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I have been reading a lot about the "Aging in Place" movement. The research seems to confirm that his healthier and less traumatic for seniors, if it can be managed. It is also more cost effective especially since assissted living centers are now charging between 2,500 and 5,000/month (and, frankly, I cannot see the value in these facilities). The problem is, I cannot find too much specific information about how this is accomplished.

I would appreciate hearing from anyone who has managed to to this and, if so, could you please share your experiences? how do you organize care? does Medicare or Medicaid support these programs? did you make modifications to the home? how mobile is your parent?
thanks,
Lilli

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Successfully for them, sure, but to the caregiver, it can be very draining. I think you should start gathering information about different programs, to decide what is the best care.

Medicare alone may not cover much. My mother and I decided on Secure Horizons to pick up where Medicare falls short. Basically, Medicare pays Secure Horizons (which, I believe, is Pacificare) to cover the medical costs.

She has quite a bit of coverage, but not out-of-home care, unfortunately. It does cover hospital care and short-term convalescent care. They do provide some basics, like wheelcahairs (that don't fit through the doorways). As far as home modifications, that is solely up to you, unfortunately.

The type of care, your parent needs, can only be determined by what is best for both YOU and them. I stress the word "you" because it can be very draining and you really have to come first and this is a selfless act, if nothing else.

I think that's what it really boils down to. How old is your parent? Are they in the "last stages" or are they somewhat healthy with one or two ailments? The diseases, my mother has, drag on for years and that isn't something to take lightly. You give up your entire life for long-term care. When it's finally "over", you may find yourself alone and aging, yourself. Family, friends and the medical profession forget about the caregiver. You're left there to pick up the pieces.


My mother has multiple sclerosis, congestive heart failure, osteoporosis, arthritis and spondilosis (Good god, I could be missing something). Considering how bad she is, she can move around in a wheelchair, but she has been in and out of the hospital too many times to count. She broke her foot and that required me to literally transfer her everywhere, with my bad back.
I've been doing this seven years (longer if you count certain things from chilhood), following my father's death. I am literally her nurse and parent. To list all of what she needs, could take days, as it would for any long-term caregiver. Bedsores, cleaning up "accidents" and becomming a personal taxi, are to name just a few.

Depending upon the amount of care, your parent requires, I'd even check into a reverse mortgage (if your parent owns or is close to owning their home), to help pay for outside care. What you may not see as a "value" now, you may see it different, after a couple of years. Just keep every possible option open. In my persoonal experience, I am starting to see other options and wished I had went that route.
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I think the idea of allowing elders to stay in their home is the very best for most. Unfortunately the limiting factor is usually finances and personality.

My mom lived independently until 2 years ago. At that time she began falling (advanced Parkinson's) and could no longer stay alone. To hire a care giver 24/7 in her condo would have depleted her finances in a very short time. The alternative was to have her move in with me and my husband. She now has someone with her while I work and we hire addition hours when we want to get out. She is unable to transfer herself at this time, so it is really 24/7 care.

We remodeled the first floor bedroom and bath. Built a ramp off the sundeck. Alot of resouces online, but be careful some of these are lots of money. If you are serious about long term the bathroom should have a roll in shower.

At this pace finances will last a few more years but she will most likely deplete her funds and I will have to quit work or work to pay a caregiver.

Like most on this site, my only sibling bailed early. His expectations were for me to quit my job and save his inheritance.

While I really like this site and appreciate the sharing and support I think you should realize that at least some families do handle caregiving together and it works. Unfortunately those people don't usually go to the internet for support. They don't need to.

It sounds like at least right now your family is working together and looking ahead. 2 factors that mine never had.

For example, if your mom will accept help now you may be able to postpone a crisis. My mom knew she was living over the edge but refused to make her condo more fall proof. The rugs were more important. One fall later she lost all of her independence.

Back to caregivers. I know many will respond with bad experiences, but it is worth a try.

I read some books about hiring your own help, paperwork, taxes etc. I then went to the local hospital, churches, etc and posted an ad. I interviewed and hired a great woman who has been here now 2 years.

As far as I know medicare does not help with any of these expenses. Medicare is for acute, short term help. If some one has no financial resources every state has a form of medical assistance. But this is very limited and not user friendly to say the least.

I have been a practiceing RN for thirty years (wow I feel old). I have arranged home care, hospice and worked with many patients as their families tried to provide the best care for them.
For my mom I saw 2 lawyers and was counseled by a pastor. I know our situation is much much better than what many on have on their plate.

Yet being responsible for a parent is still a major life event. It can happen at any moment and last for decades. God's grace to you and your family as you start this journey.
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I am currently the primary caregiver for my 93yr old mother. Until May of last year when my sister was diagnosed with Lymphoma and needed surgery and chemo, she and I shared this responsibility. Mom lives in my home with my husband and I. She has severe Artial Stenosis, a colostomy bag due to an Ileostomy more than 50 yrs ago, and suffers from the beginning stages of Dementia. Two and a half yrs ago she fell and fractured her right shoulder. Because of severe osteoporosis, the bone was not able to be set or pinned and was left to heal on its own. Within a couple of days of the fall she experienced a stroke, (we are thinking due to the fall/shock of the broken shoulder) and now has muscle atrophy in the right hand, she will need surgery the to release the nails from digging into the palm of her hand. It is easy to see that she is certainly not able to care for herself at all. We get no financial assistance, but we do have a semi-electric bed (which Medicare paid for)to make it easier to move her, but she needs to be lifted, walked, and laid down when she gets in and out of bed. We purchased a lift chair for her living room to make it easier for us. I don't know if everything we do for her is how outside medical personnel would be doing it, but we are doing it to the best of our ability. I am sure that if the decision had been made to place her in a facility rather than keep her home, she would not be here today. The depression alone of being away from us would have done her in.
My husband, although not able to bathe and dress her, helps to lift her, get her in and out of her transport chair when there are appts. and make meals for the three of us if I am busy with her. I couldn't ask for a more supportive person. It is overwhelming, it is tiring, and sometimes so emotional that I ask myself, "why"? But then I look at her sitting in HER living room, visiting with her great grandchildren in the surroundings that are HER personal surroundings and answer, "because it was right".
I am not saying that it is right for everyone, but it was the decision we needed to make. It is a promise I will not go back on and with my husband by my side and the support of this community, I know it is something I will continue to do until she no longer needs me.
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So well put. My parents have been aging in place. My father was able to stay in his house until his death. My mother wants to do the same. I've been with them for 6.5 years and feel 20 years older than I did when I started. I look it, too.
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Not to throw a monkey wrench in anything but I got the bill for my moms in home care services and for 2 weeks the bill is $1,900.00. For the first week it was $963.00. It's still cheaper than a facility but I know with medical what they do is consider her income and pay the balance and give her $30.00 misc. What can a person do with $30.00 I ask.

About those scooters, I'd been trying to get my mom to get one of those for the longest but she kept saying she didn't want one even though everytime she saw someone in one she'd say "I don't want one of those". Tried to do the same thing with a wheelchair so it would be easier than walking a foot a minute when we take her out, but again no she didn't want it. Although when I'd take her to the market she'd ride those little motorized baskets. She'd run into everyone towards the end and then one time she ran into an entire display and complained because someone at the store had the audacity to put a display so far out!!!! Can you believe that I still laugh at that one.

But all in all she seems to be content being at home. In the beginning after her stroke she would say that she wanted to go somewhere if just for a while. Ke't wanting to go to a rehab center. But she can olny be transferred there from the Hospital so that was out. When she wanted to go I went and investigated a few facilities. They were just too sad for me though and I couldn't see putting her there. Now I feel differently. If she was there I'd be able to go see her without seeing those volchers who live in her house. But I would be at the facility all the time and they would have no choice to treat my mom with dignity.

Keep me posted on what you do as I'll keep you posted on my situation.

Again I'm so glad I found this site. It's really been a help for me.
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It depends on how much care your parent needs and their mobility. My Mom is 87, can still drive, and has full cognitive thinking. She pays her own bills, drives, etc. So that I can have a life, we hired a caregiver company to come in 4 hours a day/5 days a week. You can choose however many hours and the cost depends greatly on what part of the country you live in. Medicare covers a lot of the cost and she has a supplemental that then matches what it would cost to stay in assisted living. The company I chose is right at home They are the 3rd largest in the nation. The caregiver they match to your parents' personalities will do light housekeeping, drive your mom to doctor visits, grocery shopping, read to her, provide companionship. They are there on a timely basis as they must call from the customer's phone to let their homebase know they have arrived. If Right at Home doesn't get a call within 7 minutes of when the caregiver is to get there, they will call you and get someone else to your home immediately.

Our cost in the East Texas area is $12-14/hour.

We did modify my mom's home slightly to avoid a step that she trips on consistently. We merely did this by moving furniture from one room to another. Also, we put a banister down the hallway so if she tripped she would have something to grab. In the bathroom, we put grip bars in front of the commode so she could pull herself up. I will be happy to answer more questions if you have them.
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My husband and I made the move from the east coast to the west to take care of my in-laws in their condo. We were the only ones in his family with the ability to do so - and felt that his parents deserved the right to spend the remainder of their years in dignity in their own home. They could not afford assisted living either - it is just so outrageously expensive for most of the elderly to afford.

One thing we have found, which makes things difficult, is that there really is no outside assistance (my husband's brother and sister live back east in other states, but do make trips here once a year) from any organizations...with the exception of one situation - if either of them were to be hospitalized...then there would be home health care afterward for a period of maybe six weeks. It is indeed a shame that that is the case, as there are many of us from the 'sandwich generation' with both parents and children to look after.

My husband and I have managed with great difficulty - we have the rails and the seat in the shower, the wheelchair and walker. His Mom passed away in our second year here, and in the past six months now, his Dad has gone down hill as his heart is giving out. We finally got him to use the walker in the house, but he will not use it when he goes out...and, he states, the wheelchair is out of the question - so my husband patiently walks with him when he goes to the doctor, etc. Other than the doctors, the only other thing his Dad enjoys is going to his favorite casino...and while we do not want to constantly spend our time in casinos, we do this for him. We think it's important to let him enjoy the remainder of the time he has left.

And, while insurance covers some things, it is a shame there do not appear to be any organizations - at least here in Nevada - that offer assistance to family caregivers...it is a sad commentary on the way we treat not only our elderly, but the forgotten family members who care for them at great mental, physical and financial cost.
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I have been supporting my mother's decision to age in place for more than 16 years. She has resisted every attempt to make things easier. She has had two knee replacements but wouldn't do the rehab. Needed hip replacement but wouldn't. Then she fell and broke the "good" hip. She has an ostomy from rectal cancer 25 years ago. She has severe to profound hearing loss which could have been treated and stopped progressing with hearing aides which she refusex to wear. I hurt my back helping her in and out of wheelchairs whenever she left the house.She finally started using a w a lker after breaking her hip. She broke her arm and it didnt set right so she cant put in the hearing aide she finally wants when its just about too late. I retired early in exhaustion and now need back surgery. She just moved into assisted living after a rehab stay after a bowel obstruction caused by ignoring her doctors instructions to stop irrigation of her colostomy. I have been called by lifeline at 2 am more times than i can count to find my mother covered in excrement when her bag burst in the night and she had removed the depends for comfort. She has fired or alienated homecare workers and now shes working on getting herself kicked out of AL for bad behavior. She has been assessed for dementia but instead was pretty much assessed as stubborn and narcissistic. She is developing some paranoia now. She has aged in place and i have been an idiot
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My parents [90's] were doing ok aging in place in their 3-story home UNTIL the time came when they were having issues trying to get up and down the stairs. And UNTIL my Mom refused to let caregivers or house cleaners come in to help her.

So I helped as much as I could but I never moved in, gosh I was a senior citizen myself with my own age decline issues, but my parents still viewed me as some whippersnapper who could still do everything :P I must have aged 20 years in those past 7 years of dealing with my parents who refused to move and live in an elder friendly environment.... why on earth are you still in that house???

As usual it was a medical crises that changed everything. Mom passed and Dad accepted caregivers but having 24/hour caregivers was costing him $20k a month. Dad decided to move to Independent/Assisted Living for $4k a month and brought along his caregivers but shorten their days and hours to $2k a month. Still was cheaper then living at home.
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I'm not sure if it's a success for the seniors to remain in their home if they are suffering and at risk. My parents are still in theirs and so far, it's okay. I've been there for the last couple of years, but they are still able to manage pretty independently, though the costs for home maintenance and repairs are going up. I know that eventually, it won't make sense to stay there. There is a lot of land and requires lots of upkeep. I don't think it will be feasible to stay there, even though things are on one level. Still, if they need easy access to bathroom and kitchen, wide hallways, etc., it's not likely to work for them.
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