You might be hearing a lot more about eldercare lately, with efforts to shore up at-home and community-based care services in the news, and the pandemic, which has disproportionately affected older adults. You may already be a family caregiver in the company of the estimated 47.9 million other family caregivers in the United States who are trying to fit caregiving into their busy schedules and figure out how to pay for it.
Jump ahead to these sections:
- What’s Eldercare?
- Are There Different Types of Eldercare?
- What Kind of Eldercare Do You or Your Loved One Need?
- How Do You Know If You or a Loved One Are Ready for Eldercare?
- Can You Plan Ahead for You or a Loved One’s Eldercare?
- What Are the Different Ways You Can Find Eldercare in the US?
Eldercare is hard to define because it’s a constantly shifting landscape of needs and options. Stress and confusion result from these main factors: not being educated about what eldercare is and the options available, and failing to plan for the future.
Fortunately, we have you covered and will explain what eldercare is and how to prepare for it.
The aging population is amazingly diverse and includes a broad spectrum of abilities and disabilities. Some older adults are vibrant, independent, active, and working. At the same time, many elders have multiple medical conditions and require around-the-clock care. Then there’s everyone in between those two ends of the eldercare spectrum.
Eldercare is unique in that someone might need immediate help due to a catastrophic illness or accident, while others face a slow decline that requires increasing care over time. At the one extreme is nursing home care, and at the other is an elder who only needs occasional help with medications and doctor’s visits.
Are There Different Types of Eldercare?
As mentioned, there are several different types of eldercare available. That’s because elders have different health and care requirements. Here are the most common types of eldercare.
Home care is a service provided by private caregivers who assist primarily with activities of daily living (described in more detail below) in someone’s place of residence. In most states, these private caregivers can’t perform any medical tasks. Home care, unless you have a long-term care insurance plan, is private-pay. Many families start the journey of eldercare by hiring home care workers to alleviate family caregiving duties.
Home health care
Home health care, unlike home care, is a time-limited, insurance-covered medical service. Home health care staff consist of nurses, physical and occupational therapists, aides, and speech and respiratory therapists. Unlike home care providers, home health care providers can administer medical treatments.
Home health care requires a physician’s order, and you must be homebound (unable to visit a doctor’s office) to receive it. Once you or your loved one have met the goals of home health care, the program stops. Home health care can take place in your home or in assisted living.
Independent, assisted living and memory care
Most independent senior communities have a continuum of options that include independent living, assisted living, and memory care. Some elders start in independent living, and then when they need more care, they hire home care staff or move to assisted living, which has more support built into the community structure.
At some point, you or your loved one could decide that the cost of home care and the complexity of the care you require is better served in assisted living.
Memory care is for people with dementia, Alzheimer’s, or other cognitive conditions requiring more intensive staff time and monitoring. You can get both home care and home health care in memory care.
Adult daycare is a day program for elders that offers activities, meals, and some health services. Families use adult daycare due to its affordability and the respite it provides from caregiving duties.
Nursing home care
Nursing homes are the most intensive level of care available outside a hospital setting. Nursing and other medical services, such as x-rays and diagnostic testing, are often offered on-site.
Nursing home care is expensive, and most people end up qualifying for Medicaid, the low-income health program to pay for it.
Hospice care is end-of-life care. When you or your loved one chooses hospice care, you agree to stop medical treatment and pursue comfort care only.
What Kind of Eldercare Do You or Your Loved One Need?
With so many types of eldercare, you might be wondering how to choose the type you need. Below are the basic factors that determine what level of care an elder likely needs.
Activities of daily living (ADLs)
“ADL” is a term commonly used throughout the healthcare system to describe a set of non-medical care needs. Activities of daily living include the following:
- Mobility: Help with walking or using a wheelchair.
- Dressing and grooming: Assistance with getting clothes on and off and help with personal appearance, such as putting on makeup or shaving.
- Bathing: Helping someone in the shower or tub and assistance with washing.
- Toileting: Getting someone to the toilet and, if necessary, helping them with the process.
- Transferring: Helping someone from a sitting or lying position to an upright position or another location.
- Feeding: Assisting an elder with the act of eating and also cooking and shopping for food.
Instrumental activities of daily living (IADLs)
Someone could be very physically independent but need help with other, more complex skills that require thinking and reasoning. These are a few of those activities:
- Managing finances: Paying bills and keeping track of accounts.
- Transportation: Traveling to appointments or assisting with accessing transportation.
- Home maintenance: Keeping up with basic household chores.
- Medication management: Setting up medications and ensuring they’re taken correctly.
- Communication: Managing the telephone or video conferencing platforms for telehealth visits, as well as help communicating needs and wants to other parties.
When someone has had a fall or an exacerbation of an illness, they may need assistance through rehabilitation services to recover to their previous level of functioning (or at least recover to the extent that they can go home with support).
Medicare will cover the cost of rehabilitation if you meet specific criteria. Since rehabilitation is short term, you or your loved one might still need eldercare once you get home.
Nursing is a medical service provided by an RN and involves taking vital signs, performing wound care, changing catheters, managing medications, giving injections, and more.
Most people prefer to avoid nursing home care, so they exhaust all of the other options first. This sometimes involves bringing a professional nurse into the person’s own home.
Other healthcare providers
Other healthcare providers include physicians, specialty doctors like cardiologists or nephrologists, and mental health workers. Most elders have at least a primary care provider and usually other specialists, as well.
How Do You Know If You or a Loved One Are Ready for Eldercare?
Knowing when you or your loved one is ready for eldercare is complicated and, to some extent, depends on personal preference and the willingness to accept it. You could be prepared to take full advantage of care in your home or move to assisted living where another loved one may resist all efforts to introduce eldercare.
The ideal situation is where you can arrange and afford to pay for eldercare that helps you stay safer, recover from an accident or illness, or increase your social interaction and companionship. Some key “tipping points” to start eldercare for you or a loved one include the following:
- Safety: Safety is a broad category that includes help with activities of daily living to prevent falls, monitoring someone with dementia, assisting with transportation, cooking, and cleaning. Particularly if someone has mobility problems, having home care can make a significant difference in fall prevention.
- Medication management: If you or a loved one isn’t able to take medications correctly to treat critical medical conditions, the consequences could be significant. You might need someone to set up your medications and give you reminders.
- Isolation: Increasing isolation can lead to mental health problems and general physical decline. Companionship is a valuable part of eldercare and can bring stimulation and engagement to you or your loved one. Many older adults opt for senior living communities due to the variety of activities and the built-in social environment. It is not unusual for an elder to move to independent or assisted living before they need it due to the availability of other people to connect with.
- Difficulty managing the household: At some point, due to cognitive or physical impairments, you or your loved one might not be able to manage household duties. Included in this are housekeeping, lawn care, and home maintenance.
- Malnutrition and dehydration: Malnutrition is a scary word, but significant weight loss is a sign that something is wrong. Possibilities include difficulty with shopping and cooking, forgetting to eat, or a medical issue. Dehydration is another common condition in older adults and can lead to hospitalization. Home care professionals can support good health by ensuring adequate nutrition and giving reminders to drink.
Can You Plan Ahead for You or a Loved One’s Eldercare?
You can and should plan ahead for your or your loved one’s eldercare. It’s impossible to predict the future and what care you might need, but there are ways to plan that allow for flexibility and financial stability.
Advance care planning is the best way to cover anticipated needs, preferences, and costs. Meet as a family to plan so that everyone can discuss the options, review insurance coverage, decide who will be involved in caregiving, and how to pay for care when needed.
As part of that planning, you’ll want to explore the services and eldercare options available in your community. We’ll talk about that more in the next section, but finding eldercare during a crisis is stressful and risky.
What Are the Different Ways You Can Find Eldercare in the US?
Finding eldercare in your community can be a tough job, and our senior care guide is a good place to start. If you live in a large metropolitan area, the choices for any kind of eldercare could be overwhelming, but we have some tips to get you started.
- Consider hiring a geriatric care manager. An experienced geriatric care manager knows the companies and communities with the best reputations and care. They can help guide your decision-making and assist with planning.
- Ask other healthcare providers. Healthcare professionals typically have expertise with companies and can usually make some reliable recommendations.
- Use a senior care placement specialist. These professionals know the senior living community and can make recommendations based on locale, amenities, and cost. If at all possible, use one that is local. An excellent local senior care placement specialist will often do personal tours with you or your loved one.
- Ask friends who they have used and liked, but ask detailed and specific questions about what they like and don’t like. People sometimes exaggerate the good and the bad qualities of a particular service or place.
Eldercare Options for You and Your Family
Getting older does not have to be stressful and expensive if you educate yourself and plan for the unexpected.
Talk with your family about eldercare options early on, and stay as engaged and healthy as you can as you age. When the time comes to make a decision about care, you’ll be ready.