First, please consider the following questions as part of a comprehensive checklist:
- Does my loved one have more physical care needs or mental care needs or both?
- Examples of physical care needs: Are they fully mobile (i.e., can they walk or stand by themselves, or do they need support?). Will they need help being transferred from the bed to the wheelchair? Or in getting in and out of the shower or going to the toilet?
- Examples of mental care needs: Are there any signs of memory loss or change in your loved one’s etiquette towards others or “social filters? (e.g.: do they suddenly seem to have issues with people of a different race, color, walk of life that they didn’t previously? Have they been diagnosed with any memory-based conditions like memory loss, dementia, Alzheimer’s?
- How severe (or high acuity!) are the needs when we combine physical and mental needs. For example, consider the following:
- An 80-year-old Mom with uncontrolled diabetes and early-stage memory challenges
- A 65-year-old Dad with Dementia and Parkinson’s who has lived with his wife of 50 years and is anxious when she is not close by
- A 42-year-old husband with cerebral palsy or
- A 56-year-old Uncle with ALS
- An 88-year-old grandma with head injuries who is at constant fall risk and is recovering in a skilled nursing facility.
Each has a very different care needs and hence a very personalized care plan needing specific caregiver skills.
- Do you as a responsible decision maker understand the key differences between care in a facility vs care at home.
A facility means very different things depending on the type of facility, their set of services and your loved one’s needs. For example, an independent living facility has limited health related support, but is still better than a typical apartment complex. An assisted living facility will have better health support than an independent living facility but will still have limited support from a memory care floor or a skilled nursing or rehab facility.
There are pros and cons to consider about facility versus in home care, and some are outlined below. Even the journey across them over multiple timeframes needs to be thought through. And there are “combination” models of care – for example an in-home care specialist like Care Mountain caring for your loved one while they reside in a facility. In these pros and cons, we have not included COVID 19 or Delta variant related considerations that will need a more in depth and nuanced discussion.
Facility based care
In home Care
|| ● Typically less expensive than home care, but not apples to apples comparison on cost vs services
● If you are busy, in a different city, with limited family around your loved one, a facility is possibly the safer option since you may not be able to swing by in case of need after hours
| ● Vastly more personalized care. Can be set up with a specific caregiver to make things easier for your loved ones across all known and anticipated physical, emotional, mental criteria
● Preserves independence – Usually the loved one feels a lot more comfortable ageing and being care for at home – unless the nature of their physical and mental needs warrant otherwise
|| ● Staffing ratios typically 10-20 clients per caregiver, so less personalized on day-to-day care but useful in emergency situation
● Limited in scope, lack personalized care model for your loved one on aspects like food choices, preferred engagement needs, managing fall risk.
| ● Typically, more expensive than a facility.
● Takes more day-to-day involvement from you and family members. Can’t outsource day to day decisions
- How to plan for logistics and cost of care? And how far out can we plan for stability given progression of your loved one’s care?
The logistics related to providing care need to be thought out carefully – e.g. what your budget is, what are the sources of money to pay for care (Medicare, private LTC, out of pocket). Is there available in person caregiving support from members of family? If so, what is their competency and willingness and patience to learn?
Additionally, making care decisions for your loved one is like a combination of a marathon and a relay race both happening together. You need to solve for the decision-making right in front of you, while keeping your calm and stamina knowing fully well that there are more loops in the months and years ahead.
Working with experts like us at Care Mountain that have navigated many different combinations of care needs, facilities, homes, conditions, budgets help you access experience and skills to make the right decisions while personalizing the care plan and settings of care. For example, we have many clients that we have been taking care of everyday for over 7-8 years – in this duration, they have progressed across multiple physical and mental conditions and have successfully navigated being cared for at home, in ALFs, ILAs, hospitals, and permutations and combinations of the above – while preserving their personalized care plan and journey.
Give us a call at Care Mountain and we will be happy to help you in this important decision and journey ahead.