Coping with and caring for an aging family member can be tough. There is a multitude of important considerations, including medical care, finances and the overall well-being of the entire family. “One of the goals for health care providers and family is to promote successful aging, which means getting involved as soon as possible,” said Ali Rahimi, MD, FACP, AGSF, Internal Medicine Program Director at MountainView Hospital.
While these areas can be difficult to navigate, it’s important to evaluate the options early and often.
Type and level of care needed
Deciding if a family member should be living alone, with you or in a care facility can be incredibly complex.
“The level of necessary involvement can be broken down as casual involvement, supervisory involvement or intense involvement, based on the family member’s degree of frailty,” Rahimi said.
You also may have to deal with conflicting wishes of the family member in need of care and the wishes of the rest of the family.
Honestly evaluating the options and having open and frank discussions with your family member, his or her doctors and/or care team, and your spouse, siblings, etc., is the first step in making this decision. While there is no easy formula, there are some guidelines that can help.
Should my family member live alone?
Living in his or her own home may provide your family member with comfort and a sense of independence and autonomy.
On the other hand, living alone can be isolating and dangerous. If your loved one doesn’t have a medical condition, is physically and mentally capable of maintaining his or her personal needs (such as hygiene, medications, cooking, cleaning and social activity), and is able to live comfortably without frequent outside intervention, living alone may be an option.
If those are not the conditions but it’s still in the best interest for the family member to live alone, there are resources that can help.
Some choose to hire a nurse, an alternate live-in or part-time caregiver, or have another family member move in to assist with care. Hiring a housekeeper or personal chef, or using a food-delivery service, also may provide enough assistance for solo living to be comfortable.
The potential isolation of living alone also should be considered, as it can lead to depression and exacerbate physical and mental decline. “Depending on the dynamics of the family and community, one of the best options to increase socialization is support from community programs and churches. Adult day programs and public senior citizen centers are available and are very supportive,” Rahimi said.
Should they live with family?
For many aging people, moving in with family may be the preferred option, as it affords the comforts of home while still providing care and companionship. They may still need to maintain a certain level of independence to healthfully live with family, and additional care may still be necessary, as well. Further, the capability and availability of the family needs to be taken into account.
“Taking care of an older individual is labor-intensive and can create a significant time and financial burden on the caregiver,” Rahimi said. Balancing your personal life, familial obligations, career and other responsibilities can be difficult when caring for an aging family member, but for many people it also can be rewarding. Before deciding if an aging family member should move in with you, take stock of the level of care they require, how much time you have, financial limitations and any conflicting responsibilities, such as caring for children.
If an aging family member is going to move in with you, you will have to evaluate the conditions of your home and may need to make modifications. This could mean making your home wheelchair accessible, adding handles or supports in the bathroom and increasing lighting. Consult with an occupational therapist or a geriatric-care specialist prior to having your family member move in, as they’ll be able to tell you what modifications are necessary for the circumstance.
What about live-in care facilities?
Care facilities can be a great option during any point of the aging process but are especially helpful for people who require daily medical care and/or around-the-clock assistance and supervision. Care facilities also are beneficial in providing a steady routine for residents, socialization opportunities and assistance with daily tasks. There are different types of care facilities available to accommodate different levels of patient care, so it’s important to do your research and consult with doctors before choosing the right one.
Financial burden is one of the biggest concerns when considering a full-time care facility; however, there are many ways of coping with that.
“Collaborative family action, or having multiple family members chip in to cover the expenses, is one option. The family may also decide to downsize property, sell relevant assets or consolidate finances,” Rahimi said.
It is helpful to consider the amount of time and care that will be required for the individual and then make a realistic, long-term budget to weigh the expenses of living at home with assistance, versus moving into a full-time care facility.
What’s the “Sandwich Generation”?
The term “sandwich generation” describes people who care for an aging parent and children simultaneously. As the baby boomer generation ages, the number of older people requiring care will grow exponentially in the next 10-20 years, and as such, the sandwich generation is expected to grow as well. People in the sandwich generation may face considerable financial hardships, an unbalanced distribution of resources and an adverse impact on their well-being and quality of life.