Caregiving can also begin as a result of unsettling warning signs that indicate a need for some sort of intervention. Perhaps your elderly spouse has wandered off and gotten lost. Or a friend has lost a lot of weight and rarely leaves home. You may be the only person to step in and become the caregiver. Or, you may be the key in a network of family members and friends willing to help. Whatever the situation, you may not be sure of the next step to take.
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What kind of help does your loved one need? Perhaps there are underlying undiagnosed causes that can be corrected. For example, prescription drugs interactions/side effects, Vitamin B12 deficiency, dehydration, low thyroid, urinary infection and other treatable problems are often mistaken for Alzheimers or dementia. According to Consumer Reports on Health, "Any new health problem in an older person should be considered drug induced until proven otherwise." A visit to the primary care physician is critical to rule out any underlying causes and determine the best approach to care.
If the problem is not correctable, what living arrangements are available for your loved one? What nursing care plans are most appropriate? If they are able to remain in their own home, what kind of services can be arranged? Is assisted living preferred over a nursing home? What challenges does your loved one's condition pose? How will both parents get their needs met when they both need different levels of care? What community resources are available? How will you manage it all – and still maintain a life of your own? Who will make all these decisions?
Hopefully, the individual has made good life preparations by having a POLST and durable power of attorney for healthcare and financial matters already established. If not, these documents should be formulated as soon as possible. The primary care physician will assist in obtaining the POLST form which indicates the person's personal preference for resuscitate or Do Not resuscitate. Family members often self-designate one responsible person to make the financial and healthcare decisions, or, they may utilize group consensus.
Of course, each elder care situation is unique. Your loved one's medical condition, financial resources, personality, personal wishes, relationships with potential caregivers, geographic proximity to services and other factors all determine what best approach to take. There is no place like home or maintaining one's usual routine, but when a change of medical condition occurs compromises must be made in order to provide optimal care within your loved one's financial constraints. If the condition has potential to improve, it is wise to consider temporary measures that can easily transition to permanent if needed. Conditions requiring daily skilled nursing and/or therapies should be cared for in a Skilled Nursing Facility. If nursing and therapy is required on an intermittent or several days/week basis, then return to home with home health support services could be considered.
Meeting one's daily needs at home despite not needing a nurse or therapist can be challenging. There are meals to prepare, housekeeping, bills to pay, medicine to refill and dispense, personal care to manage and transportation to arrange. Those who are alone could be monitored with safety monitors or periodic visits and phone calls, but often times isolation becomes problematic. If care and supervision needs are overwhelming for family/ friends or other providers to safely accomplish within your loved one's budget, then placement out of the home should be considered.
RCFE's (Residential Care Facilities for the Elderly) can be large communities, or small 6 bed homes; many offer dementia and hospice care. Those key people who are involved in placement decisions should weigh future needs (depending on the disease process) to minimize the trauma of any future transfers. Physical and mental needs as well as compatibility with others are important when looking at any communal living situation. Look closely to the daily program, menu and services to determine if there is enough structure and flexibility to meet your loved one's current and future needs. Meet the administrator and staff; are they loving, caring, patient, consistent and communicative? Don't be tempted to make your decision based solely on the look of the room or the building. Ask how your loved one will get to medical appointments or receive hair/nail care. Will the program satisfy all the physical, mental, social, emotional and spiritual needs?
Minimizing the institutional nature of a facility while maximizing dignity, choices and quality individualized care can be challenging when caring for those with complex medical conditions including dementia. When your loved one's condition requires a higher level of care that cannot be safely or appropriately managed in an RCFE, placement in a skilled nursing facility will be necessary. Another close look at the daily program, menu, services and staff in addition to the environment and activities will help you decide if the facility will be compatible for the patient as well as the family. Make sure the location is convenient for family and fiends to easily visit, and that your preferred physician will be able to continue providing care.
Please note that referral agencies may be timesaving and helpful in narrowing your choices, but they do not guarantee personal knowledge of the properties and may engage in unfair commission practices or have a conflict of interest with preferred properties. Facility or healthcare insurance social workers may be more fair and accurate in their suggestions; asking local agencies on aging or recommendations from other friends/family members can also assist in guiding you. Take your time, tour more than three facilities and meet with as many staff and administrators before making your decision; you will be establishing a new relationship with the facility & staff that will hopefully last for many years.
Please feel free to visit my website to compare what RCFE small 6 bed facilities can provide for your loved one. www.VillaCareHomes.com We provide service with personal attention and dignity, loving caring staff and the facility is managed with program structure/customized approach to aging in a home environment. We cultivate an atmosphere of friendship, comfort and consideration of our residents, visitors and neighbors. We encourage an independent lifestyle for those with even complex medical conditions so that our residents can maintain their independence while leaving the difficult tasks of daily living to our dedicated and competent staff. This is the standard you should seek when determining what care is needed for your own loved one.
