When Help is Needed
Posted on March 29, 2016 by bob in In Every Life
It can be a joy to interact with family and friends of all ages. Reciprocity can occur when different generations share tasks of living. However, experiencing an illness or injury may require additional assistance. The issue becomes determining what level of assistance is needed, for how long, and where and how to best obtain the needed level of assistance.
Most people desire to retain autonomy in the familiar environment of their home for as long as they can. Options for in-home assistance include support from home health, rehabilitative care services, hospices, community support groups such as those provided by the Alabama Department of Senior Services, or adult day services provided by some local churches.These services can be individualized to support the needs of the person and family. If safety or declining physical or cognitive function is a concern, a person may move in with family, have volunteer or paid companions in their own home, or decide to relocate to another residence.
Often difficulty with home maintenance, obtaining and preparing food, or caring for oneself prompt a decision to relocate. Some communities provide public housing for older adults or persons with disabilities, with services provided by a service coordinator. Other options include residential care which are private facilities that provide room, board, and some assistance, but no medical care. Assisted living facilities (ALFs) offer housing with options for meals and other personal care assistance (cost is based on level of assistance needed), but generally no healthcare is provided. Continuing Care Retirement Communities (CCRCs) provide independent living units, assisted living, and skilled care (SCALFs) on the same location for a person to transition to the level of care or support that is needed. Other terms for skilled care include rehabilitation facilities, nursing facilities, nursing homes, or long-term care (LTC). Some long term care facilities provide for continuous long term residence, or for therapeutic rehabilitation for a short time period, such as following a hospitalization.
It is important that those who need assistance and their family/support system carefully compare options. Considerations include the quality, cost, what the person can afford or what is covered by insurance. If public programs are available, what are eligibility requirements and is there a limit on their duration? Is an option available only after a hospitalization? Is the assistance intended for rehabilitation or supportive care and how does that classification affect reimbursement?
Often, recommendations of others can guide initial visits to preview facilities. Questions may include: Is this a private, independently owned local facility, or a part of a larger corporation? Is it licensed by the state? Does the facility have other credentialing? What is the mission and vision of the facility? What are the credentials of the staff and what percent are licensed as care assistants, therapists or therapy assistants, social workers, licensed practical nurses, registered nurses, nurse practitioners or physicians? What hours or days are the various staff members present, including what number and type of staff are present after 5:00 pm? How much and what type of personal care assistance is provided? Which person provides what type of care—such as who administers medication or therapy? Who is the contact person for coordination of care services or for any transition across levels of care? What activities promote social engagement? Personal visits to facilities at various times of the day or evening and observation of interactions can provide valuable information. Decisions to relocate to a supportive care environment require thoughtful consideration, planning, and financial preparedness.
Arlene H. Morris, EdD, RN, CNE is Professor of Nursing, Auburn Montgomery School of Nursing. Reach her at amorris@aum.edu.
