Adult Children Caring For Parents (Part 2): When is it time to bring them home or to a care facility?
In our previous article in the last issue, we discussed the indicative behaviors and home situations of elderly parents that would indicate a cause for alarm. Sometimes, it’s just a subtle change or two that is easily excusable. Don’t ignore them! Let your antennas go up and follow your instincts. These changes are indicators of the dangers of leaving your parents at home unsupervised and the need to reevaluate their living situation. We explored several different types of living arrangements that may be appropriate for you parents. We discussed living at home independently with home care services, moving them to an assisted living facility, intermediate care facility or a skilled nursing facility commonly known as a nursing home. The last option we explored was moving your parents into your home.
As you explore possibilities to care for your aging parents, and review all the different options, you may decide that having them live with you is the best option. There are certainly challenges to this arrangement, but many people have found that living in a multigenerational house can be an enriching experience for the whole family. However, no matter how close your family relationships are, adding another person to the household changes things. There are many things to take into account when considering this option.
Proactively consider these questions:
* How will the move affect your spouse, your children and your siblings?
* How will your parent’s presence impact your family routine, activities and privacy?
* Are there unresolved issues between your spouse and your parent?
* Will you expect other family members to help out?
* Should part of your parent’s income go toward living expenses?
* Will the move mean you need to adjust your work hours to provide care?
* What will you do when you vacation? Take your parent? Arrange for care?
* How does your parent feel about the move?
* Will you need some home care assistance?
Having a parent move in to your home will require some physical rearranging. Some family members may be displaced or inconvenienced by the new setup, so communication with everyone is vital. If you can afford it, consider an addition with a prefab unit attachment or explore converting a garage or side porch into an in-law suite. Some families may rent an apartment in their building or on their block to be close by and give their parents a sense of privacy. Your parents may struggle getting acclimated to a new living arrangement and neighborhood. To help them settle in, spend time helping them find the local pharmacy, bank, faith community, recreation center and other services. If they are looking for independent daytime activities, visit a nearby senior center for information on classes and programs. If your parents require more intensive care, look into a Certified Home Health Agency. If you and your family are providing full-time care in your home because your loved one is not covered for home care under Medicare / Medicaid or not enough hours are provided, look into supplementing the care with private pay home care. Supplementing with a few hours a day of home care from either private pay or some type of insurance will go a long way to make the situation work. Some families may just need weekend hours because that is when family members are often away and cannot have steady supervision. Consulting with a Geriatric Care Manager or social worker may be beneficial as you consider your options and what you will and will not be able to do for your parent.
A once-authoritative parent may become more dependent. You may become the guardian who gives direction and controls many aspects of your parent’s life, while trying to preserve as much autonomy as possible for your parent. You may have less time for your spouse and for yourself. Come to an agreement with your siblings regarding how much and what kind of help you can expect to receive from them. You may need your children to help with more household responsibilities including care of their grandparent. These role changes can be hard adjustments for everyone. Be honest with yourself and do not allow unresolved conflicts or feelings of guilt or obligation pressure you into taking on more than you can manage. Be prepared for resistance from your parent if they feel that they can no longer set the rules, control their situation or fear losing independence, but make sure your parent is involved in the decision-making process and that their perspectives and preferences are heard. Agree upon financial arrangements up front. Given available resources, will your parent be able to contribute towards food and utilities? If you have siblings or other family members with whom your parent is comfortable, can you agree in advance that they can stay with your parent, or accommodate your parent temporarily in their home so you are able to get a break from care giving or take a vacation?
It is likely that your parent has lived in his or her current home for many years and has developed strong ties to community, family, friends, healthcare providers, social life and daily routine. Packing and moving out of their home is a significant chore for anybody, but for an older adult with decades of memories and possessions, moving can represent a tremendous emotional challenge. Furthermore, leaving one’s own home represents a decrease in independence and signals a new life stage. This can cause great sadness and cause a delay in the decision to relocate. While you help pack their decades of history, talk through the difficult feelings, acknowledge the loss that your parent is experiencing and reassure him/her that you are making the best decision possible. Allow time and opportunity for them to reminisce. Reassure them that you will still be involved in their life regardless of their living arrangements.
Despite the challenges, many adult children find that providing support and care for their parents is one of the most rewarding experiences they have ever had and provides you with the extraordinary opportunity to give back what your parent once provided to you. Grandchildren have the unique opportunity to learn and absorb family history and maybe even learn things about family that they never knew before. Your parent will need time to adjust to his/her new living environment and role with your family. Your patience and support will help make this transition smoother.
About the Author: Mutty Burstein is the Education Outreach Manager of the Patient Relations Department at Americare CSS, a Certified Home Health Agency and Attencia, the private pay division of Americare. The Americare Companies, founded in 1982, provide high quality home care services in the N.Y. metro area, including the 5 boroughs, Long Island, and Westchester, Rockland, Orange, Dutchess, Putnam, Sullivan, and Ulster counties. Americare integrates compassionate patient care with family needs and is ready to serve 24/7 with registered nurses, home health aides, PT's, OT's, speech therapists, and social workers. In addition to all the regular aspects of home care, Americare has a special license to work with patients with behavioral health issues and patients with dementia, Alzheimer’s, and/or depression, as well as the developmentally disabled. Mutty can be reached at 917-287-1636 or firstname.lastname@example.org for any questions regarding health care or eligibility for Medicare, Medicaid, and managed care.
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