Providing a loved one with adequate in-home health care is important when that person wants to try to remain independent but is struggling. Individuals with disabilities, those recovering from illness or injury, and aging adults are all people who may need in-home care. There are some cases, though, in which in-home care just isn’t enough to provide someone with adequate safety, comfort, and needed medical care.
It can be difficult to come to this realization, and furthermore to tell someone you care about that they need to move to a residential care facility. Understand the limitations in the home, what you can afford, and the signs that a move is inevitable. Make decisions about residential care together, take your time to make the right decision, and remember that your loved one’s well-being is most important.
What is Home Health Care?
Home health care is any kind of care that a patient receives in the home, from unskilled assistance with chores and errands to help with hygiene to skilled nursing services. Care in the home may be provided by a family member, by unskilled workers, or by skilled nursing assistants or nurses. Depending on how much care an individual gets in the home, there may be more than one caregiver. Some home care is around the clock, while for others the care is provided for just a few hours here and there.
People who need home health care may include those with disabilities at any age, from young children to older adults. For instance an adult with a developmental disability may need someone in the home during the day while the primary caregiver, a family member, goes to work. This kind of care is long-term, as it involves permanent disability.
Home care may also be needed on a temporary basis, for someone who has been injured or is recovering from surgery or going through treatment for a serious illness. Older adults who can no longer live completely independently can benefit from home care for everything from errands to basic hygiene and medications. Elderly home care patients may have memory-related illnesses, like dementia, or they may simply be physically unable to do everything around the house that they used to do.
Signs that Home Health Care Is Not Enough
It is often the case that people who need home health care prefer to stay in the home. It may be the family who wants to keep them in the home. Generally, people prefer to stay home and get care there as opposed to living in some type of residential care facility. Home is more comfortable, holds memories, and staying home with care provided helps people feel as if they still have a degree of independence. However, with some people, especially those that are aging, at some point getting care in the home isn’t adequate. Here are some signs that your loved one may need more care than can be provided in the home:
- You cannot afford the level of care your loved one needs or the number of hours they need care in the home.
- The primary caregiver is getting burned out, and there is no one else who can step in to help.
- Your loved one is having accidents in the home and has gotten hurt.
- Memory issues have become a safety issue, as when they cause someone to wander and get lost or leave an iron or other appliance on.
- Your loved one doesn’t feel safe at home.
- There are a lot of medical needs that require skilled care, at least nursing.
- Your loved one has reached a point at which he or she needs around-the-clock care or supervision.
- There is a possibility of emergency situations that the family or caregiver would not be equipped to handle.
When you realize that your loved one needs more than in-home care can provide, there are several options. Understand those options to help make the best choice. If possible, choose the new living arrangements with your loved one so that he or she feels comfortable with the move. It also helps to involve one or two other family members to share the burden of making this big decision.
One of the options in going from in-home to residential care is assisted living. This is usually for older adults, but some people with permanent disabilities may also be right for assisted living. It is a level of care that provides basic services, not necessarily medical services. Assisted living usually includes things like cleaning, cooking, laundry, errands, transportation, or in some cases basic unskilled care like assistance with bathing and dressing. Assisted living is a good option for anyone who can’t live alone anymore but who does not need a lot of medical care yet.
Nursing Homes and Memory Care
For those people who do need more medical care, and who need 24-hour supervision and care, a nursing home is often the best option. These are facilities for people who have serious or chronic conditions and need to be monitored around the clock. Nursing homes are not designed to be permanent living arrangements.
An exception to that is the memory care nursing home, or a memory care unit within a facility. This is for patients who are struggling with dementia, Alzheimer’s disease, and similar conditions. These are conditions that won’t get better, so the facilities provide specialized care for patients who will likely live out the rest of their lives there.
Palliative and Hospice Care
When someone is living with a terminal condition, palliative or hospice care may be needed. This kind of care can be provided in the home, but it isn’t often practical. Palliative care is health care with the goal of making patients with chronic or terminal conditions comfortable, while hospice care is for those patients who are in the process of dying. Palliative and hospice care often go hand-in-hand. A residential facility that provides this care is often the best option for terminal patients because it can provide much more comprehensive care than can be given in a home setting.
How to Talk about Leaving Home
Talking to a loved one about moving on to more dedicated care isn’t easy. It is a sensitive subject and most people do not want to face the reality that they are unable to live independently. When it’s time for you to have that talk, involve just a few people so your loved one won’t be overwhelmed. Involve those people he or she respects and is likely to listen to.
Be prepared with options so that your loved one can still feel as if he or she has control and can make decisions. Discuss the positive aspects of a move, such as being able to socialize more or the possibility of more activities that a residential home can offer. Talk to your loved one with respect, but emphasize that your first concern is their safety and well-being and that you are no longer capable of providing that.
Knowing when home care isn’t enough is not that difficult. You probably already know, but the real challenge is facing that reality and convincing a loved one that a move is necessary. Be patient, be prepared, have options, and be respectful of the loved one you are trying to help as you make sure they understand that you have their best interests in mind.