A Senior Moment: Aging at home or in a facility?Posted on January 22, 2014 by ElderCare Resources Phoenix in Blog, Caregiver Education, Education, Geriatric Care Management, Home Care Non-Medical, Home Health Care Medical, Independent Living, Long Term Care Information
By: Leslie Howard
Let’s face it. Most of us, given the choice, would rather age at home than move to a facility. According to the report, “Where will boomers get long-term care?” 90 percent of Americans age 50 and older want to stay in their own homes as they age and remain independent for as long as possible. (Sacramento Bee, Dec. 27, 2010).
That won’t always be possible. People who can stay at home with a little help may decline physically or mentally to needing more help than family caregivers can handle, even with assistance from hired professionals. The costs in terms of dollars and stress may become an overwhelming burden.
A fact sheet about placement options from the Mountain Caregiver Resource Center at Passages Adult Resource Center, the local branch of the Area Agency on Aging, lists the following signals that out-of-home placement is needed:
- Around-the-clock care or supervision is needed.
- Your health as caregiver is adversely affected.
- Patient wanders away from home.
- Patient cannot carry out basic activities of daily living such as eating, toileting, bathing, etc.
- Patient receives no stimulation or needed rehabilitative therapies at home.
- Caregiver suffers from exhaustion, stress, fear, isolation.
While we are still in our new year resolution mode, here are some suggestions for maximizing the time you, your spouse, parent or other aging family member can stay at home.
First, do your part to live a healthy lifestyle to minimize health problems that require hospital stays and skilled nursing care. Eating a healthy diet, maintaining a normal weight and getting regular exercise will help prevent heart disease, diabetes and other degenerative conditions. If exercise clubs are really not your thing, a brisk walk can do wonders to relieve stress and improve cardiovascular health. Find forms of exercise and healthy foods you enjoy so you’ll stick to your new regimen.
A typical road to the rest home begins with a false step and a fall at home. Falls are the leading cause of both fatal and non-fatal injuries among older adults, and it’s estimated that one out of three adults age 65 or older will fall each year, according to Dr. Joseph Mercola’s website article “Elderly Exercisers Have Fewer Broken Bones after Falls” (Nov. 15, 2013,http://fitness.mercola.com/sites/fitness/archive/2013/11/15/elderly-exercise-program.aspx.)
In 30 percent of falls, people have hip fractures, lacerations or head traumas, which lessen the chance of being able to live independently. Get rid of throw rugs and obstructive furniture arrangements that may trip you up. If you have a tendency to fall, take a balance training class or teach yourself the exercises from one of the books on that topic at Enloe Health Learning Center. Strength training will increase bone density so that if you do fall, you will be less liable to be injured.
Even with careful living, most of us who are lucky enough to live long lives will find our mental or physical capabilities will eventually degenerate. Your second set of new year resolutions should center on doing your homework now to determine in advance your best choice for out-of-home care, should you need it.
If you do this before there is a medical emergency, you will have time to investigate all the options carefully and make sure you thoroughly understand any legal implications of admission agreements you will be asked to sign.
It is important to understand the different levels of care, their costs and limitations. The Mountain Caregiver Resource Center Fact Sheet on Placement Options, mentioned above, gives detailed information about these.
A residential care facility is for people who do not need skilled nursing but who can no longer live alone. These range from small board and care facilities with around six patients to medium or large assisted living complexes. They help with hygiene, grooming and temporary bedside illness. They also provide some recreational and social activities. They cost the least of all facility types but are not reimbursed by Medi-Cal, since they aren’t medical facilities.
A skilled nursing facility, also called a nursing home, convalescent hospital, or rest home, provides continuous nursing services under a licensed vocational nurse or registered nurse. Trained staff provides help with bathing, dressing, eating, toileting and recreational activities. Many of these have special units with secured grounds for dementia patients, special architectural design that allows safe wandering, and therapeutic activities. These dementia facilities are much more costly and are not generally available to Medi-Cal or low-income patients.
There are several resources locally and online to help you gather the information about in-home resources and out-of-home facilities. Staff at Passages can provide a wealth of information on available facilities and services (25 Main St., suite 202, Chico; 1-800-822-0109 or 898-5923,www.passagescenter.org.) They have listings of facilities with directory information, numbers of beds, and other pertinent information.
The website for CANHR (California Advocates for Nursing Home Reform, www.canhr.org,) is the source for many of the handouts available at Passages. It also has up-to-date information about legal issues regarding care homes. CANHR has a nursing home guide athttp://www.nursinghomeguide.org that can help you locate facilities in your area that suit your needs.
Online, www.seniorcarecompass.com and www.aplaceformom.com are nationwide companies that can help you narrow your search for an appropriate placement. These organizations are free to users, as they receive payment from facilities that contract with them. Online contacts I made to these two websites resulted in swift return phone calls from staff who were able to access information about facilities, but who do not have personal knowledge of them. Since they are national companies, they can also help gather preliminary information when you are arranging placement for a family member who lives in a distant location.
Information you get from local offices or online research can help you narrow the search, but to make a good choice, you need to visit facilities in person. Making the decision about elder care is difficult and requires careful planning and thought. Topics for future columns include local home care companies and other services such as adult day care, respite care and assistance with meals as you “age in place.” For out-of-home placement we will look at assessing a facility, planning ahead for making the transition, pitfalls to avoid in an admissions agreement, and financing for long-term care.
Leslie Howard has called Chico home since 1983. She enjoys learning, travel, time with family and friends, and volunteer interests. Send comments and suggestions for future columns firstname.lastname@example.org.
Published: Chico ER News