one’s doctor or hire a geriatric care manager. Sometimes hearing feedback from an unbiased third party can help a loved one realize that things need to change.
If your loved one is becoming incapable of making decisions
Are you worried that your loved one is putting him or herself in danger? Someone with worsening memory problems, for example, may forget to turn the gas off or wander outside and get lost. This may be a concern with diseases such as later stage Alzheimer’s disease or other dementias, Parkinson’s disease, or stroke.
If you have the opportunity, its best to bring this up before your loved one has reached the level of incapacity, although it’s a hard conversation to have. If your loved one has designated someone with durable power of attorney in case of incapacity, then that person can make decisions if your loved one is no longer able to. If not, then you may need to petition for guardianship or conservatorship. You may want to consult an advocacy group and an elder law attorney to best understand your options.
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