It’s a tough decision: you don’t want to infantilize your parents and create resentment but you do want to know that they’re safe and cared for when you’re not around.
Finding what is the best level of care for your aging parents is a delicate balance of ensuring their independence and happiness against your concerns that they aren’t fully up to the task of caring for themselves. The problem is made worse if you don’t happen to live nearby, making frequent visits difficult and costly.
Figure out what their needs are
The level of care your parents will require will depend on their actual needs, not what you might perceive as being their needs. You might feel more comfortable if they were in a care facility or a retirement community but they might not need or want that level of care. Pushing them into a care situation too soon will only result in unhappiness all around.
Ask questions to get down to the details:
- Do they need help with shopping and getting to appointments? Or do they need a little more, like ensuring that they eat regularly, take their medications and monitor their blood pressure?
- Are they at a point where they are no longer taking care of their home or their own personal hygiene or is it really just a matter of getting them some help with the heavy lifting?
Take a long look at what they can do and enjoy, and what they can’t.
Look at the situation from their point of view
You have to look at what they can and can’t do, what their needs are, but you must remember to do it from their point of view and always with the intention of maintaining a maximum level of independence.
While your widowed mother might be happier in a retirement community, with other seniors for company, she might not. The parent who needs some social connection but wants to remain in their own home, and is physically able to, should be able to do what suits them and their personality best.
Home care as a starting point
At a basic level, some seniors really just need a little help with some of the heavier tasks, like gardening, shopping for groceries, or cleaning up their home. They might also benefit from the social connection that a home care worker could provide.
A home care worker would be able to come on an occasional basis, either regularly or as needed, to help with some of these tasks. They won’t provide any kind of medical services, so if that is on your parents’ need list, a different level of care would be required.
Personal care is the next step
When your parents are no longer dealing with some of the basics of personal hygiene or eating correctly, a personal care worker could step in, offering services and some occupational therapy tools that would assist your parents, while still giving them the independence of remaining at home.
This kind of care is about prevention: seniors who don’t eat well, with a balanced diet, are exposing themselves to a higher risk of illness or injury prematurely. A healthy diet, eaten regularly, can make a big difference, as would maintaining a standard of personal hygiene.
It’s best not to assume the reason that they’re not keeping their usual standards. They could be afraid of falling in the bath, and not want to mention it, for example. Getting down to the details of why certain behaviors are occurring with your parents can help you to decide what they need in the short term.
This kind of care can be part-time or full-time (daily) but not live-in, depending on the level of need.
Nursing care
When there are medical issues, or a parent is recovering from illness, injury or surgery, it’s best to engage some professional medical care to stay on top of their vital signs, make sure that they are getting the appropriate wound care (if applicable) or taking their medication as directed by their doctor.
Under this category, you could also consider respite care. This is of particular value when one of your parents is suffering from an illness or requires more care than the other. When the other parent is acting in the role of caregiver, for example to a spouse with dementia, they need to be able to get breaks from that role. Respite care can help ensure that they maintain some of their habits and enjoyments in their own lives, while being confident that their spouse is being well taken care of. It’s a level of self-care that can make all the difference to their health and well being, both physical and mental.
Assisted living
This is an option for your parents if they need more than in-home care can provide, even in a full-time situation. If your parents need to be able to have access to services, not have to deal with home care or meals and have medical resources at their disposal, an assisted living situation might be right.
They will have a measure of their independence, with access to a community of people who can help them and provide a social space to engage in.
Placement at a specialized care facility or nursing home
When your parent can no longer cope with day to day activities at all or is affected by dementia, it might be time to consider either full-time live-in care or placement in a facility designed to manage their care needs, 24/7. This option needs, for most people, to be a last step as it represents a major curtailment of freedom and independence that can actually harm a person’s mental health, if they aren’t prepared for the change or willing.
At some point however, safety for them and others has to be a paramount concern. It’s best to research available options long before this becomes a necessity so you aren’t put into the position of making a rushed decision.
Hospice care
This is care that is meant to manage a terminal illness where the prognosis is six months or less, creating the most comfortable environment possible for your parent, with the least amount of suffering. In hospice care, your parent can have their symptoms and pain managed continually. The physical and emotional support that this kind of environment provides is beneficial for your parent, and for you as well.
Whatever stage your parents are at, the key to ensuring that they are safe and cared for is to open up a discussion with them. Forcing them into a situation against their will won’t be beneficial for either of you. It’s a hard conversation, but it’s essential if you really want to get down to the details of what they need, and also what they want. They’re not children and barring serious dementia, they are able to understand their own personal needs far better than anyone else. Make them part of the discussion, rather than dictating a solution to them, and you’ll find the transition easier for all of you.