More and more families are facing dilemmas regarding the needs of their elders and the available resources to meet those needs. People 85 and older are the fastest growing segment of our society according to the U.S. Census with an estimated 21 million in this population by the year 2050. Many myths and misconceptions cloud decisions made for seniors. Chief among them is that seniors cannot make sound decisions for themselves. Western society often equates getting old with going to a nursing home, but there are other options less extreme.
Home Nursing Care
“The greatest need of the in-home senior patient is for someone to listen to her and advocate for her,” says Robyn Luna, RN with the Visiting Nurse Association of Texas. “Many elderly people feel frustrated because they are starting to lose control of their lives due to their advanced age and illnesses. Their children and other family members are beginning to care for them and make decisions for them. In many cases, the senior wants to maintain some control and autonomy. I am a liaison between the patient and the family in my role as a nurse caregiver.”
Home health care agencies provide myriad assistance that allows seniors to remain in the comfort and familiarity of their own homes, with the degree of independence appropriate for each individual. Registered nurses manage the medical aspects of patient care such as medication regulation, pain management, and disease assessment. Complementary caregivers assist with activities of daily living including: meal preparation, household chores, personal hygiene, shopping, and transportation.
“Many times a home environment needs modifications to be made safe,” says Elizabeth Durham, Physical Therapist for Sovereign Home Health. “It can be as simple as clearing a hallway by moving a piece of furniture and removing throw rugs. Also, adapting a bathroom and using medication boxes are essential for safety.”
Assisted Living Facilities
Assisted living facilities are best suited for patients who need more social activities to combat loneliness and/or a greater level of care and supervision. Most offer a wide variety of services to residents such as movie nights, games, arts and crafts, shopping trips, and dining room amenities. An adjustment period is often necessary for seniors transitioning from their homes to assisted living.
“A lot of elderly people don’t realize they need assisted living,” says Melinda Najdek, LVN – Resident Services Coordinator of Flower Mound Assisted Living in Texas. "There is a grieving process for many residents because they are losing their house and their way of life. We encourage them to be as independent as possible. There are many levels of ability and within those levels individuals need to be given as much control as possible in their daily activities. If a resident isn’t able to put on his own shirt, I urge my staff to at least let him choose the shirt he will wear.”
The approach a family takes to talk about assisted living with a resistant loved one is the key to acceptance. Rather than framing the move as what’s best for the elder, children can suggest that it is something the elder can do for them. The elder can then view the decision as a choice he is making that affords his children greater peace of mind.
Najdek believes the greatest need of this patient population is to feel needed. “They have worked hard all of their lives providing for themselves and their families. Now they are in a situation where they need assistance, but they still need a feeling of self-worth and usefulness.”
Resources for Seniors
The needs of many seniors can be met equally with home health agencies or assisted living facilities, long before the necessity arises for continuous skilled care in a traditional nursing home. The decision between the two options is largely one of personal preference. Some seniors find peace and comfort in the familiarity of their own homes, while others thrive better with the social activities and companionship afforded at assisted living facilities.
There are currently no Medicare/Medicaid assisted living facilities in the United States, so residents need to use their own financial resources and long-term care insurance benefits to cover the costs. Some states participate in the Medicare/Medicaid Program for All-Inclusive Care for the Elderly (PACE), which will assist with expenses at affiliate facilities. PACE also assists with the provision of home caregivers as do long-term care insurance providers.
The Visiting Nurse Association has affiliates throughout the U.S. and the United Way has senior services affiliates in most major metropolitan areas.
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