THE LONG-TERM CARE CONTINUUM

Way back in the day, older people who required care received that care at home, from their family. That’s probably one of the reasons people had such large families – so there’d be more people around to help with the work.

As time went on, families got smaller and nursing or rest homes became more popular. But nobody wants to go to a nursing home. On a regular basis a client will say to me, “I don’t ever want to go to a nursing home.”

Some wise business person must have heard all of these people and their collective fear of being placed in a nursing home, because different methods of caring for the aged and disabled have been blossoming in the past decade. Like never before, long-term care has become an industry.

Yet still, people cannot separate the image of a nursing home from the concept of long-term care. While nursing homes continue to play an integral part of the care being provided in the long-term care spectrum, they are by no means the only form of long-term care being provided to our aging population.

Unfortunately, many people continue to labor under the misperception that nursing home care is the only form of long-term care. For example, a number of people have come to see me who have a parent who is currently living at home, alone, and for whom they are seeking nursing home placement. The parent may have memory problems, possibly Alzheimer’s or dementia, as well as other problems generally associated with old age.

But the fact of the matter is, the parent is living at home, alone, and is living. Maybe the parent isn’t living how the child would like. Maybe the parent isn’t living a high quality of life – as the child would define “high quality of life.” Maybe the child has legitimate concerns for his or her parent’s safety. But the fact remains, the parent is living.

Although living in a 40 year old house that is less than clean, watching television or sleeping in a chair most of the day may not be my definition of the high life, for many older people, the independence of living alone is somewhat of an x-factor in the “quality of life” equation. The more independence that is removed from an individual, the less important the person feels. Self-worth has its foundation in autonomy and the ability to take care of one’s self.

So, is it possible to make everyone in my hypothetical situation happy and comforted. After all, the child probably does have legitimate concerns about the parent’s health and safety. And, the parent certainly has the right to live his or her own life.

The care options that have developed in recent years attempt to offer a compromise solution to this situation – which, by the way, is a situation that repeats itself thousands of times a day, each and every day.

A home health aide – part-time, full-time, or live-in – can provide a child with the peace of mind associated with knowing that a parent is alive and well. Most home health aides will clean the house, cook the meals, provide companion care, and monitor the intake of medication.

An assisted living residence – many of which are modeled after hotels and have health aides present to provide assistance – will provide all of the services that home health aides provide, plus the additional benefit of socialization. Many older people become accustomed to living at home alone. They feel safe at home. But there is an element of socialization that is sorely missing. Many times, when exposed to other individuals in their same situation, they open up and are happier for doing so. Sharing lifetime experiences with others who have had similar experiences can be strong medicine for the depression that is often associated with old age.

Of course, this is not to say that nursing homes are a product of yesterday, or that nursing homes are bad. Nursing homes continue – and will continue – to serve an integral part on the continuum of long-term care. It’s just that today, that continuum is a bit broader than it was twenty years ago.

Explore your options. You and your parents will be happier if you do.