Home, sweet home: It’s where the great majority of seniors want to stay as they age, and many of them do — even when they need support in their daily life.
According to recent data from the Family Caregiver Alliance/National Center on Caregiving, 80 percent of older adults — including many with several functional limitations — receive care in private homes, not in nursing homes or other healthcare institutions.
If you’re caring for an older adult who wants to stay home but needs help with daily activities or to stay there comfortable and safely, then it’s worth considering professional help.
Let’s investigate some of the myths that exist regarding home care:
Cost of care is very often the elephant in the room, regardless of what services you’re considering. If your loved one wants to stay home and you’re able to provide care for free, why pay for it?
Cost of care is more than merely a bottom line expense. We often forget there are hidden costs in providing “free” care as family providers, like lost wages when we can’t work, diminished health when we try to manage more than we’re physically or emotionally able to handle or less quality time with other family members. Your role within the family changes too, requiring you adapt into the role of a caregiver instead of your traditional place within the family.
The cost of home care cannot be ignored, so let’s talk about the numbers:
The national average daily cost for a private nursing home room is $253 dollars a day, according to a survey by Genworth Financial. The national average daily cost for home care services? $125. (That’s assuming 44 hours per week.)
Nursing care at home can cost nearly twice as much as home care. And while it can provide 24/7 services, many seniors residing at home don’t need that intensive level of round-the-clock support. In fact, many home-based seniors do not even need 44 hours of home care a week.
But even at that number, the cost is considerably lower than nursing home care—and comparable with national averages for assisted living ($119/daily).
No one really wants to think of a parent as “needing help.”
If your father was an accomplished banker, it’s hard to see him unable to balance his own checkbook. If your mother was an amazing cook and made meals for your extended family of 25 without breaking a sweat, it’s hard seeing her struggle to read and follow a simple recipe. Now imagine if the tables were turned. How would your mom or dad feel if independence was becoming more and more challenging with each new day?
Losing one’s independence, no matter the reason, is a difficult life shift. As those losses compound over time, it just gets harder. That’s why so many people — caregivers and our loved ones alike — resist the idea of help. We want to do things ourselves.
The truth behind dispelling this myth is that it is all in how we frame it. If we think of it as a means of gaining back, maintaining and even growing independence instead of “needing help,” perhaps we’d find our loved ones could really benefit from home care before there’s a dire need for it.
For example: Maybe your mom can still make a delicious meal but just can’t drive to the grocery store alone, load the heavy bags into the car or make a reasonable shopping list. Instead of saying, “Mom, just have your meals with us,” or “We’ll take care of it and bring you prepared meals for the week every Sunday,” (which emphasizes her growing dependence), you could introduce the idea of a sous chef. “Mom, would you like a personal shopper who can bring the groceries you need each week and talk about a meal plan with you?”
By discussing the support in a positive way — while finding a way to meet a need without making your loved one feel incapable — is an effective strategy for reframing the “I don’t need help yet” myth.
Allowing a stranger into the home can feel uncomfortable at first. But professional caregivers can easily become like an extended member of the family if you’re open to the possibility and committed to the success of the arrangement.
In many cases, aging parents would actually prefer a home care worker over a family member. Why? Because again, going back to the loss of independence that so many wrestle with, some seniors truly resent the thought of being a burden on their loved ones.
On the flip side, some adult children may find it difficult to be both daughter AND caregiver, and feel uncomfortable in the role. And sometimes these adult children feel like they haven’t even been in communication with a parent and are suddenly thrust into the role of caregiver now tasked with bathing their parent.
For any number of reasons, the idea that only a loved one can bring comfort to a parent who needs care is just not true, and bringing in an “outsider” to provide personal care does not have to be a negative thing. One of the benefits: This allows the family caregiver to move back to being the son or daughter, not the caregiver.
Recall from earlier, 80 percent of seniors receive care at home. Those 80 percent of seniors can experience a wide range of symptoms; from loneliness, minor vision impairments or mobility challenges to the terminally ill. Home care serves them all.
Home care can and does provide services to the very sick and the terminally ill, but it also serves people in the early stages of Alzheimer’s who just need medication reminders or the boost a bi-weekly friendly visit brings.
It serves people being discharged from the hospital after a fall, people who need help getting showered and dressed in the mornings and people who need help for two weeks, two years and everything in between.
Home care can be customized to meet whatever your loved one’s care situation is, both in the present and for the future.
This may be true for a time, but as a senior loved one’s limitations advance, your family’s ability to address those limitations may not always increase accordingly.
Some siblings may be enthusiastic about providing support at the beginning, but you may find their participation declining over time, leaving one of you with the bulk of the responsibility, which can lead to caregiver burnout and resentment. Even with sibling support, one person is typically responsible for coordinating the care, and that individual carries more of the caregiving burden.
Another disadvantage to this approach of “just stopping by” is you don’t get a true picture of your loved one’s needs throughout the day.
For example, your mother might be perfectly able to manage basic activities during the day, but she struggles with sleeping through the night and gets up often to use the bathroom or get a drink in the kitchen. If she is at risk of falling during these hours of darkness and disorientation, then your sibling popping by on a lunch break won’t represent a true spectrum of mom’s independence or needs.
This is not to say you and your siblings shouldn’t visit, or that a home care worker should only help at night. Your family’s involvement and participation is key, but sometimes more is needed than what a simple “stop by” visit provides.
The first goal of home care is to maintain independence at home for as long as possible. It’s best to think of a professional caregiver (and even yourself as the family caregiver) as a team member or a care partner — not just the sole provider.
Bring in a professional caregiver to fill in the gaps in independence, not to increase your loved one’s dependence before it’s necessary.
For example: If your father-in-law is struggling to get dressed, don’t bring in home care to do all the work of dressing him. Bring in the home care provider to come alongside him in the process: “Which of these three shirts would you like to wear today? Do you want to wear jeans or slacks? Brown slip-on shoes or black sneakers?” Once he’s made his choices, the home care worker can jump in when he gets stuck — buttoning the last two buttons on his shirt, tying his shoes — instead of doing it all.
 Genworth Cost of Care Survey, 2016: https://www.genworth.com/dam/Americas/US/PDFs/Consumer/corporate/48590_070717.pdf
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