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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 care giving.
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, every day. 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 care giving 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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