One of the most common plea adult children hear from their parents is, “Please don’t put me in a home.”  To remain at home and “age in place” is a primary goal for most older adults. Unfortunately, many families don’t plan for the day that Mom or Dad can no longer safely care for themselves independently.  They wait until they are in crisis mode.  Mom has fallen, or Dad has had a stroke, or some other chronic illness has now made it difficult for them to accomplish even basic activities of daily living.  Tasks outside the home, such as grocery shopping, attending doctor’s appointments, or continuing to participate in social activities, have now become impossible.  Toss in having parents who live in a distant city and the challenges of long distance caregiving, and you can have a recipe for disaster.

At Assisted we suggest people pro-actively plan for the day when their parents will need help if they are to remain independent in their own home.

1. Have a family planning session, even if distance requires some family members to attend via telephone.  Include your parents whenever possible.  The first obstacle to overcome might be convincing your parents that they need help in the first place.

2. If there are many siblings in the family, one sibling should be designated “in charge.”  That individual will be the chief contact with the agency and the one who will instruct the caregiver in their duties.  Everyone needs to be on the same page for caregiver success.  Medicare or Medi-Cal does not cover non-medical custodial care.  Long term care insurance typically covers this type of care, but the amount of service reimbursed does have limitations so review your policy.  Planning ahead for the out-of-pocket expenses of caregiver services will help, especially if your parent’s needs change.

3. Write down all aspects of your Mom’s or Dad’s routine – social, medical, activities of daily living (including personal hygiene, toileting, cleaning, eating, etc.).  Sort your parent’s routine under these four headings.:

Can Do Independently

Can Do With Minimum Assistance

Can Do With Maximum Assistance

Can No Longer Do at All

4. There a few ways to approach this list when trying to prioritize the need for care.  People who need assistance do not always have to have around-the-clock care.  Maybe your Mom only needs someone for 4 hours in the morning to help her with her morning hygiene routine, assistance with a shower and someone to make breakfast.  Maybe Dad only needs someone to be in the house at night to safely assist him with frequent trips to the bathroom.  Looking at the list, starting with the areas of most need and working backwards, identify how frequently those tasks are done and see if you are able to prioritize the most immediate needs that would require outside help.

Sometimes it is necessary to introduce a paid caregiver into your Mom or Dad’s routine gradually – just a few hours per day or only a few days per week.  If your Mom or Dad has never had help in the home, they might perceive a paid caregiver as intrusive and they will willingly or unwillingly try to sabotage the arrangement.  Can certain tasks be arranged so family members can assist as well?   Once your parent becomes accustomed to care, adding caregiver hours becomes very simple.

Planning ahead is the best gift you can give to your parents – and to your children.

Sherry Netherland is the Director of Special Projects for Assisted Healthcare Services, a Medicare certified, CHAP accredited home health agency with 7 branches in California and Arizona.  She founded the Assisted Speakers Bureau and she speaks on a variety of healthcare related issues.  To learn more about private duty nursing and how Assisted can help, www.assisted1.com/private_duty_care.