Age-Old Debate

May 2017 View more

Stuck in the middle.

It’s a common phrase with an almost universally negative connotation. It unfortunately can be applied to a situation that more and more families either are now, or will be, encountering as the population continues its inevitable march into old age—deciding how best to care for an elderly parent. In addition to presenting a very difficult and emotional set of decisions in its own right, for many families this debate comes into play as the children of those aging parents are often still in the process of raising their own children, thus thrusting them into the role of caregiver on two fronts.     

“The shift from a parent taking care of a child to taking care of his or her parent is a very emotional thing, and it’s not unusual for people to really struggle with it,” says Bob Spoerl, owner of Sunny Days In-Home Care in Plainfield.

Indeed, while many adult children feel an obligation to personally take care of the parent or parents that took care of them for so long, there are a number of important factors to take into account. Options may include an elderly parent moving into one’s own home, a home-care service (helping out in the parent’s home) or a move into an assisted-living facility.

While there’s no sure way to sidestep every potential emotional landmine inherent in this process, the key is to try and ensure that the ultimate decision will be one based on solid information and rooted in open and honest communication among family members.

Safety First

While most senior-care professionals tend to agree that allowing an elderly patient to remain in his or her home is generally the best possible situation,
Dr. Richard Krouse of the BreakThrough Care Center at DuPage Medical Group says that patient safety should always beat out comfort, cost or convenience as the top consideration in the decision. “The best thing for most patients is to remain in their home and out of an institution, but safety has to be the number-one priority,” he explains. “A lot of older individuals are at high risk for falls or instability, so ensuring their safety absolutely has to be a primary component of the decision.”

One way to make a home situation more attractive from a safety perspective is to enlist the aid of an in-home service to provide assistance with everything from meals to medications to mobility. In addition to these crucial areas, a regular visitor can provide a sense of companionship that the patient might not otherwise have during the day.

“We want to be there to help support the family,” says Spoerl. “As a home-care company, we’re certainly helping the patient, but we’re also providing an ancillary service to the family. It’s important for family members to know that bringing in another resource to help with that care, rather than bearing the burden on their own, is an option worth considering.”

Welcome Home

Safety and security are, of course, important factors in the decision to bring an elderly relative into one’s home. Configuring the physical space to accommodate the patient’s conditions and limitations through the addition of handrails, ramps or zero-depth-entry bathing facilities is but one piece of an extremely challenging puzzle; the mental and emotional preparations warrant just as much consideration.

“Choosing to provide total care for your loved one can affect one’s own physical, mental and emotional health,” says Linda Conlin, a social worker at Edward Cancer Center. “Many caregivers are also working, caring for their own children or spouse and sometimes even other relatives. Caregiving can be a full-time job, and caregivers often put their own needs and feelings aside while caring for their loved one.”

Dr. Krouse also notes that because some conditions are more taxing on a caregiver than others, an elderly relative’s particular circumstances need to be taken into account before bringing them into the home. “Being in a home among family is usually going to be the best situation for the patient, but it’s important to take an honest look at what effect this kind of situation is going to have on the caregiver and family dynamics,” he says. “Given the proper commitment and financial resources, almost any physical obstacle can be overcome. However, conditions such as dementia can be problematic because they essentially require a round-the-clock and very labor-intensive care. In these cases, from an emotional or mental standpoint, the caregiver has to understand that there is going to be very little downtime once the patient moves in.”

Team Effort

Regardless of the ultimate care decision, Krouse, Conlin and Spoerl all agree that two of the most crucial aspects of the process are getting in front of the issue before it becomes a crisis, and engaging the full and honest involvement of everyone in the family.

“Be proactive so you can plan and organize as much as possible ahead of time, and utilize the experience of your medical team in anticipating what needs may arise,” Conlin says. “Gather as much information as possible, find out what is needed at home and follow through. In addition, be aware of your own limits and the other factors in your life—such as your job, spouse and children—that will tug you in different directions.”

Family communication becomes especially crucial in this process, Spoerl notes. Whether sorting out the responsibilities for each family member with respect to the care plan or the finances involved in the decision, he says that conflicts most often tend to arise when one family member tries to forge ahead without the input of everyone else. Dr. Krouse echoes this key element of the process, noting that full participation from everyone involved—including the elder patient in question—will help ensure that the best possible decision is made.

“It’s important to have an open and honest discussion about the time and resources that are going to be required, and who is going to be taking on that burden,” he explains. “Especially when the family is spread across a wide geographic area, it’s important to make sure that one local member of the family isn’t stuck with an outsized share of the trouble or expense. It can be hard to work through, but families need to sit down and have these frank discussions, because everyone needs to be heard.”