In home care.....realistic? (stepfather, state, coverage, friend)

[charlygal]

Getting help is one thing. Moving a stranger into your home is another. An option is to hire a service for a few hours a day if all you need is errands and such.

[jrkliny]

I have a relative that is involved in an organization promoting a community of older people who look out for each other. That sounds like a great idea but there is a major problem. When we are younger, we have different demands and interests. By the time we become interested in a community of old people, we are too old to help and are just interested in being helped.

[selhars]

Try to have a flexible plan, and/or a plan for various needs you may have.
And get the best estimates you can on how much the various elements of your plan may cost.
(live in, day workers in home, assisted living, nursing care, continuing care retirement community, etc)

And, yourself, also try to be flexible....and realistic (as a couple) about your needs as they arise.
Sometimes certain adjustments only lengthen the time at home (delay moving for a certain time) and you STILL may eventually have to move elsewhere. How much does staying at home for all the services you need cost you verses ing to where comprehensive needs can be met?)
-- At what care level WILL or WOULD you be open to leaving your home for other living arrangements?
(Being obstinate ad refusing to leave your home, may not help you get the care or services you need. But as long as you're in your right mind, of course you retain the option to refuse care and services.)

-- You may not be able to count on friends/family. Maybe you WILL, but what if you can't?

-- What if you are incapacitated? What if your wife is? Suppose one of you is, then a year later the other is also?
-- You may have to pay for every BIT of help you get. That adds up.
-- What monetary assets do/will you have and what will you realistically be able to afford?
(24/7 live in care through an agency in the Philly area is $7,750 a month. And that's just the care -- not food/groceries, car/transportation, personal care items

-- Who is handling your finances and making sure the agency gets paid? Who is managing your care plan? Getting you to appointments? MAKING SURE the AIDS give you GOOD care, and are doing their jobs?
-- Are you in that great middle class that will likely have too much money for free or sliding scale services? But can't afford the money-is-no-option, options?

-- Have you arranged the ancillary matters that need attention: estate planning wills, POAs, wills directives?
(If so do others know about these and where they are)

You are doing the right thing in exploring your options. There's a steep learning curve to all these issues and matters.
The getting -- and development of the plan -- is the tedious part of the work....once you have a plan you can tweak it as need be because you've built some 'what-ifs' into the plan.

I found that the learning curve experience with my aunt and mom, helped me learn sooo much about elder care that I'm much more prepared than I otherwise would have been.

And I'm not saying I'm ready to die tomorrow. But I also am already 57 resigned to the fact that one day I MAY NOT be able to do ANYTHING for myself....and at a minimum someone may have to look after my affairs (and care) for me.

[dblackga]

Have been through this with both my parents and my husband's parents.

My husband's parents were very smart. They sold their lovely home when they were in their early 70's and still pretty healthy and moved into a duplex on a CCF (continuing care facility) campus. Yes, it was expensive, but it turned out to be amazing for both of them:

1. They were still young enough to enjoy the activities that were offered -- and there were a LOT of activities. Trivia night, an active fitness center and wellness programs, on-going poker and bridge games, excursions to local sporting events (they live in a college town), and many concerts/programs brought over from the college's music and theater departments.

2. They were young enough to make friends with the people around them, which helped stave off feelings of isolation.

3. They immediately were in a community where ongoing maintenance is no longer an issue. For example, she went to trivia night one evening, and was greeted by one of the staff. She casually mentioned that she needed to call maintenance to see what was up with her dishwasher, and the staff member said, "Oh, I'll send someone right over!" By the time my MIL had finished trivia night, the dishwasher was fixed. :-)

4. When my FIL became ill a year or two after they moved in, he was cared for in the nursing home component and my MIL could walk over to see him whenever she liked and spent a great deal of time, but the burden of 24/7 care was dealt with by professional caregivers and she was also free to do things without worrying about arranging temporary care, etc.

5. My MIL had an amazing support group around her when my FIL died -- the community is more comfortable with end-of-life issues, as that's how most people tend to leave.

6. This particular CCF has single family homes and duplexes on the campus, then you can move to apartments or ALF's as needed, and on to more levels of ALF (light assistance to almost nursing home type care). Transportation is also regularly provided to local medical centers, shopping centers/grocery stores and places of worship.

7. You can still pursue your interests in a CCF -- it's not a jail. If you want to go shooting, go shooting. Etc.

8. Moving into a CCF community earlier rather than later is preferred. So many times, people wait until they are compromised before moving to a CCF facility -- as a result, they tend to experience isolation and loneliness, because they aren't able to make use of the amenities and get out and meet people, even just a neighbor who likes the same walk you enjoy each morning. The isolation and loneliness often leads to depression, which has a huge effect on future health issue.

Now, my mother did it all wrong. :-) She was adamant about staying at home, so we went through a gazillion caregivers from a reputable company for a year or two. Round the clock care was prohibitively expensive, and unfortunately, my mother needed someone there at night because she tended to wake up at 1 or 2 am and think, "Oh, breakfast and medicine time". Her memory issues also became problematic, and after a couple of scares, I finally put my foot down and said, "This isn't working." Plus, her house had some steps that were ill-placed, and posed a constant challenge.

It happens so damn fast, sometimes. At 81, my mother was driving herself everywhere, had weekly lunches with her friends, went shopping, to the theatre, etc., etc. At 83, my mother's memory deteriorated, and she has frequent hospital stays to deal with health issues that have sprung up. Every hospital stay leaves her more and more debilitated, and she is now in a wheelchair. She moved into an ALF this past summer, and then ended up staying in the hospital for two weeks, and rehab for almost 8 weeks. Her macular degeneration finally came home to roost, and her vision is very poor. So here she is, in a place where she doesn't really make an effort to meet anyone, would prefer just to stay in her room and listening to Court TV. I hate it for her, but staying with me or my brother was not an option because our homes are not elder-friendly (too many steps, bathroom facilities are challenging for wheelchair accessibililty, etc.)

Be very, very careful about inviting someone into your home to care for you. Unfortunately, unskilled and uncaring caregivers are not the exception in cases like that -- they often have chaotic lives that have caused them to seek out these kinds of positions so that they have a place to live. Stories abound about unscrupulous caregivers who steal from their employers -- basically, anything that can be pawned for sold.

[yellowsnow]

Most likely by the time you need help, shooting, hot rods, and movies you can hear on Pluto will no longer be on your radar. You will probably be concerned with access to services you need.

[Windwalker2]

Originally Posted by Mr5150

Maybe, maybe not says this retired Social Worker. I worked with seniors in our area and the great majority were fine in their 80s then died before needing to have a live in caregiver or needed assistive living.

With that said it doesn’t hurt to plan. But it’s not a given you’ll live long enough to require care.

Do you mean they died suddenly without the usual period of decline that made care necessary?

[Coloradomom22]

Originally Posted by Mr5150

Maybe, maybe not says this retired Social Worker. I worked with seniors in our area and the great majority were fine in their 80s then died before needing to have a live in caregiver or needed assistive living.

With that said it doesn’t hurt to plan. But it’s not a given you’ll live long enough to require care.

Honestly I think the agonizing, slow-decline deaths you see today are going to become much more prevalent. People used to "live until they died", but now we have so many new medical advances (procedures and medications) that prolong life. So that person who might have been perfectly fine living alone at 81 and died at 82 suddenly will linger in a declining state for years. That person who would have dropped of a heart attack will have a stent put in and be good to go. That other elderly person who would have died in his sleep due to sleep apnea will use a Cpap and live for years. Elder healthcare is now the management of multiple chronic illnesses. The rate of dementia and Alzheimers is also increasing which is a whole other gamechanger. The fact is many more people will need some type of long-term care.

[lenora]

I would have a Plan A and Plan B.

Plan A is continuing to live at home until death. If you're a member of a religious community, there are usually volunteers that assist the elderly. Some (in your area) even have R.N.s that make house visits. In addition, rent is so darn high in your community I would be surprised if you could not entice a young person to assist you with small chores, limited cooking, and/or light cleaning in exchange for reduced or zero rent. If any of your wife's friends are long time locals, ask her to chat with them about the possibilities. For that matter, if you have shooting buddies, talk to them, too. (And if you don't have any good friends nearby, make some.) Also, consider speaking with your primary care physician and his or her staff about your concerns as well. These people KNOW your community and its resources.

Plan B is when all else fails. Check out assisted living/memory care/nursing facilities that operate in your county. Know what's available now so you will have a back up plan that is ready to activate, just in case.

Or, save your energy and take it one day at a time.

[Heidi60]

PBS has run two hour programs Saturday and today about the state of care giving and who delivers the services. One lady said that she placed her mom in a nursing facility when she could no longer take care of her but then had to hire private nurses 24/7 since mom wasn't getting her required medication.

The other thing that surprised me was that a home care worker didn't even have green card and another one lived in a shelter with a child. But, they worked through some sort of group that found them work and is trying to avoid the licensed agencies.

The program also had a spouse saying that the care was exhausting to do full time and that often the caretaker spouse will die first from the stress.

My brother did it right, played golf in the morning, came home, sat down in his favorite chair, and was gone before his nurse wife could do CPR!

[silibran]

I am thinking that if the OP doesn't much care for people, inviting people into his house to live with him sounds like hell.

You can downsize to a smaller house. But moving is awfully expensive. IMO, you should have moved ten or so years ago. That would have made sense. As it is now, you need to live in a smaller, one level home that will work for you for around a decade. A one level condo would be good, but you've mentioned that you dislike people, so--. I don't think a condo is a good choice for you.

Or, you can stay in your larger home, paying the taxes, the utilities, and eventually struggling to keep the place up, and eventually give up and go into an ALF. By that time your home will have deteriorated, maintenance might have been deferred, appliances will have become dated. At least that is what happens all too often when older folks stay too long in their homes.

If you are both in good health at this point, discuss what would be the best place for you to live now? In 5 years? Make your decision based on what your needs will be in a few years.