Elder Care - How to Know If They Can Still Live on Their Own
If your parents or spouse can no longer completely care for themselves, one of the earliest, most difficult, and most important decisions you will have to make has to do with keeping them in their own home or moving them somewhere else.
Like everything having to do with care of the elderly, matching their needs with the resources available is a dynamic and ongoing process.
The primary consideration, of course, is to choose the safest and most practical residential setting that best meets their needs, and minimizes any impact to their dignity or independence.
There are a myriad of factors entering into this decision, including their physical and mental condition, your willingness and ability to care for them regardless of the location, financial and family issues, and the residential resources available in your community.
In this article we will look at the option of your elderly parents or spouse continuing to live in their own home in light of some of those considerations.
Future posts will deal with other residential options.
Continuing to live at home Assuming that you are providing some of the care and bringing in outside, paid help periodically, this is the ideal situation if your older parents or spouse need less than 2 to 3 hours per day of assistance.
Any more than that can put you on the road to caregiver burnout.
My wife and I watched our parents take care of their parents, and their parents take care of their parents, and I am sure it went on for several generations before that.
We have seen the toll caregiving can take on the person responsible for the care, as well as all of the other family members.
That is why we suggest no more than 2 to 3 hours total per day of your time, and a balance betweenyou providing the care and someone else, like other family members or paid help stepping in as needed.
(This is suggested even if you are taking care of your spouse in your own home.
) Of course, if money is not an issue, then you could have up to a full time caregiver in the home, as long as you personally don't exceed the 2 to 3 hours per day of your time.
Of course, 2 to 3 hours is the ideal.
A lot of caregivers end up spending far more of their time than that.
So how do we determine if our older parents or spouse can continue to live safely on their own? It is important that you perform a careful assessment of their ability to meet their own needs in the area of independent living skills.
These are most often termed "Instrumental Activities of Daily Living" ( IADLs ) such as shopping, cooking, managing finances, and so forth.
Track the ability to perform these skills by using a simple assessment, such as the "Instrumental ADL Scale".
The ability to handle these more complicated skills is normally lost before the ability to handle basic "Activities of Daily Living" ( ADLs ), such as grooming, eating, and toileting.
In addition to using an assessment, be observant and look for patterns like certain parts of the day that seem most difficult.
Is meal preparation a problem throughout the day, or just in the evening? Most importantly, are there any safety issues like pots left on the stove, or doors left unlocked? Be aware of increasing forgetfulness, getting lost more often, and other potentially serious safety issues.
While not addressed specifically on the assessments, safety should be at the top of the list when making this type of decision.
Once you have identified all of their needs, create a calendar and estimate the number of hours in a day it would take to meet all of those needs.
Look to see if you can cluster all of the needed help into a 2 to 3 hour block of time during the day.
That is the maximum that you should commit to.
If that works for you, and, if you are able to have other family members or paid help fill in during other needed blocks of time, then independent living in their own home is still feasible for your older parent or spouse.
Of course, nothing is forever, and recognize that independent living may be a very temporary option.
As your parents or spouse age and lose abilities in ADLs or IADLs, you will have to change the living situation accordingly.
That can mean moving your parents in with you, placement in assisted living facilities, or even considering nursing home facilities.
Like everything having to do with care of the elderly, matching their needs with the resources available is a dynamic and ongoing process.
The primary consideration, of course, is to choose the safest and most practical residential setting that best meets their needs, and minimizes any impact to their dignity or independence.
There are a myriad of factors entering into this decision, including their physical and mental condition, your willingness and ability to care for them regardless of the location, financial and family issues, and the residential resources available in your community.
In this article we will look at the option of your elderly parents or spouse continuing to live in their own home in light of some of those considerations.
Future posts will deal with other residential options.
Continuing to live at home Assuming that you are providing some of the care and bringing in outside, paid help periodically, this is the ideal situation if your older parents or spouse need less than 2 to 3 hours per day of assistance.
Any more than that can put you on the road to caregiver burnout.
My wife and I watched our parents take care of their parents, and their parents take care of their parents, and I am sure it went on for several generations before that.
We have seen the toll caregiving can take on the person responsible for the care, as well as all of the other family members.
That is why we suggest no more than 2 to 3 hours total per day of your time, and a balance betweenyou providing the care and someone else, like other family members or paid help stepping in as needed.
(This is suggested even if you are taking care of your spouse in your own home.
) Of course, if money is not an issue, then you could have up to a full time caregiver in the home, as long as you personally don't exceed the 2 to 3 hours per day of your time.
Of course, 2 to 3 hours is the ideal.
A lot of caregivers end up spending far more of their time than that.
So how do we determine if our older parents or spouse can continue to live safely on their own? It is important that you perform a careful assessment of their ability to meet their own needs in the area of independent living skills.
These are most often termed "Instrumental Activities of Daily Living" ( IADLs ) such as shopping, cooking, managing finances, and so forth.
Track the ability to perform these skills by using a simple assessment, such as the "Instrumental ADL Scale".
The ability to handle these more complicated skills is normally lost before the ability to handle basic "Activities of Daily Living" ( ADLs ), such as grooming, eating, and toileting.
In addition to using an assessment, be observant and look for patterns like certain parts of the day that seem most difficult.
Is meal preparation a problem throughout the day, or just in the evening? Most importantly, are there any safety issues like pots left on the stove, or doors left unlocked? Be aware of increasing forgetfulness, getting lost more often, and other potentially serious safety issues.
While not addressed specifically on the assessments, safety should be at the top of the list when making this type of decision.
Once you have identified all of their needs, create a calendar and estimate the number of hours in a day it would take to meet all of those needs.
Look to see if you can cluster all of the needed help into a 2 to 3 hour block of time during the day.
That is the maximum that you should commit to.
If that works for you, and, if you are able to have other family members or paid help fill in during other needed blocks of time, then independent living in their own home is still feasible for your older parent or spouse.
Of course, nothing is forever, and recognize that independent living may be a very temporary option.
As your parents or spouse age and lose abilities in ADLs or IADLs, you will have to change the living situation accordingly.
That can mean moving your parents in with you, placement in assisted living facilities, or even considering nursing home facilities.
