Rather than moving into a long-term care facility as they age, many older adults prefer to stay at home for as long as possible. This may be the right choice for you if you only need minor assistance with your daily activities and enjoy a close network of nearby family and friends. These guidelines explore the range of home care services available to help you maintain your independence within the comfort of your own home.
Is home care right for my loved one or me?
It’s natural to want to stay at home as you grow older. However, taking a step back to look at the big picture can help you decide whether staying at home for the long term truly is the right step for you. Too often, decisions to leave home are suddenly made after a sudden loss or emergency, making adjustments all the more painful and difficult. Take a look at your options, your budget, and some of the alternatives.
Deciding whether to stay at home
Your home situation is unique, and several factors will weigh in on the best choice for you. Here are some of the issues in evaluating your options:
Location and accessibility. Where is your home located? Are you in a rural or suburban area that requires a lot of driving? If you’re in an area with more public transit, is it safe and easily accessible? How much time does it take you to get to services such as shopping or medical appointments?
Home accessibility and maintenance. Is your home easily modified? Does it have a lot of steps or a steep hill to access? Do you have a large yard that needs to be maintained?
Support available. Do you have family and friends nearby? How involved are they? Are they able to provide you the support you need? Many older adults prefer to rely on family to provide help, but as your needs increase, they might not be able to fill in all of the gaps. It’s important to consider proximity to community services and activities as well.
Isolation. If it becomes difficult or impossible for you to leave home without help, isolation can rapidly set in. You may not be able to participate in hobbies you once loved, stay involved in community service that kept you motivated, or visit with friends and family. Losing these connections and support is a recipe for depression.
Medical conditions. No one can predict the future. However, if you or a loved one has a chronic medical condition that is expected to worsen over time, it’s especially important to think about how you will handle health and mobility problems. What are common complications of your condition, and how will you handle them?
Finances. Making a budget with anticipated expenses can help you weigh the pros and cons of your situation. Alternate arrangements like assisted living can be expensive, but extensive in-home help can rapidly become expensive as well, especially at higher levels of care and live-in or 24-hour coverage.
What can help me stay at home?
You may be used to handling everything yourself, dividing up duties with your spouse, or relying on family members for help. But as circumstances change, it’s good to be aware of all the home care services available that might be of help. What you may need depends on how much support you have, your general health, and your financial situation.
Keeping a household running smoothly takes a lot of work. If you’re finding it hard to keep up, you can look into laundry, shopping, gardening, housekeeping, and handyman services. If you’re having trouble staying on top of bills and appointments, financial and healthcare management may also be helpful.
Transportation is a key issue for older adults. Maybe you’re finding it hard to drive or don’t like to drive at night. Investigating transportation options can help you keep your independence and maintain your social network. You may want to look into local transportation such as buses, reduced fare taxis, and senior transportation options to appointments.
If your mobility is becoming limited, home modifications can go a long way towards making home more comfortable. This can include things such as grab bars in the shower, ramps to avoid or minimize the use of stairs, or even installing new bathrooms on the ground floor.
Help with activities of daily living, such as dressing, bathing, feeding, or meal preparation, is called personal care or custodial care. You can hire help with personal care, ranging from a few hours a day to live-in care. People who provide this level of care include personal care aides, home care aides, and home health aides. Home health aides might also provide limited assistance with things such as taking blood pressure or offering medication reminders.
Some health care services can be provided at home by trained professionals, such as occupational therapists, social workers, or home health nurses. Check with your insurance or health service to see what kind of coverage is available, although you may have to cover some cost out of pocket. Hospice care can also be provided at home.
Involving loved ones in home care services
Everyone has different family structures and support. In deciding your own options, take a look at your own family structure, culture, and the expectations you and family members might have. You may have already made alternate plans, preferring to keep family as little involved as possible. Perhaps you and your family want to work out a system where caregiving by family is your primary support for staying in the home. Or it could be that work, health issues or location of your family may not make this feasible. Your family could live far away and prefer that you live with them or move close instead, which would mean giving up a local support system.
While this conversation may not be easy, it’s better to discuss these issues earlier than to wait for an emergency when options may be more limited. An independent opinion, such as a home assessment by a geriatric case manager or consulting with other professionals, can be helpful in defusing family tensions too. You have the final decision as to where you want to live, but input from family members is also helpful. Are they worried about your safety or a health problem such as Alzheimer’s that will eventually require heavy care? Listening to concerns and keeping communication open is key.
Even if you have strong family support, be open to the idea of having other help too. Many people have an initial feeling of “not wanting strangers in the house.” But caregiving can be physically and emotionally exhausting, especially if it is primarily on one person such as a spouse. Your relationships will be healthier if you are open to the idea of getting help from more than one source.