Dear CCGG,
My Mom is 88 y/o and suffered a fall last week. She was hospitalized and discharged fortunately without breaking any bones, just sore and moving slow on aging hips and knees. She lives alone in Orange County and I’m caring for my own family in the Midwest. I think my Mom needs 24-hr care but it’s expensive. What do I do?
Sincerely,
Billy Jean in Ohio
Dear Billy Jean in Ohio,
Thank you for reaching out, it must be a stressful time for you and your family being so far away from Mom. It can be a very challenging time, but the good news is help is on the way and this is a common concern.
A few things we’ll do as a gerontologist is identify the needs of your Mom from a biological, psychological, and social perspective. We’ll also identify what resources are in place and what resources exist locally to support your Mom (and you from far away). And most importantly, we’ll ask your Mom what she wants. This last piece of information will drive the direction of support - and will ultimately create a smooth transition for everyone involved.
First, several questions about the fall:
1. How did the fall occur? Was she at home or out and about? Day time or night time, in a familiar place or somewhere new? Was she alone or with others? How did she get to the hospital?
2. Is this Mom’s first fall incidence, or are falls becoming a pattern? The greatest risk factor for falling is a prior fall. Having multiple falls can be indicative of several things, so these questions can help narrow down the course of correction.
3. Is Mom on any new medication or has Mom been to the Doctor for a medication check-up recently?
4. How is Mom’s nutrition? Does she prepare her own meals and how often does she eat?
5. Does Mom use any durable medical equipment such as a cane, walker, stair lift at home? Does she have an Emergency Response System (in case of a fall)? Some everyday electronics such as watches and phones are detecting falls these days as well.
6. How is Mom’s vision? Does she wear corrective lenses and/or is the current Rx the appropriate strength?
7. Can Mom ambulate/transfer, meaning stand up and walk, independently or does she need some assistance?
8. Can Mom dress herself and use the bathroom (eliminate) independently? Are there any safety modifications at home in the bathroom such as grab bars, shower chairs, and good lighting throughout the house?
9. Does Mom still drive? And if so, how confident is she behind the wheel? Here in Orange County, there are a lot of drivers on the road but if the areas Mom visits are routine and known well by Mom, this can help.
10. How are Mom’s financial resources? In-home care can be very expensive, and often not covered through insurance unless a policy was purchased years ago (Medicare/Insurance can cover some in-home services such as during hospice, palliative care, physical therapy, and follow-up nurse discharge care - but not for an in-home caregiver).
11. Does Mom have friends, Church, recreation classes, or hobbies she enjoys? How often does she engage with these and does Mom have visitors come to see her?
12. Is Mom connected to any resources locally, such as Meals on Wheels, Senior Transportation, financial programs, or self-help programs through local senior centers?
13. Does Mom have any memory-loss related concerns?
Depending on what Mom wants, what Mom needs, and what resources are in place (be it existing with Mom or available to Mom), having an in-home caregiver may not be absolutely necessary. There might be one or two pieces to the puzzle that can stabilize the situation and bring comfort to you and Mom.
And there isn’t a hard and fast rule of what can necessitate an in-home caregiver, rather it often will boil down to her activities of daily living and need (whether she can transfer and ambulate/eliminate/dress/prepare meal and eat independently).
If Mom can complete her activities of daily living (ADLs) independently, then having the conversation with Mom about the other resources to help support her at home might be the solution. But if she has difficulty completing 1 or more of her ADLs independently, then resources might need to exist for safety and ability to age in place.
Lastly, finances are a big factor. In-home caregivers from a licensed/bonded/insured agency can run more than $30/hr, which adds up fast. Agencies also often require a minimum number of hours/days per week for labor management - which also adds to the cost.
Answering several of the questions above and finding a gerontologist or care manager/social worker at the local senior center can assist you and Mom identify the right level of support to be safe at home. Remember, Mom’s voice is critical and some level of professional guidance can go a long way.
Sincerely,
CCGG
DISCLAIMER:
THE CALIFORNIA COUNCIL ON GERONTOLOGY AND GERIATRICS (CCGG) DOES NOT INTEND THIS BLOG TO BE AN ALL-INCLUSIVE GUIDE TO DETERMINING SAFETY AT HOME OR WHETHER IN-HOME CAREGIVING IS NEEDED.
THE CALIFORNIA COUNCIL ON GERONTOLOGY AND GERIATRICS (CCGG) USES THIS BLOG AS AN INFORMATIONAL RESOURCE FOR INDIVIDUALS TO CONSIDER THE NEEDS FOR AN AGING LOVED ONE.
Comments