Making a Realistic Commitment to Caring for an Elder

Whether older people have the option to receive long-term care while maintaining their independence often depends on the extent to which family members are able and willing to help them. But family situations vary widely in terms of whether relatives are willing and able to provide care, transportation, companionship, or financial support to an elder. Before any long-term care program is organized, particularly when the elder is to remain at home without a spouse, family members must get together and discuss what each of them will do to help meet needs that cannot be met by outside care or would be prohibitively expensive if provided by paid caregivers. Staying at Home An older person’s ability to stay at home while receiving long-term care may depend on several kinds of family help. The elder may need daily or weekly assistance with personal or medical care that is not provided by a home care or other outside agency. Help with housekeeping, shopping, and home maintenance may also be necessary. And there will certainly be a need for regular visits and transportation to allow the elder to maintain contact with the outside world. The elder may also need help to plan, coordinate and oversee outside care programs and to plan and administer financial matters. Moving in With the Family If older people are unable to maintain themselves in their own homes, they may still be able to avoid the cost and loss of independence a residential care facility requires by moving in with willing family members and receiving long-term home care there. This kind of arrangement may permit family members to supplement home care provided by outside agencies with direct care of their own, which can help keep down costs while allowing the elder more personal control. But such an arrangement is obviously not for every family. It requires physical space and financial resources. And both the elder and the relatives with whom the elder lives must be willing to make it work. Everyone involved has to give up some room and privacy and make adjustments in daily habits and expectations. Relatives with whom the elder does not live with must also be willing to share the responsibility by visiting, taking the elder on outings, and providing financial assistance. Obviously, all this takes a lot of talking, planning and ongoing cooperation among all family members. Entering a Residential Facility Recent surveys of nursing facility residents have shown that contact with the world outside (leaving the facility for visits and outings and receiving visits, phone calls, and mail from family and friends) is their single greatest concern. So even when an elder moves into an organized residential setting that provides personal care and social activities, or into a long-term care facility that provides complete care, family participation remains of the utmost importance. To prepare for any residential care setting, family members must be willing to discuss how much each is realistically able and willing to help. There are resources for elder care help available. But most important, family members must discuss the future directly with the loved one who needs care.