Caring for an aging relative or loved one is a task that few of us anticipate with excitement – but this is a task that most people will be faced with at some point, so we believe it is good to recognize that reality.
and plan accordingly. All too often, children, nieces, nephews, cousins and other relatives are forced by necessity into taking on the role of in–home elderly care provider without warning, causing stress and difficulty for everyone involved. Should your relative have a slip in the bathroom, or end up in an auto accident, or simply fall suddenly ill, the changes come very rapidly and elderly care faces relatives with extremely difficult decisions without warning. You could find yourself frantically searching account numbers to pay bills, while simultaneously in a feud with the insurance company, and considering the impossible decision of relocating your relative to an assisted living facility.
Meanwhile, you’re struggling to stay on top of things at your own job trying to keep track of all the balls in the air – your appointments, your obligations, your kids… it may feel like it’s all about to come collapsing down around you. Listen to us very carefully: don’t panic. Take a breath. In–home elderly care is positive for your relationship, preserves a sense of normality, and completely manageable if you’re prepared1.
The first step is to acknowledge the reality of your responsibilities for elderly care.2 According to a recent study, the number of unpaid elder home care providers (that is, relatives) is set to increase by 85% in the next 30 years, so planning for that reality now will help you to better face the responsibility when it finally arrives. There are many ways you can prepare yourself to care for elderly parents or relatives, including hiring in–home elderly care to take the stress off yourself – here is a breakdown of how to plan for your own elder home care needs.
First, think about your own life. When you get older, would you prefer living in your own home if you could do it without being a burden on family or friends? If you’re like the overwhelming majority of Americans, the answer is yes. Planning ahead will greatly increase the likelihood of this plan succeeding.
The first, and most important step, to planning for in–home elderly care is to plan on hiring a professional. An in–home elderly care professional is knowledgeable, impartial, and totally prepared for the tasks of elderly home care that are overwhelming for those of us with no experience in the subject. You can find a reputable in–home caregiver and they can help you every step of the way, whether your needs include an in–home companion for a parent, or just an impartial mediator to settle family disagreements over elderly care decisions.
Now – some people may feel guilty about hiring in–home elderly care may seem like giving up. You may like to think that you’re capable of handleing the responsibility yourself – but when you are emotionally so close to a situation like this, the decisions have incredible weight, the tasks seem endless, and meanwhile you still have your own responsibilities to take care of. Hiring in–home elderly care is the first and best decision you can make when planning elder home care for your parents or other relatives.
Before we actually start down the road of elderly care, it’s also good to lay some groundwork so that the process of aging3 and the transition from autonomy to having elderly home care isn’t so jarring.
Take a look at some of the technological advances that are available to ensure you can feel safer about your loved ones being in their own homes. Products like in–home motion sensors can mean checking in on your elderly loved ones is just tap away. There are no cameras or microphones in this sort of setup, so your relatives’ privacy is protected – but if mom or dad goes into the bathroom and never comes out, you’ll be able to know almost immediately. Other solutions like medical alert technology are a good idea, as well. At the very least, ensure that your loved ones stay in contact with either yourself or someone close.
The next step in preparing for in–home elderly care is to make some changes inside the home to make it a safer place for your loved ones. Regular conveniences like a bathtub can become a booby trap for an elderly parent. Handles on shower entrances or even a walk–in conversion on an in–home bath/shower combo will help to ensure safety on slippery bathroom floors. Consider installing anti–scald devices on in–home faucets, or set the home water heaters to a low temperature of about 120 degrees. This will prevent accidental burns – you or I may be fine if we place our hand in a stream of extremely hot water (if a little uncomfortable for a bit), but older skin is far more sensitive to temperature changes, and can easily sustain burns.
Carbon monoxide detectors in addition to smoke detectors are highly recommended for any parent who stays at home. Carbon monoxide is toxic to anyone, of course, but elderly individuals are even more sensitive to its effects. Even worse, the effects of carbon monoxide poisoning over a longer period of time can mimic neurological effects associated with aging, such as memory loss. When choosing smoke and CO detectors, choose detectors with strobe lighting, vibration, or other additional alerts to ensure your loved one is properly awakened or alerted should the alarm be triggered, because the high frequency of a smoke detector’s alarm can be at the edges of, or even outside, the range which your elderly loved ones can reliably hear.
Even if you are planning to hire in–home elderly care, don’t forget the importance of real time together. As someone who has known your elderly loved one for most of your life, you’ll have a better idea of their mental state, living situation, and overall safety, so working together with your home elder care assistance provider will be important for you, the caregiver, and your parent or loved one. While looking around the house, keep an eye out for little changes: are plants watered, or wilted? Is there a growing pile of unopened mail? Are pets being fed and cared for? Changes in behavior will be observed by you in ways that may not be so obvious to a caregiver.
Of course, one of the largest stress sources related to home elderly care is the expense associated with it. While hiring in–home elderly care can help to offset many of these costs, especially the costs of lost wages from work, added expenses, if not planned for, can be difficult to deal with. Before you need elderly care at home is the time to research the associated costs – some of those will be toward making improvements like those mentioned previously, attempting to make places like bathrooms safer and ensuring that smoke a CO detectors are in place and functioning. For other in–home medical needs, consult with your loved one’s insurance and Medicare benefits. Often, these expenses will be covered – and if anything falls through, you can deal with wrangling approval or making financial arrangements ahead of time. Consider finding long-term care insurance4 to help with planning ahead. In the case of in–home elder care, some of these costs may be covered as well, so it’s certainly worth looking into.
Before your elderly loved one has an accident, fall, or illness requiring elderly care, it is a well-known fact that getting regular exercise can help guard against disease and accidents – in fact, regular exercise can make an elder loved one’s body functionally 10 to 15 years younger. For a guideline, both the American Heart Association and the American College of Sports Medicine have published exercise guides for elderly care calling for a number of workout routines each week. These are exercises designed with seniors in mind, so they are both capable of completing the routine without overexertion, and will feel great afterward.
Most of us who have an elderly family member, are familiar with the problem of prescription medication management. While your mom, dad, grandparent, or other relative may have their own elaborate pill organizer, if it is prepared inaccurately, they won’t be getting the care they need. For this reason, work with your in–home elderly care provider and your relative’s pharmacy to get familiar with all the medications your loved one takes, how often they should be taken, and any common side effects to watch out for. Aging changes the way we metabolize medications, so even medication that your loved one has been taking successfully for years could start to manifest new side effects, so knowing what to look for will give both you and your home elder care provider a leg up on potential problems.
Perhaps one of the more difficult discussions many of us have with our loved one is the question of driving. A loved one who has been driving well all their life is often reluctant to relinquish their driving privileges – and indeed, sometimes it’s realistic to allow for a few more years of safe driving in an elderly relative5. However, if tell–tale dents and dings begin to appear, of if it appears your loved one is having trouble negotiating distances or parking spaces, it may be time to talk about other transportation options. In other cases, a loved one may be perfectly capable of driving, but require some assistance with mirrors, or turning the steering wheel with arthritis. Solutions for these problems are available via vehicle add–ons: consult your local AAA or AARP office for some insight here.
If it’s time for your elderly loved one to stop driving, this idea can be quite depressing and off-putting. Many of our relatives will respond with nothing less than absolute refusal – but the reality is that as we age, reaction time is diminished, our bodies don’t move as well or as quickly as they used to, and some folks experience diminished cognitive function. For all of these reasons, if your loved one’s driving is becoming erratic, it’s important to have a serious conversation about hanging up the keys before someone is seriously hurt. Resistance can be overcome by the help of your in–home elderly caregiver as well as your loved one’s physician – and if all else fails, a visit to the DMV may be the final step. Failing a driving test, or a vision test will result in non–renewal of a driver’s license. Finally, if finances to cover transportation are an issue, selling your loved one’s current car can provide a handy transportation fund, and you can be assured of your relative’s safety.
Every adult – and that includes you, but in particular the elderly ones – should draw up a power of attorney document for their healthcare. This is sometimes called a healthcare proxy, and it is used to designate yourself as the person to make healthcare decisions on a loved one’s behalf if they are unable. If your elderly loved one doesn’t have a healthcare proxy, that should be step one for paperwork. Next, work with your loved one to create a living will, a document that ensures, among other things, that your loved one’s wishes are respected in the case that he or she requires a feeding tube or life support. Finally, and unpleasantly, it may be necessary to work with your loved one’s doctor to create a DNR, or a do–not–resuscitate order, an order that will determine what, if any, steps are taken by healthcare professionals in the event that your loved one’s heart or lungs cease to function. These are all unpleasant matters, to be sure – but it is better to deal with them while your elderly loved one is available to help you make these decisions then waiting until it’s too late.
When working on your loved one’s healthcare proxy paperwork6, consult an attorney to make sure you’re doing it correctly. Often, a parent will list more than one child as proxies, but in some states that can void the entire document – understanding these pitfalls can help you avoid unpleasant legal situations in the future.
As discussed, making plans for your own finances are essential to successfully planning and hiring in–home care for the elderly. However, older citizens are often prone to financial distress themselves, particular if they are living on a fixed income. Complications such as injury, illness, or cognitive troubles can exacerbate these troubles, so consider ways in which you can help.
As you probably know, older generations tend to keep financial details very private and prize their independence. This combination of pride and privacy can lead to some elderly people making dire financial decisions, like taking on large credit card debts that no one knows about. These debts aren’t always spent on convenience or extravagance – often, they are used to cover common household expenses which are simply out of reach due to the limitations of a fixed income. This, and other common financial issues are things you need to discuss with your loved one, especially when planning to hire in–home elderly care.
Often, asking directly will only result in an argument or annoyance on the part of your loved one, so sometimes you’ll have to do a little work to tease the facts out of your loved one. Saying something like “Mom, we’ve been thinking about getting some of our debts consolidated. Have you ever done that?” can sometimes open the door for a conversation that would normally be shut down. While you’re at it, take the opportunity to discuss the possibility of buying long–term care insurance to assist with hiring in–home elderly care down the road.
While on the subject of finances7, it may be a good time to consider a durable power of attorney, which would give you the ability to control your elder loved one’s finances in the case they are unable to. If no one but your elderly relative has access to financial accounts and records, problems can slip by – and it can mean more than just secret debts. Seniors are often the target of frauds or scams, and financial elder abuse is sadly a common offense committed by a family member. For this reason, it’s a good idea to have a dedicated person like yourself, and often a second, impartial person like an accountant, named in a durable power of attorney with the ability to keep an eye on financial information every month.
If you do find financial issues when you look into elderly care8, it may be necessary to find some extra money for your loved one. There are tools available like reverse mortgages which can help improve the cash flow situation for senior citizens, but another solution may be moving into a smaller, affordable, senior–friendly condominium. There are also programs available to help offset the costs of regular monthly bills, food, or prescription drugs, so determine where help is needed, and then do some research. Many people who qualify for assistance programs never use the benefits, so help your elderly loved one to get everything they possibly can.
As we mentioned previously, elderly citizens are especially vulnerable to scams. These can come in the form of fake phone solicitors, fake investment opportunities, or simply conning the person into sharing personal information like their social security number. These scams can be quite convincing, especially to an elder. Recently, a trend of fake phone calls offering Medicare Advantage plans created victims of a large number of elderly citizens. For this reason, it’s important to be vigilant, and to make sure your loved ones are. This is another area where hiring an in–home elderly care provider can help – they can be a constant voice of reason in your love one’s home.
Checking your loved one’s credit score using one of the many free services available can help you to identify fraudulent activity, and it’s possible to place a “security freeze” – a temporary, reversible hold that is different from a fraud alert – on the credit report, which will prevent would–be identity thieves from using your loved ones’ information even if they do manage to obtain it.
In addition to hiring in–home elderly care9 for your loved ones, there’s no need to abandon them to home. If possible, get them involved with something in a way they can manage. Volunteer programs including animal shelters, helping kids to get immunizations, and even sharing the wealth of knowledge they’ve amassed by counseling new business owners or tutoring young middle or elementary school students are all possible ways for our elderly relatives to spend their time. If there is a senior center nearby where they can go to socialize, play games, and have fun, that’s a good idea as well. Maintaining a level of activity can, like in the case of regular exercise, help keep your loved ones healthy in both body and mind, and that’s the ultimate goal of elder care assistance.
Another way to help alleviate the monotony of home life is by meal sharing. In addition to being a great social gathering to help keep your loved ones engaged and active, it’s a way to help alleviate common difficulties with meal preparation experienced by a lot of older people. These group meals could take place at the family table, or, for a wider social circle, at the local senior center.
Finally, it’s also important that your loved ones don’t feel stranded at home. Even when they have in–home elderly care professionals around to help with care and cleaning, a person without the freedom to travel where they want when they want is bound to start to feel isolated and depressed. Public transportation is a good option, but if that’s lacking where you live, get creative to keep your loved ones mobile. A three–wheeled bicycle is an excellent mode of transport and makes a great way to get some exercise, too.
So, as you can see, there are many considerations10 and many benefits to seeking out home elder care assistance rather than consider a nursing home or assisted living situation. While it may be difficult to get your loved ones to admit they need the help, often in–home elderly care can mean the difference between languishing and thriving for many seniors.
Of course, opening a loved one’s home, or your own home, to a caregiver who is essentially a stranger is certainly a major step, and it’s one that you cannot make without a certain degree of caution. As a relative, you may feel that you are the “de facto” caregiver, and fear the idea of handing over the control of your loved one’s elder care to someone who doesn’t know them as well as you do; who doesn’t understand their humor, or doesn’t know exactly how they like their eggs cooked or their shirts folded. For the elderly loved one, as well, the idea of a stranger coming into their home, having access to their medications, their laundry, their antiques, and all their other possessions can be quite nerve–wracking.
These kinds of fears can only be allayed by carefully determining what you want from a caregiver, writing a detailed job description, and choosing the right person for the job – together with your loved one. There are many options available to you when seeking a caregiver, and one of the best ways to find peace of mind when on the hunt for in–home elderly care is through a professional service. Using an agency that is specialized in this kind of service means less vetting of the candidate on your part, because they have already been vetted. Even still, it is absolutely recommended for you to ask your candidates for references and background checks11 no matter what method you choose to utilize for hiring home elder care assistance.
When you choose an agency rather than a classified ad or a friend–of–a–friend, you benefit in several key ways: First of all, agencies screen all applicants, meaning less worry on your part. They also train professionals and handle all the cumbersone paperwork like payroll, taxes, and other such legal matters. Additionally, should your primary home elder care professional be unavailable due to illness or other unforeseen emergency, backup care providers are available to step in at a moment’s notice – a certainty that can make a world of difference over hiring an individual.
Before you hire a caregiver, no matter if you use a home elder care agency12, or look at individual candidates, we recommend checking up on their credentials and licensure. A candidate with experience is good, but a candidate with appropriate training and credentials is even better. Ask if your candidate is Red Cross certified, CPR certified, or certified in First Aid. Additionally, perform a background check. It is vital to perform a background check on any potential hire. You can request background checks for in–home elderly care givers via a number of services, and never forget the value of Googling or Facebook friending a potential hire to get a better idea of the quality of their character.
Additionally, always ask for more references than you’re offered, and actually call them. By calling references, you want to speak with folks for whom this provider has performed in–home elderly care, and you’re not only listening for overt complaints, but also hesitation – some people will give a verbally positive review, but a tell–tale hesitation can reveal that there’s something else you should be aware of. Also, ask how long the candidate did home elder care for the reference. If your candidate has been with one or more clients for a long period of time, that’s a good sign.
We hate to mention that this is necessary, but if you feel it may be appropriate, consider checking up on immigration status as well. It’s a polarizing political issue, but no matter where you stand, hiring an illegal immigrant can land you and your loved one in hot water, and no one wants that. If you’re using an agency, you’ll have the assurance that our providers are all legally authorized to live and work in the United States – but if you’re hiring an individual, don’t take chances: get an I9 form from your caregiver to document their status.
While interviewing your candidate, discuss all the details and don’t leave anything vague: you and your elderly loved one need to determine definite hours, duties, privileges such as meals, and other such particulars before your caregiver starts. Also, remember to make clear your expectations regarding access to personal property and private information – both you and your loved one need to be totally comfortable allowing your home elder care provider access to your home.
As you can see, the question of hiring in–home elderly care13 is not one to be approached lightly or spontaneously – but it also shouldn’t be put off. If you have a parent or relative who is getting older and living alone, don’t wait for an accident or illness to prompt the need for home care or you will find yourself completely overwhelmed. By starting early and putting as many pieces in place as possible, when the time for home elder care arises, you’ll be completely prepared, and you’ll be glad you are.