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CAREGIVER SUPPORT: When Help Is Needed
Nursing homes are no longer the only option for aging parents.
C oming to the realization that loved ones may no longer be able to care for
themselves is never easy. Not only is a parent's health in decline, but the idea of
putting Mom or Dad in "a home" can be a difficult consideration for any family.
Fortunately, reports Sandra
A. Pezzoli, M.Sc.N., R.N., at the Johns Hopkins University School of Nursing, as
increasing numbers of Americans are living past age 80, the options for care are also
increasing. The bleak, restrictive institutions that used to be the norm are giving way to
assisted living facilities, some complete with cruise-like recreation directors.
Signs Of Problems
The first step in getting the
right care for an aging parent is recognizing that there is a problem. The signs can be
easy to miss unless you know what to look for:
- Increased forgetfulness. This isn't the common memory lapses we all have, like
forgetting where we put the car keys or neglecting to send a birthday card. This means
forgetfulness that can become harmful. Small fires or floods are signs that an elder is
leaving a stove or iron on or forgetting to turn off water faucets. Also, talk to the
elder's neighbors. They may notice changes in the elder's routine, such as forgetting to
pick up the mail for several days.
- Not taking medications properly. The easiest way to find out how well seniors are
taking medications is to ask how often they were instructed to take medication, and
compare their answer to what's marked on the prescription label or count the number of
pills. Many elderly people rely on medication aids such as the seven-day pill dispenser.
All the medications for the week are placed in daily sections. If your loved one is using
a system like that, you can easily check to see whether they're keeping up with their
medicines.
- Weight loss. There are many possible reasons for weight loss, all of which need
to be addressed. First, check to make sure there is adequate food in the house. Many
elders can't get to the grocery store often enough or carry all the food they need. Weight
loss can also be a symptom of a disease or of mouth pain that makes the elder unable to
eat.
Continuum Of Care
If you recognize there is a
problem, you need to have an open and honest conversation with the elder about the variety
of options. Pezzoli provides this run-down:
- Senior centers. Typically run by government agencies, but occasionally by
hospitals or churches, senior centers are available to any senior citizen, free of charge.
These full- or half-day programs encourage socialization, offer health education and may
provide meals for a nominal charge. Depending on the size of the community, some senior
centers have swimming pools, arts and crafts, dancing and immunization programs.
- Adult day care. This service is similar to child day care; it's designed for
seniors who need daily attention and monitoring. Caregivers can drop off their loved ones
before work, then pick them up at 5 p.m. The service is available one to five days a week,
and fees vary by location and number of days. There are nurses on site to monitor
medications, and physician visits can be arranged.
- Assisted living. This level is meant to be a bridge between totally independent
living and the need for skilled nursing care. Assisted living facilities offer elders
their own apartments or quarters (depending on the facility) in a building or community
that houses other seniors. A certain degree of independence is still required —
elders must be well enough to manage their own affairs, to dress themselves, etc. But
there is a safety net: A certain amount of nursing care is provided weekly to monitor
medication use and keep an eye out for new problems, such as a diabetic ulcer. There is a
communal dining room for meals, although meals can be eaten in the elder's own quarters.
This monitored environment offers a high degree of independence, with the added benefit of
special programs and activities. The more sophisticated programs even have full-time
recreational directors.
- Skilled care. These are usually thought of as traditional "nursing
homes," which provide a high level of medical care for elders who are simply not able
to perform the basic activities of daily living, such as bathing, eating or dressing
themselves. This level of service offers sheltered supervision with dependence on nursing
staff to provide comfort and care. Physicians visit elders in this setting to manage
chronic conditions or address new medical problems.
- Life care communities. These newest facilities are often large complexes that
offer several levels of care in one location. A senior can move from independent living to
assisted living to skilled care as needed. For example, an elderly person living
independently would be moved to skilled care to recuperate after a stroke. But once
recovered enough to take care of basic needs, the senior could move to assisted living.
These facilities often incorporate support services such as gift shops, beauty shops and
dining rooms. These communities provide a lot of security and peace of mind for people as
they age, knowing they will maintain their independence but have the care they need if an
emergency strikes.
For all services, you should
check out the specific facility to make sure that it is clean and professionally run and
that the staff is attentive to the people who attend. Visit the facility to check the
quality first-hand, and make a point of talking to both staff and elders in their care to
make sure all your concerns are addressed.
To locate services or
resources in your area, call the toll-free Eldercare Locator at 1-800-677-1116. Also
consult your local office on aging, which can provide information on aging services near
you.
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