Most families eventually have to deal with a complicated and heart-wrenching question: How do I know when an aging relative needs more help than the family can provide? On the one hand, there are numerous 90-year-olds living completely independent lives; on the other hand, there are lots of people in their 70s and even 60s who find they need more help ifrom day to day.
This decision causes families grief. No adult son or daughter wants to admit that a parent -- who provided life, nurturing and help to the child for so many years -- is now in need of care that simply can't be provided in return.
Does it make sense to drive back and forth between homes several times daily to make sure your loved one is eating enough, when a care facility would be able to feed him or her on time, every time, every day? Can you afford to take time off your job to provide the level of care that is needed? How much time, given that the situation likely won't improve? Are you even able to provide the skilled level of care that is required?
Maybe your loved one is still mostly independent, but is showing worrying signs such as forgetfulness or confusion. Are there care options available for those who don't need constant attention?
We'll answer these questions throughout this article -- and learn five signs that your loved one may need the services provided by an assisted-living facility or nursing home
Healthy, but Can't Live Alone Safely
Even the healthiest among us are prone to slips, trips and falls. Most of the time, we can just pick ourselves up and carry on. For older relatives, however, there's a much higher risk of bone fractures due to progressive loss of bone mass. An otherwise perfectly healthy (albeit somewhat unsturdy) elder may suffer a serious injury that then presents new challenges in healing and continued care.
Often, the homes we live in when we are in our 60s and 70s are no longer safe when we reach our 80s or 90s. Stairways, serpentine hallways, slippery tile and tall shelving units present potentially dangerous obstacles that must be negotiated daily. Also, large yards with uneven terrain, poorly lit rooms or small bathrooms in the home of an aging loved one may give family members good reason for pause.
When older family members are still too independent for full-time nursing-home care, many need a much lesser degree of help with daily tasks. These tasks include bathing, cooking, eating, changing clothes and getting safely into and out of the bathtub. For these people, assisted living may be the answer. Assisted living facilities fill a gap between complete independence and around-the-clock care. It's an option for those who are "mostly abled" and who still want (and can safely live with) a high degree of freedom and independence.
Early Stages of Alzheimer's
More than 5 million Americans have Alzheimer's disease, accounting for upward of 80 percent of all dementia cases [source: Alzheimer's Association]. The disease affects memory, judgment and perception. It creates havoc in the lives of those afflicted, as well as for family members. Over time, those suffering from Alzheimer's will lose the ability to speak, walk and swallow. It is a progressive and fatal disease. Researchers are making progress toward finding new treatments to delay the advance of the disease, but there currently is no cure.
A person still in their 30s or 40s may begin showing early symptoms of Alzheimer's, though it more commonly presents itself in those who are retirement age or older. In the early stages, a person has difficulty processing information, remembering simple items or tasks, and concentrating. While these people can still care for themselves most of the time, that independence will continue to shrink as the months and years pass. Even in the early stages, a momentary absence of thought can be disastrous while driving, working around the house or taking daily medications.
About 10 million people in the United States are providing their own home care to loved ones with Alzheimer's [source: Alzheimer's Association]. However, the challenges of caring for an Alzheimer's patient at home only multiply, so just when you think you can sufficiently help a loved one handle a certain level of disability, his or her needs increase. Professionals in care facilities are often equipped and trained to help residents with Alzheimer's. As soon as a loved one is diagnosed with Alzheimer's disease, family members need to begin discussing options for long-term care.
Physical Impairment or Disease
It is not easy knowing when a family member's needs have extended beyond the level of care that a family can provide. Some conditions, such as diabetes, are perfectly manageable for long periods of time before worsening to the point when professional care is needed.
Many diseases, like Parkinson's disease or kidney failure, are widespread in elderly populations and require around-the-clock care that friends and family simply can't provide. The slow advance of these conditions may make it difficult for the affected family member to accept that living without around-the-clock assistance isn't feasible, even when it's fairly clear to others familiar with the situation.
Advanced diabetes often affects eyesight, making the performance of daily tasks downright dangerous. Loss of vision also creates enormous risks of mishandling prescription medications. Conditions such as severe or reccurring strokes necessitate an environment in which a person can not only be carefully treated for pre-existing or recent bouts of disease, but also given intense preventive care.
When it seems like a relative is spending as much time at a medical facility as he or she is at home, advanced care options need to be explored. The risk of accidents, infections or disease-related episodes can be vastly diminished by making sure a loved one will have the level of professional care that is needed.
Decreasing Hygiene or Changes in Personality
Whether it's due simply to advanced age or to the presence of dementia, a noticeable drop in personal hygiene, appearance or social habits may be a sign that a loved one should be placed in an assisted-living or advanced-care facility.
As we age, our reward for long life is often physical decline, new and unexpected sources of pain, and recognizing far too many names when reading newspaper obituaries. The new difficulties of daily life, from incontinence to needing help changing clothes, can also be frustrating.
All of this often adds up to a saturating sense of depression. Not only does depression affect a person's perspective, it also adversely affects the immune system, making a depressed person that much more susceptible to further physical ailments. Also, depressed seniors may withdraw into a cocoon of isolation, making it next to impossible for others to reach out to them or just lend an ear.
Nobody should be left in this type of environment. If you notice signs that an older family member is no longer able (or seemingly interested) in living with a basic amount of dignity, socialization and contentment, that person may very well benefit from the care, attention and understanding that can be provided by care facilities.
Too Great a Burden on Family
Families all over the world are juggling children, jobs and aging parents in an effort to "take care of their own." There can come a point, though, when the demands created by caring for an aging parent outweigh the logistical, financial or emotional resources available.
It's not uncommon for people to feel they're abandoning a family member or "getting rid" of the problem. Sometimes, these feelings are exacerbated by an older person's shared belief that he or she is being put out of sight and out of mind.
The reality is that a point may come in an elder's care needs when professionals can provide a much safer and healthier environment than a family can. Family members must take leave from jobs, drive great distances daily to help out, and take on the costs of the elder's mortgage, utilities and other bills. Then, there's the cost of home-care nurses, trips to the hospital, ambulance rides and other health-related expenses. Also, when a relative cares for an elder who has sizable needs, not only is the care usually less than that provided by a professional, but the relative has traded one full-time paying job for one full-time non-paying job.
The burden of providing care without outside help can deplete your family's resources and emotion well-being. Before this becomes the case, you should explore the option of placing a disabled relative in a long-term care facility.
For more articles on elder care and aging, please see the links on the next page.
What happens when the child becomes the parent? Being a caregiver to your parent can be a hard job. Get tips and information on when a child becomes the parent.
Related HowStuffWorks Articles
- AARP. "Assisted Living: What to Ask." (March 9, 2009) http://assets.aarp.org/external_sites/caregiving/checklists/checklist_assistedLiving.html
- AARP. "Long-term Care Insurance." (March 7, 2009) http://www.aarp.org/money/financial_planning/sessionfive/longterm_care_insurance.html
- Alzheimer's Association. "2008 Alzheimer's Disease Facts and Figures." http://www.alz.org/national/documents/report_alzfactsfigures2008.pdf
- Alzheimer's Association. "What is Alzheimer's?" Feb. 20, 2009. (March 9, 2009) http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp
- Administration on Aging. "Housing." June 2, 2008. http://www.aoa.gov/eldfam/Housing/Housing.aspx
- Arizona Department of Health Services. "Assisted Living Homes/Centers, Adult Foster Care Homes & Adult Day Health Care Facilities." (March 9, 2009) http://www.azdhs.gov/als/hcb/hcb_index.htm
- Assisted Living Federation of America. (March 8, 2009) http://www.alfa.org/i4a/pages/index.cfm?pageid=3267
- Consumer Consortium on Assisted Living. (March 9, 2009) http://www.ccal.org/
- Haywood Lodge and Retirement Center. "Payment Options." (March 8, 2009) http://haywoodlodge.com/
- Medicare. "Nursing Homes." U.S. Dept. of Health & Human Services. http://www.medicare.gov/Nursing/Overview.asp
- Medicare. "Paying for Long-Term Care." U.S. Dept. of Health & Human Services. (March 6, 2009)http://www.medicare.gov/LongTermCare/static/PayingOverview.asp
- Medicare. "Types of Long-term Care." U.S. Dept. of Health & Human Services. (March 8, 2009) http://www.medicare.gov/LongTermCare/Static/HomeCare.asp?dest=NAV%7CTypes%7CTypes%7CHomeCare#TabTop
- MedlinePlus. "Assisted Living." U.S. National Library of Medicine and the National Institutes of Health. Feb. 3, 2009. (March 8, 2009)http://www.nlm.nih.gov/medlineplus/assistedliving.html
- National Association for Home Care & Hospice. "Regulatory Affairs." (March 7, 2009) http://www.nahc.org/regulatory/home.html
- National Center for Assisted Living. "Assisted Living State Regulatory Review 2008." March 2008. http://www.ncal.org/about/2008_reg_review.pdf
- PBS. "Depression: Out of the Shadows." http://www.pbs.org/wgbh/takeonestep/depression/pdf/dep_stats.pdf
- Seniorresource.com. (March 9, 2009)http://www.seniorresource.com/hal.htm