Long-Term Care In The Home
What type of help is available when the individual with health challenges lives at home, either in his or her own home, or in the home of another family member? There are several types of services that may be of assistance.
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Adult day care centers provide a safe and enjoyable environment for the individual to spend all or part of the day, on a regular schedule or only occasionally; the individual receives appropriate care and socializes with other individuals in attendance and the caregiver has time to go to work, to visit the doctor, to shop or to relax.
Non-medical home care services are sometimes called companion, sitter orhomemaker services.These services place a caregiver in the individual’s home to provide non-medical assistance, which can include meal preparation, assistance with dressing, light housekeeping, medication reminders, transportation to shopping or medical appointments, companionship and supervision.
Medical home care provides a higher level of care, which can include medication administration, hands-on assistance with bathing or using the toilet, wound care, companionship and supervision, transportation to medical appointments and other nursing services. Some agencies offer both non-medical and medical home care, which allows an individual to receive whatever level of care is required at a given time, coordinated and billed by one office.
Respite care is care intended to relieve the family caregiver of his or her caregiving responsibilities, perhaps only for a few hours, or, if desired, for a few days. Adult day care can be used to obtain brief periods of respite. In-home non-medical or medical care can be arranged to provide blocks of care, again ranging from a few hours to a few days. Temporary stays with local assisted living or skilled nursing facilities are also sometimes available when a family caregiver needs time off (for work, vacation, family events or personal health needs).
Hospice and palliative care services can be brought into the home, or may be provided in residential care facilities. Hospice and palliative care services provide assistance when an individual has been determined to be terminally ill (often defined as being more likely than not to die within the next six months) or when the individual’s goal is to manage the pain and symptoms of the illness, as opposed to an aggressive attack on the illness (an example would be a cancer patient who might refuse further chemotherapy, but who needs assistance to manage pain so that he or she is comfortable).
All these services can be used by an individual living in his or her own home and may increase the individual’s independence by making him or her less dependent on family and friends. These services may make it possible for the ill individual to remain at home for a longer period of time safely and for the terminally ill individual to perhaps remain at home for the remainder of his or her life.
In addition to persons with obvious physical care needs, individuals with Alzheimer’s disease or other dementias are also excellent candidates for the use of in-home services, particularly the companionship and supervision provided by non-medical home services in the early stages of a dementia or the supervision and support offered by adult day care.
Families often wait too long to begin using in-home services or adult day care. The early use of in-home services can keep aging or ill individuals healthier longer, and at home longer, by providing improved nutrition, by keeping an individual safe, by providing companionship that keeps the body, mind and spirit active and by noting health changes that need immediate attention. Using in-home services also lessens the demands on family caregivers and gives them more time for spouses, children, careers and rest.
Using in-home services can also be cost-effective. By using a part-time schedule of in-home care, it may be possible for an older or ill adult to remain at home permanently, or at least for a longer period of time than if he or she were struggling alone, thus alleviating or delaying the more expensive costs of residential care.
