When a family realizes that a parent or loved one needs additional care, often the first thought in people's minds is to find someone to come into the home to provide care.
It used to be common for elders to go live with a family member or a nursing home if there was frailty of body or mind. Caring for a family member is not easy. As the family member ages, so does the caregiver; their mobility, strength, and patience begin to wane. The act of caregiving can be physically challenging for the caregiver. Living with the unpredictability of someone with dementia can wreak havoc on a caregiver and the entire family. Talk to someone who has been a caregiver to a family member. A small percentage will tell you what an honor it was to care for someone else, but the majority will tell you stories of unbridled family stress and will encourage you to find a paid caregiver to provide care so you can continue to maintain cohesiveness in the family.
Many people elect to find a caregiver they can hire on their own. The main lure here is that the hourly rate may be less than that charged by an agency. Essentially, you're becoming a business owner. When someone needs care, they need consistency and reliability. Unless you've hired multiple caregivers, you'll always be waiting in the wings to fill in when someone doesn't show up for work.
Private-duty in-home care agencies take the "employer" aspect out of the picture. Initially, the industry boomed, but then the reality of finding enough quality staff and paying them a sustainable wage became difficult. Also, as our communities grew, so did the traffic congestion. Agencies that once offered to visit a home for a single hour began moving to two, three, even four hours as a minimum per visit.
At the same time, assisted living and residential assisted living (homes that care for a small number of residents) came onto the scene. Both Oregon and Washington put forth plans to change the face of nursing homes. Families were no longer willing to accept having their loved one placed with three or four other residents in a small nursing home room. Since then, a growing number of nursing homes are no longer intended to be places where people live out their entire lives; instead, they have become short-term rehabilitation facilities where people stay for ten days to several weeks to receive intensive physical, occupational, and speech therapy.
In the Vancouver and Portland Metro area we have an abundance of options available through which to receive care. We have around 75 in-home care agencies, just over 1,500 private homes offering care for three to eight residents in family-like settings, and just under 200 retirement living, assisted living, and specialty memory care communities. With all these options, knowing which is most appropriate can be difficult. The costs are significant, so it's important not to make mistakes when selecting a care option.
This is where senior care referral agencies came into being, to help families sift through the mountains of information and understand how it affects their options. There are now over 50 such agencies in our geographic area. To find a quality agency, visit the Oregon Senior Referral Agency Association (which includes agencies in Vancouver, Washington) at www.osraa.com.
Is In-Home Care the Right Fit?
In-home care is best for a person who requires a specific number of tasks that can be readily scheduled. Someone needing help with a set number of tasks (getting up in the morning, showering, having breakfast, and getting set up for the day) is an ideal candidate. It would not be a match for someone who needs unanticipated help at varying times of the day or night.
For people with dementia (at certain stages in the memory loss process), in-home care is a good option. At other times, the person with memory loss may find it unsettling to have a stranger in their home, or they may even refuse to allow a caregiver into their home at all.
Questions to Consider
When considering the options, here are just a few things to think about:
- What has changed that is causing a need for care or a change of living environment?
- What type of setting would best work for the older adult?
- If you want in-home care, do finances allow for an approximate hourly cost of $45+/hour?
- What specific geographic locations are best?
- If a retirement or assisted living community is preferred, how long can the older adult be left alone?
- What are the specific health concerns and diagnoses?
- What type of care is needed and at what times of the day, evening, or nighttime?
- What is the personality of the person who needs care?
- What sight, hearing, or speaking impairments exist that may need special attention?
- What inspires the person, what are their joys, what do they find upsetting?
- Is the person at risk of falling?
- Is there a spouse or significant other that will be making the move as well?
- Is the person a veteran or a spouse of a veteran?
- Does the person qualify for any discounts on monthly base rent based on income?
- What income and assets are available to pay for care; if finances are limited, how long before the person will need to transition to state assistance?
- Is there a pet that also needs care? Can the person care for the pet or will they need the caregiver's assistance?
When you enlist the help of a referral agency, they will likely ask you well over 100 questions before defining your options.
Whether a person is staying at home or making a move to a community-type or home-like setting, it's always critical to think about the actual and specific needs of the older adult. Family members, while well intentioned, often seek out options they want to see for the elder, not the ones that fit best. The senior's wellness depends on the family making the best decisions after fully understanding the multitude of options.
Les Ostermeier, Housing & Care Advisor/Owner, 1st CHOICE Advisory Services, Inc.
Serving Washington and Oregon seniors since 1993.