Aging Parents And Home Care

How many Americans provide home care for their aging parents in the US today?

We know that one in ten people over 51 will be providing care for their elderly parents. Somewhere between 19% and 25% of all Americans are involved in taking care of an older or disabled adult family member. The numbers are huge.

Who provides the majority of in-home care services?

The majority of in-home care services are provided by families. Typically eight out of ten families would do it themselves, often even without the community support.

What are signs that my parent needs home health care?

I think it's human nature that most people wait for the crisis to get health care and then it becomes a bigger than life situation. Some of the signs that people may need health home care is if they're having difficulty maintaining their home. If we're looking and they can't make meals anymore so they're often not able to get to the market or not able to prepare their meals. On the next level is taking care or their own needs and that may again be because of memory problems or physical problems. So you'll notice people that are previously very well groomed forgetting to wash their hair or wearing clothes that are soiled. And then again the more obvious one when people have very hard time getting up or down, their vision is impairing them and they're starting to get in car accidents and all kinds of other problems associated again with physical impairment or memory impairment.

Who can help families develop and implement a home care plan?

Probably the people that are most available to deliver a home care plan are care or case managers, and they again are in the private sector and in the public sector. I personally am involved in the private sector, but there are professionals with backgrounds in nursing, mental health, or social work, that go out and evaluate with a lot of objectivity and a lot of information about the knowledge of what's out there; and also can understand the functional level on many different levels for the older adult.

What is a geriatric care manager?

A geriatric care manager is a professional that deals with the long term care needs of older adults. They can do something as simple as creating an evaluation or a plan like a road map, or doing a full on oversight and coordination of all the services.

What home care services are available to help families?

One is community organizations that may have registries. These are going to be independent contractors, that the family will be the employer. The other is through each state, there are health care organizations that have a screening. If you want home care agencies that at least you're sure have the basic insurance coverage and protections and screening through basic state private organizations. You can get some of the screening done. Probably the best way to get this home care is through recommendation of others. Sometimes it's their health care professionals, more often it's friends and family that have used various agencies before and are satisfied or not. The only thing you have to be sure of is that their needs are similar to yours.

What if my parent needs medical care every day?

If a parent needs skilled, medical care everyday it is really a challenge. Our acute care system is made up of going to the doctor, and going to the hospital. Getting incremental home care to come into the home or as a last resort for many people is a nursing home that is overseen by a registered nurse that can take care of their needs.

Is long-term home care a practical solution?

I think long-term home care is probably the most practical solution. It balances out the family's desire for people to stay in the home. If we can get the community revved up to add some additional supports. It certainly is more cost effective than the high cost of facilities, and it also is a more humane way of treating older adults rather than warehousing them.

Is the quality of home care as good as nursing facilities?

Again, the quality of care between nursing facilities and home care can vary very greatly. A top quality nursing home is best; it can have a very good staff. You have to understand the ratio of patients to care givers in a nursing home. Even the best nursing home is probably three or four hours a day per patient. In a home, if there's a difference between getting 24 hour care from a person that is able take care of the needs of the individual and getting somebody that does not speak the language and has little skill set other than fact that they're willing. So it's a difficult question to ask because it really depends on the situation. It also depends on how much family or other support is given out there, if a family member, older adult has an advocate for them, if somebody's going to the nursing home everyday, it's a very different experience than if somebody being left there and left vulnerable to overwork and overstress staff that working in the nursing homes.

What are the most important home care issues that should be addressed?

The most important home care issues that should be addressed are, what are the specific needs of the individual and what are the specific needs of the family? For some families, a little tiny bit of respite care is enough, and this is particularly true of couples. Couples are normally devoted and really want to take care of each other. They are nurturing, and they made a pledge a long time ago that they are going to take care of each other and to really enjoy that experience. So home care is appropriate for them, for maybe one or two days a week for a home care person to come in just so they can go out and see their friends, get their hair done or just go to the movies and have a little bit of respite. For another older adult that maybe has memory impairment appropriate home care would be somebody living in twenty four hours a day, seven days a week, overseeing all aspects of their care, and for most people it can be someplace in between the two.

What if my parent refuses to consider home care options?

Having parents refuse home care options is very common. In fact, it's very surprising when an older adult really wants those home care options. Sometimes children come in and they are concerned about the safety of their older parent, and the older parent is concerned about hanging onto their autonomy and their independence. Get a professional in there to mediate between the two, to assure the older adult that we're not going to take them out of their house, and that they can still do the things that they want to do. They're getting the little assistance that they need, and balancing total safety and putting somebody in a bubble to protect them, and having a little bit of risk in letting them stay home, keeping them engaged in conversation. Making those decisions can make all the difference in the world.