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One of the greatest fears of older
adults is the loss of independence.
That loss is felt acutely when it translates into the need for
institutional living. Even the most luxurious congregant living
facility isn’t the same as your own home. “Aging in place” is
the chief desire of our aging parents, but for some, it just may
not be possible without assistance. It is not uncommon for an
ailing, frail adult to be cared for by their aging frail spouse,
who will soon become ailing as well from the stress and demands
of caregiving. Frail seniors who will be facing old age alone
may have a poor outcome if living independently.
It is an
especially frightening prospect for those of us who have an
aging parent in a different city. Imagine having a parent who
doesn’t always hear the phone when it rings. How many alarm
bells go off in your head when the phone rings off the hook?
Are they taking a nap, or lying unconscious on the bathroom
floor? Do they have groceries? Did they remember to take their
blood pressure medication? When was the last time they took a
shower?
Professional
help in the home can take many forms, but custodial care
(assistance with bathing, dressing, meal preparation, errands,
companionship, light housekeeping, etc.) is the type of care
most frequently needed by the aging population. This type of
care is not covered by Medicare or senior HMO. Long term care
insurance is the only third party payer designed for this need
and different policies have different allowances.
When arranging
for care, realize that care might not have to start out all day,
everyday. Examine what the actual current level of need truly
is. Which of the tasks necessary for safe and healthy home
living are no longer able to done independently? It might just
be assistance with meals, trips to the doctor’s office, or the
occasional outing for exercise and mental stimulation. On the
other end of the spectrum, however, it might be that an
individual is so frail they are no longer able to safely bathe
and dress themselves. Perhaps knowing that someone is awake in
the house at night for assistance with trips to the bathroom
offers a sense of security. Care can be provided in a
shift-work, live-out arrangement from 4 to 24 hours per day, or
live-in. Costs vary according to the level of care (e.g.,
simple companionship vs. providing personal care). These needs
can change over time and caregiving can be flexibly arranged to
match the need.
Another
consideration is whether to use an agency or hire privately.
There are obvious advantages to dealing with an agency. The
staff are pre-screened for you. Additionally, if an agency
caregiver is ill or on vacation, another caregiver can easily be
substituted. An agency handles the payroll taxes and workers’
compensation coverage for its employees. Inquire if the agency
utilizes employees, or are their caregivers “Form 1099”
independent contractors. Be aware that for the latter, the
client will be responsible for the payroll taxes and must be
certain that their home owner’s insurance will cover workers who
may get injured while in their employ. This will also be true
if the caregiver is hired privately.
Another
advantage to working with an agency is they will help the client
adjust during the initial phase of having a caregiver in the
home. To some fiercely independent seniors, having a caregiver
is seen as an affront and they will work very hard to sabotage
the relationship. They will find fault with everyone. (“You
sent me someone with blue eyes! I can’t be cared for by someone
with blue eyes!” Yes, it’s happened.) That can mean a
revolving door of caregivers until they become accustomed to
having someone in their home. Ultimately, regardless of the
route taken to hire a help in the home, to quote a popular
commercial, “Finding the right caregiver - priceless.”
Sherry
Netherland is available for
seminars for community and professional groups, Corporate
Wellness Programs, or as a keynote
speaker for your organization. |
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