Help
is available – half the battle is pulling it all together.
By Lisa Esposito Staff Writer March 30, 2016,
at 11:02 a.m.
YOUR PARENT PRIZES
HIS or her independence
and insists on living at home, alone. However, you see signs of vulnerability
and a precarious situation with the potential for falls
and injury, poor nutrition and your parent becoming neglected or housebound.
You want to help, but you live at a distance and don't know where to start.
Concerned children can build a network of services to keep
aging parents safe
First, Meet Basic Needs
Eating healthy
meals, taking the right medicine, being safe, talking to other people and
getting out of the house for fresh air. When you realize parents are missing
out on these basics, it's time to tap into local resources.
At Meals and Wheels of Takoma Park, in
Maryland, a hot meal of macaroni and cheese, baked beans and spinach is on the
current menu. "Comfort food," says cook Cathryn Pethick, on a recent
rainy February morning, as she and the kitchen crew filled trays.
Many clients are the "old old" in
their 80s and 90s, says Jill Feasley, director of the Takoma Park program. The
low-fat, low-salt meals contain two-thirds of needed daily nutrients, she says.
While there's no minimum-income requirement, those who can afford it are asked
to contribute $7 a day or $140 a month toward costs. You can a find a local provider at
the Meals on Wheels America website.
Driver Kay Behall covers a regular Wednesday
route of suburban Maryland houses with wheelchair ramps leading to the
front porch or "No Smoking: Oxygen in Use" signs on the door. Her
clients include Kathy Yowell, 83, who has lived in her bungalow more than
50 years. She loves to chat and Behall is happy to listen. "I
thrive on service organizations," Yowell says, explaining how she manages
day to day. At another stop, Moses and Virginia Rich both receive meals: He has
Alzheimer's disease, and she's the caregiver. The service is
"lifesaving," Virginia says, since she wouldn't otherwise be able to
provide balanced meals.
Lay the Groundwork
To find a host of area services, the
nearest Agency
on Aging is a good place to start, says Sandy Markwood, CEO of the
National Association of Area Agencies on Aging. You can use the Eldercare Locator to
sort out aging programs, services and resources.
If at all possible, start the caregiving ball
rolling with an in-person visit to your parent's hometown. That gives you
a chance to accompany your parent to see his or her primary care provider. You
can learn about your parent's health status, ask questions and streamline and
update medications. If your parent has been on the same prescription drugs for
years, or can't say why he or she is taking a medication, ask whether the drug
is still needed. Your parent's pharmacist also can evaluate
his or her current medications.
Meet and talk to neighbors – they represent
valuable eyes and ears looking out for your parent's well-being. Make sure you
have their phone numbers and they have yours. To find help with
strenuous chores like mowing the lawn or shoveling a snowy sidewalk,
Markwood suggests joining a neighborhood listserv.
Consider Home Care
Companionship services, light housekeeping,
meal preparation and help with transfers, hygiene, bathing, dressing and
medication-adherence are some of the home care services available to seniors,
says Phil Bongiorno, executive director of Home Care Association of America.
When hiring home
health care, especially from a distance, he suggests family members
consider the following: Are they going through a referral agency that just
places members or a company that has dedicated employees? Will there be a care
plan? Is backup care available? Is the company available 24/7
if you need to contact them? Are caregivers licensed and certified according to
state requirements? Do they undergo background checks? The issue, Bongiorno
says, is accountability.
You'll probably have to pay for services out
of pocket. Medicare provides limited coverage of
home health care that's necessary for the treatment of illness or injury, such
as skilled nursing services by a registered nurse. However, services such as
24-hour-a-day home care, meals delivered to the home, shopping, cleaning and
laundry or personal care like bathing or dressing are generally not covered.
According to an April 2015 study on regional
private duty billing rates from a survey done by Home Care Pulse, hourly rates
ranged from $21 to $28 for one-to-two hour visits in 2013, the latest year for
which data are available. With longer visits, hourly rates drop incrementally.
For instance, with care episodes lasting 12 to 24 hours, hourly rates ranged
from $17.25 to $21. For live-in care, daily rates ranged from $240 to $315.
If you want to keep your older mother or
father in their own home, and their situation is complex, for instance involving
dementia, it's "critical" to arrange care in person, says Stephen
Golant, author of "Aging in the Right Place" and a University of
Florida gerontologist.
"You have to make that one-week trip to
interview, very carefully, that caregiver," Golant says. "You can't
rely, in my opinion, on the home-care agency approach, where you're getting
someone three or four hours a day. Someone who has early-stage Alzheimer's more
likely needs somebody for 24/7 care."
Coordinate the Network
Putting together a network of home and health care
providers and other local services – all while keeping lines of
communication open – can be complicated, especially from a distance. Care
management is one solution, says Jennifer Leeflang, senior vice president for
Partners in Care, a subsidiary of the Visiting Nurse Service of New York.
"We send out a registered nurse who
completes a comprehensive assessment," Leeflang says, including evaluating
a patient's medical, psychosocial and environmental status. The provider
completes a report and makes recommendations based on individual needs –
anything from adding grab bars in the bathroom to having a certified home
health aide accompany seniors to adult day care, so they can socialize more.
Services most people might not be aware of
include assistance writing checks and paying bills, walking and navigating the
city together or even accompanying people to theaters and restaurants.
"When the nurse and the aide goes to visit, we explain, 'This is not about
you losing your independence,'" Leeflang says. "'It's about you
helping you maintain your independence and keeping you safe at home.'"
Online care coordination sites like Lotsa Helping Hands help
families track how someone is doing and improve how members communicate.
"Basically, you build a community," says Jody Gastfriend, a licensed
clinical social worker and vice president of senior care at Care.com.
"The community can be family; it can be friends; it can be professional
paid caregivers." It's a way of being more organized and not duplicating
tasks or stepping on one another's toes.
Access Tech and Transit Assistance
Personal emergency response systems – which
can detect falls, connect to emergency call centers and allow communication
with family members – are geared toward people living at home who want to age
in place, Gastfriend says
The simple cellphone is the best, most-used
technology for connecting families, says Andy Cohen, CEO of Caring.com, a resource
for family caregivers. From what his group hears from family members, most
seniors don't like to Skype that much. "They think it's because it's not
intuitive and it's difficult," he says. He believes seniors will be more
comfortable with newer-model TVs that offer Skype interface.
Gerontologist Amoke
Alakoye, herself a family caregiver, describes how going online helped her
aunt. "She fell in love with the laptop about six years ago," Alakoye
says. "Because her world had closed so much socially without her being
able to get around without her wheelchair. Now she's on the Internet and she
emails us all kinds of things and she's talking to so many of her friends."
You can find computer and technology classes for seniors through the AARP website.
Putting down car keys doesn't mean seniors
can't get around anymore. But for people who've been driving their entire adult
lives, switching to public transportation can be daunting. Many locales have
"mobility ambassadors" who work one-on-one with seniors to introduce
and help them understand community bus, rail and shuttle systems.
Editor's Note: This story was written with
support from the Journalists in Aging Fellowships, a program of New America
Media and the Gerontological Society of America, sponsored by the Silver
Century Foundation.
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