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Monday, May 24, 2010

Best Laid Plans -- Oh, Well

At Support For Home, we urge families -- whether they will be working with us or some other agency -- to plan ahead, in terms of homecare for loved ones.  That planning involves a number of factors, including:

  1. What is the budget? 
    • What will homecare cost, at several levels of care, from perhaps 4 hours a few days per week to 24 hours, 7 days per week?  That is a wide range of care, and it corresponds to very different costs.
    • How will homecare costs be paid?  Is there Long-Term Care Insurance?  Is the loved one eligible for Veteran's Aid & Attendance benefits to subsidize homecare costs?
  2. What is the "tolerance" for homecare?
    • While it may be clear that assistance with ADLs (Activities of Daily Living) and Instrumental ADLs is critical to success in aging in place, we all have different levels of tolerance for that assistance.  We have each been independent for a long time.  There are issues of pride and privacy that need long and sensitive discussions.  Often it is better to start with a smaller schedule, to allow adjustments, if #3 allows it.
  3. What is the goal of implementing homecare?
    • This is actually a big deal.  In our view, homecare support should be started before there is a major crisis, such as a fall and a broken hip or a stroke.  Our goal is to begin supporting our clients early enough that we are able to help maintain a safe environment and high quality of life for them, avoiding crises to the extent possible.  If we are already in a crisis, the immediate well-being of the senior is the key, always.
One of the reasons it is so important to have these discussions and make plans early enough is that we do not know when the crisis will arise.  A family called us in last Tuesday, to begin a schedule of 4.5 hours per day, Monday through Friday.  By Thursday, when we met with the senior and her family, the need had changed to seven days per week, starting the following Monday.  By Sunday morning, the need had changed to 24-hour shifts, seven days per week, starting that day.  The crisis was here.

Neither the family nor the client have had time to adjust to homecare or the costs of it.  That means more stress than they need, but ...

So, plan ahead, but be ready to move quickly, as the situation changes.  Need for homecare goes up, down and sideways.  We can help you deal with it.

Best wishes, Bert

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