Once an aging family member loses mobility and the independence to come and go as needed and desired, it can be very challenging for families to decide what living environment options and caregiver assistance needs to be provided. Because the loss of mobility will likely increase over time, the family has to be vigilant and flexible about tweaks and changes which need to be made to both living and caregiver options. It is a delicate balance which continually requires calibration of circumstances.
I experienced this progression with my grandmother. Once she lost mobility, she progressed through several living arrangements as her needs increased. When she was self-sufficient (could cook, clean, bath, etc.) and only needed transportation for errands, food, and medical appointments, we chose a single apartment in an age restricted community and several family members shared the responsibility of making sure her transportation needs were met.
As her eyesight deteriorated, we noticed that it was becoming unsafe for her to live on her own. Cooking and preparing meals became difficult, so we immediately arranged “meals on wheels” to deliver all of her daily meals. We then noticed her having difficulty cleaning as we were finding broken pieces of things that had dropped and she could not see or reach to clean up.
Unfortunately, she tripped and broke her elbow and it became apparent that she needed to move to an assisted living facility where she still had her own independent apartment space, but all of her meals and needs were met on site. Our family still shared the transportation responsibilities, which were less difficult as more of her needs were met at the facility. She eventually progressed to needing assistance with most needs and was able to continue to live in the same space with a stepped up care role from the staff. This arrangement worked well for our family and gave her peace and happiness as her needs changed not to be uprooted multiple times to have her needs met.
In the example above, we were fortunate to begin this journey with her aging at home in a senior living apartment community. Other aging at home options might include, sharing housing with a roommate, moving in to a very small space so there is less square footage to negotiate, or moving in with a child. Any of these options can be paired with different options for care-giving as aging progresses.
There are several in-home helper options including, hiring a service (or individual) to assist with needs on different schedules depending on the level of need. The service may begin on a so many times a week basis to provide cleaning, running errands, cooking, and companionship. This service may progress to daily help to provide needs such as bathing and assisting with medication compliance.
Many families will choose to combine personal assistance to their family member for some duties and hire in home helpers to address needs they are not able to accommodate. This helps reduce the burden of cost for the service and stress to the family member(s) to handle all needs personally.
What is so important to realize is that no two families are identical. Every family’s circumstances are unique and having conversations which explore all available options and decisions about what will work best for the elderly family member and the supporting family members financially, logistically and emotionally is the key to preserving quality of life for all.