1)  Do it all yourself.  Most families begin with this choice, especially when care needs are few.  Care becomes more difficult when a parent needs assistance with several daily activities like driving, laundry, housekeeping, cooking, bathing, and paying bills.  Doing all care personally may eventually require nearly 100 percent of your time and effort, or may require that you live with your parents or they live with you.  Burnout and stress are common pitfalls, and older adults who spend most of their time at home often lack age-appropriate socialization and experience loneliness.

2)  Hire help at home.  Sometimes a family friend or neighbor is willing to take the job, or you may find an individual with good recommendations.  There are also caregiving agencies that will supply you with a caregiver, some handle background checks, call-ins, and other issues for you. Hiring in-home care can be one of the most costly and time intensive options.  Socialization for the older adult is often limited to one-on-one interaction with the hired caregiver.

3)  Assisted Living services:  Assisted living residences generally provide an apartment, along with additional services such as meals, housekeeping, laundry, and personal care.  Transportation is usually available, along with activities designed to encourage social interaction.  Assisted living can give a parent and child a level of privacy and peace of mind, while allowing both to maintain some independence. Older adults can regain a feeling of autonomy since they aren’t “at the mercy” of family and friends to meet their needs. Lonely seniors benefit greatly from the peer socialization that naturally occurs in an assisted living environment.  Often, assisted living is significantly more affordable than hired in-home care.

4)  Residential Care Homes/Dementia care.  Residential care homes provide care for 5 to 8 people in a house.  Some dementia care can be done through a residential care home, or an assisted living.  Precautions are taken for residents who wander, including security codes and fenced outside walking areas.  These smaller homes offer limited activity and socialization opportunities.

5)  Nursing Homes.  Nursing homes are medical facilities that provide nursing care around the clock, and most offer rehabilitation services such as physical and occupational therapy.  While nursing homes are covered by Medicare and Medicaid to some extent, private payment at a nursing home is costly.

6)  Sliding scale housing/community services. Area Council on Aging organizations set up senior centers, sometimes providing a noon meal, organized activities, and limited transportation for seniors, often at little to no charge. Sliding scale housing developments provide low-cost rental housing, are age and income restricted.

Choosing the best care option or combination of options takes time, good communication, and plenty of flexibility.  Don’t be daunted by the overwhelming amount of information, but keep persisting until the right solution emerges for you and your family.

I suppose my children and I will survive those crazy mornings relatively unscathed, but there are some things in life about which none of us should procrastinate.  As I work each day with seniors and their families, I often see the difficulties produced when individuals put off thinking about and preparing for long term care needs as they age.  Kind of like that yearly physical exam, or a termite inspection, long term care can easily be something we put off for a later time, thinking it isn’t an urgent need today.  However, an event like a fall, stroke, or heart attack can often create a “rush” much like my morning frenzy as family members or caregivers try to piece together long term care solutions.  Often the person in need of care is able to have little to no input or control over a last-minute decision about his or her well-being and lifestyle.

Thinking about long term care doesn’t have to be a tedious process.  Exploring the various options now available for Americans as they age can actually be an interesting project.  Just as we have the “American dream” of life with a family, picket fence, and successful career, Americans want to have options and preferences as they encounter the inevitable processes and challenges of aging.  Taking time to check out the options available and think over which options best fit you and the lifestyle you want to live can save time, money and heartache when the time comes to actually implement a long term care plan.  Since nearly all of us will have long term care needs at some point in our lives, putting off these thoughts until later isn’t something any of us can afford to do.

Tonight, I think I’ll lay out everyone’s clothes, make lunches, and place everything we need beside the front door.  Then I’ll watch my little ones file out the door with happy smiles and a peaceful mama in the morning.  As I walk into work, I’ll see some of my dear friends who live at St. Francis Villa Assisted Living, ladies who could tell me from experience how a little advance preparation makes for happier babies and happier mamas.  They could also tell you how a little advance preparation makes for much happier families and individuals when long term care is needed.  Don’t be tempted to “indulge yourself” by putting off this preparation for later.  You can avoid the unnecessary “rush” and the loss of your independence by researching and expressing your preferences now.  The peaceful process that your preparation will produce will be a priceless gift to yourself and your family when you are ready to begin using long term care services.