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Most people, in fact 85% don’t want to go into a nursing home–that’s what they used to call them.

Many of our seniors cringe at the word and imagine long, dark halls, people screaming, sitting in soiled diapers, horrible food, and being abused. Thank goodness, this is not the norm–and there’s more vigilance to report elder abuse and substandard care today.

According to surveys done by AARP, most of us would prefer to Age in Place–meaning, stay in our homes  and augment care as needed–a mix of family caregiving, professional caregiving services, adult day cares, and other elder-care community based resources.

I highly recommend staying at home, including various elements of family caregiving, paid care, and community care–but I do know that there are times and circumstances when this just isn’t enough.

What Are the Different Kinds of Care Facilities–and Which One Is Right For my Loved One?

Contining Care or Graduated Care is when you buy into a community in which you can choose your living condition (small home or condo at first), and then “trade” it in when/if your care needs increase. Within one “complex” you might see homes or duplexes, condos or apartments, a building (care facility) that houses many units of care, and all these may be near a hospital or hospice facility. These are usually a large development and can offer meals, hired care workers, transportation, activities, and other amenities.

Assisted Living is similar and can be a part of graduated care. Assisted living can be houses/duplex, condos/care facility where the person has their own apartment but has access to additional help. There may be a place for meals, a van for transportation, and non-skilled care workers can be hired to do various needs and levels of care. Some assited living and care facilities are individually owned while others are a part of a larger corporation.

Care Facility or Skilled Nursing Care is considered a full-care facility and is what people think of when they say, “nursing home.” They can be a part of other facilities, such as the continuing care, or assisted living home, but they have the added component of a skilled nursing staff (RN’s–registered nurses) as well as non-skilled care, usually called CNA’s (Clinical Nurse’s Assistant). Care facilities are for people who have medical needs, have severe mobility issues (can’t walk, falls), and need supervision as well as medical care. They often have a staff of doctors and other care workers who will come to visit them, prescribe medications, and offer in-house treatments such as physical therapy.

Memory Disorder Facility or Center can be a part of an assisted living or care facility and focuses on the needs and care of people with neurological disorders such as brain injuries, advanced Parkinson’s or Lewy Body, Alzheimer’s and dementia.This facility has the feature of secured doors and exits so that people who tend to wander can’t leave. They specialize in dealing with the behavoiral, psychological and physical issues that come with neurological disorders. Since this is an area that overlaps, many of their clients need medical care/skilled nursing care/visiting doctors, etc.

Rehabilitation Facility is usually a short term facility that focuses on people recovering from surgeries, accidents, and for those who need various care treatments such as physical or occupational rehabilitation therapies. They are a “half way” facility people go to when they’re not quite ready to go home, or need more care than a graduated or assisted living facility offers. Most rehabilitation facilities are corporate owned and work closely with hospitals and doctors. 

How Do I Assess If My Loved One Should Go Into a Care Facility?

  1. They choose a graduated/continual care or assisted living on their own.
  2. They have no family nearby and no one can or will coordinate their care (don’t forget how helpful geriatric care managers can be in figuring out various stage of care and evaluating care facilities)
  3. They need full-time care, perhaps with needs of skilled nursing care as well–and this has become too much to manage for a loved one to deal with.
  4. Their dementia/Alzheimer’s has increased to a level to where they’re not manageable at home–violent, escapes, can’t be managed by one care helper–needs more supervision, medication, and physical control than the family/and caregivers can provide.
  5. Are at the late stages of various diseases/aren’t mobile/and the family can’t manage their care–perhaps hospice is involved and there are end of life and palliative care needs (pain management).
  6. You, the family caregiver simply can’t do it anymore–your own health or finances are falling apart and you’ve done all you can.

There are valid reasons for your loved one to enter a care facility.

You have not failed as a caregiver–nor are you “done” when your loved one enters a care center/facility.

Your loved one needs you more than ever to oversee their care and make sure they are safe, respected, and receiving all the care they need and deserve.

Also know that the first care facility may not be your last one–it may not be a good fit, you may have to change and try a different one. Also, as time goes on and their care increases, you may have to move them again.

Don’t forget that hospice and palliative care is still needed (and must be asked for) to supplement their care at the end of life.

You may also consider letting them come “home” to die.

You  have many options.

Helpful Links:

Great article:

newoldage.blogs.nytimes.com/2008/07/14/faced-with-caregiving-even-experts-struggle/  

~Carol O’Dell, Author of Mothering Mother–an Amazon Bestseller in Alzeimer’s and Aging Parents.

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One of the most exhausting and frustrating of caregiving is dealing with medical insurance and Medicare.  

Every policy is different and as you add on various specialists and procedures, well, it even gets more complicated.

Then, there’s Medicare. A whole other enchilada!

Just more to learn about for the already over-committed, over-worked caregiver’s life.

Medicare has taken notice of caregiversand their needs and are “detangling” their information and opening accessability.  

The new site is named, Ask Medicare!  and can be found at:

www.medicare.gov/caregivers

What is the purpose of this site?

•             To build a direct and meaningful conversation between Medicare (CMS) and caregivers;

•             Empower caregivers with information, tools and materials that will help them take action to lead to a healthier life for their loved one and for themselves;

•             Help connect caregivers to Medicare resources and other partner resources

•             Raise community/partner/policy awareness of caregiver issues

•             Foster and support a strengthened caregiver movement

* CMS stand for–Centers for Medicare & Medicaid Services, and is the US federal agency which administers Medicare, Medicaid, and the State Children’s Health Insurance Program.

This web page will provide updated, easy to use information and tools to assist caregivers in talking with their loved ones to make a family plan and in making informed healthcare decisions about a variety of topics–from Medicare coverage to technology updates to emotional support.

Knowing what options you have, what benefits you qualify for is crucial to good care.

Here’s what they have to say:

*Ask Medicare was developed in consultation with caregivers and partners to provide answers to common problems and address a wide range of questions about caregiving. We’re reaching out to caregivers who can provide helpful feedback, interact with leaders of this initiative, and ultimately feel confident sharing this resource with their readers.

***

I would have given my eye teeth (what that means, I’m not sure) to have had this access when I was caring for my mom.

Like many of you, I felt like I was “thrown” into the caregiving pool and was trying not to drown. Trying to physically and emotionally care for a person who is already ill, has different insurance than you, is eligable for government benefits that you know nothing about–that you’re supposed to figure out WHILE you’re cutting pills, changing sheets, scheduling doctor appointments, and trying to encouraging and loving–well, it’s more than one person can do.

Add on top of that children, a marriage, and my own personal (sidelined) goals and interests, and it felt like I was heaping more bricks in my wheelbarrow than I could carry. Caregivers had busy, hectic lives before their committed to care for a loved one–and getting clear and concise help is a must.

So go to Ask Medicare! and ask a question. Get familiar with the site. Look around. Share your frustrations and offer suggestions.

This is a great resource for all caregivers, and I hope you’ll get the information and assistance you deserve. Family caregivers are crucial to good care. We keep our loved ones at home and in their communities, we make sure they’re safe and watch out for them as their needs change. We find good care facilities for them when and if it’s necessary.

And we need and deserve all the support we can get.

I’m Carol O’Dell, and I hope you’ll visit my blog again.

I’m the author of Mothering Mother, and a family advisor at www.Caring.com

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