Providing the Care
Session 1: Providing Care in Their Home
Course Sessions
- Seminar Introduction
- Providing Care in Their Home
- Long-Distance Caregiving
- Providing Hands-on Care
- Involving Others
- Knowledge Test
Your mother is recovering from a broken hip, and she is unable to keep the house clean or do her laundry. You and your sister are exhausted from providing 24-hour care for your father. You live across the country from your mother and worry that she spends too much time alone. Dad needs daily physical therapy and special medical treatments, but he can't afford a nursing home.
Situations such as these are common among adult children and older parents who have health problems. Most older people prefer to stay at home even when their needs for care are great. As a result, families take on care responsibilities, which may involve managing medical treatments, assisting with daily activities and dealing with issues around dying.
Too often, adult children feel that they should take care of everything themselves—a point of view some parents may encourage. However, caregivers who get help with tasks and relief from pressures are, in fact, less likely to burn out and better able to provide long-term support for their parents. Where can you turn for help?
Community services
Community-based services that can help older parents can include everything from help with household chores to around-the-clock care. Help may be provided by a nurse, a trained aide or a volunteer, and costs range from free to expensive. The following are some of the most common types of assistance:
Help with everyday needs
- Companionship services. These services may include companionship, home supervision, telephone reassurance and friendly visits. Visits and phone calls are likely to be of minimal cost or free if provided by the local area agency on aging.
- Help around the house. Homemakers and chore aides do basic tasks such as laundry, cleaning, cooking, errands and shopping. Home repair services perform minor repairs and maintenance. These service providers generally charge an hourly rate. Check with your local aging office to see what services are available in your area.
- Meal programs. Meals can be delivered to the home or eaten in group settings, such as senior centers. Check with your local aging office to see what meal programs are available in your area.
Health care
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In-home nurses and therapists. Registered Nurses (RNs)
and Licensed Practical Nurses (LPNs) provide skilled care
prescribed by physicians, such as monitoring medications and
teaching recipients and their families about special care
procedures. Professional therapists provide respiratory,
physical, speech and occupational therapies in the home.
Sometimes these services are covered by Medicare, Medicaid or
other insurance.
-
Home health aides. These workers assist with personal
care tasks such as bathing, dressing, eating and exercising.
Sometimes these services are covered by Medicare, Medicaid or
other insurance.
-
Hospice care. Hospice care involves professionally
coordinated support services, including pain and symptom
management, social services, and emotional and spiritual
support for the terminally ill and their families. The care is
provided both at home and in other settings. Medicare, Medicaid
or other insurance may pay for hospice care for eligible
people.
- Adult day services. Local centers provide structured, comprehensive programs, including a variety of health, social and other related support services during any part of the day. Costs vary dependent upon the older person's needs.
Help for caregivers
-
Caregiver support groups. These groups provide emotional
support and information sharing among people who are
caregivers.
-
Geriatric care manager. A professional who performs an
assessment of a person's mental, physical, environmental
and financial conditions; creates a care plan; and manages
housing, medical, social and other services.
- Respite care. A service that provides temporary relief for persons caring for someone who is ill, injured or frail. Services can be provided in an adult day care center, the home of the care recipient or other settings.
Linking with community services
Community services can make a big difference, but it takes work to find the best ones for your situation and to use them effectively. Here are some tips to get you started:
- Identify needs. You can do this on your own, or you may want to have a geriatric care manager conduct a formal assessment, which will identify both needs and sources of assistance.
- Do research to find out what community services are available where your parent lives. You may want to get help from a geriatric care manager, social worker or hospital discharge planner. In addition, some community agencies provide relevant information and referral services.
- Compare costs and find out what insurance will cover. While you may be able to find free or subsidized services, some may be offered only on a short-term basis. If Medicare, Medicaid or other insurance provides coverage, find out the limits. Check with your local aging office, community or faith-based services, and your local department of social services for available programs.
Check for the quality of services
Currently, there is limited government oversight of long-term care services, so it's important that you check the quality of services carefully. Here are some strategies that can help:
- Get referrals from friends and family
- Interview providers personally, and involve your parent if feasible
- Find out about worker education, training and experience, and get at least two references
- Find out if an agency screens and bonds employees and provides training
- Visit facilities such as adult day centers to check how clean they are, what kinds of activities are going on, and the types of people participating (those with physical disabilities? difficulty communicating? Alzheimer's disease?).
Be organized
Specialists on aging suggest developing a file system for information materials from all the agencies or services you research, even the ones that are not suited to your present needs. Information you gather now may be useful later.
Be sensitive to your parents' reactions, but know your own limits
Although your parents may prefer that you or other family members provide all their care, you have the right to get help. Try to work through your parents' concerns, perhaps with the help of a geriatric care manager.
Glossary
- Area Agency on Aging (AAA or Triple A)
- An agency designated by the state with the responsibility for planning and coordinating services for older persons within a specific geographical area (a city, county or multi-county district). Often referred to as the local aging office.
- Caregiver
- Anyone who provides assistance to another person who is ill, disabled or needs help with daily activities.
- Discharge Planner
- A professional who assists patients and their families in developing a plan of care for a patient following a hospital or nursing home stay.
- Medicare
- The national health insurance program for people age 65 and older, and for some younger persons with disabilities. Part A helps pay for care in a hospital or nursing home, limited home health services and hospice care. Part B helps pay for doctors' services, outpatient hospital care, medication administered as an outpatient and other medical services. Part D offers prescription drug coverage.
- Medicaid
- The federal health care insurance program for people with low incomes. It is administered at the state level, so eligibility and coverage differ from state to state.
