My Loved One Needs More Help Than I Can Give — What Now?
Submitted by Dr. Kevin Lukenda, Medical Director at Alaris Health at Riverton in Rahway, N.J.
In my family practice, I often counsel family caregivers to look for tell-tale signs to figure out when an elderly parent requires more assistance than is available at home. There are unpaid bills lying around. You discover your dad is going out less and less. When he fell recently, your mom couldn’t pick him up and had to call the paramedics. There was an accidental overdose of one of medication. All indicate that a delicate decision must be made.
Sometimes the demands of care quickly and alarmingly become too great. In other cases, it might not be so obvious. At first, we can provide what is needed to keep loved ones safe with home health visitation, but there may come a time when it is in their best interest to consider other options, such as nursing home care. The bottom line is, we need to know that our loved ones are safe, comfortable and happy.
Today, people are living longer, and although we may not want to admit it, we all are likely to require additional care from people other than our family later in life. May 10 – May 16 is National Nursing Home Week, the perfect time to learn more about the benefits of nursing home care and evaluate if it is right for you or a loved one. While in-home care often makes sense for some adults and seniors, here are four signs that might indicate that transitioning to a nursing home may be the more appropriate choice.
1. Your Loved One Struggles with Daily Activities
Despite a sense of pride and a need to feel independent, we may notice that over time our loved ones need more help than usual with daily living activities, such as bathing, dressing, grooming, eating, taking medication, walking, etc. If your loved one has mobility issues, is bathing less frequently, or has trouble cleaning or doing laundry, it is important to think about the future. Anticipate your loved one’s needs and begin thinking about nursing home care before the situation rises to crisis levels.
2. You’re Increasingly Concerned About Your Loved One’s Safety
Safety concerns could range from a neglected pot on the stove to a fall or stroke. One of the biggest risk factors for stroke is age, so be on the lookout for its symptoms. If you notice that your loved one has weakness or numbness in his/her face or limbs, or has sudden vision loss, he/she might have had a stroke. A sudden loss of speech, sudden, severe headaches, or sudden unsteadiness can also signal stroke or could be the result of a severe fall. If you notice any of these conditions, get medical attention immediately and initiate a conversation about full-time nursing home care with your loved one’s physicians.
3. Your Loved One Starts to Appear Withdrawn or Depressed
Whether caused by physical disabilities or the loss of a spouse and dear friends, a descent into isolation should raise flags. People who have previously enjoyed a robust social life may miss the experience of having visitors and friends to connect with every day. For them, a nursing home can provide more contact with others than a sole caregiver in the home is able to give. If that is the case for your loved one, consider a nursing home that offers a broad and full calendar of therapeutic activities, such as card games, communal dining, live performances and devotional services, which can help him/her enjoy life and the company of their peers.
4. You’re Experiencing Caregiver Burn-Out
Sleep deprivation, anger, resentment and guilt can all become part of what happens to a family caregiver. Caregivers may wonder if they could or should have done more; they may feel separation anxiety in moving their loved one to another location. If you are the sole caregiver for a loved one and you start to have conflicting emotions of “I’m not doing enough” while at the same time feeling that you’re living for your loved one rather than yourself, it is time to take a step back. Juggling the demands of an aging loved one along with the responsibilities of raising your own family isn’t easy. You want your loved one to get the best care possible, and if you’re exhausted it can be difficult to provide that care.
Most families wait too long to make the decision to move their loved one to a nursing home, possibly for reasons of guilt. If any of these reasons resonate with you and your family’s situation, don’t wait. Learn about the options available and come up with a plan you are comfortable with, prior to it being urgently needed.
It’s never easy to discuss other living arrangements with your loved ones, but the sooner you’re able to recognize the signs and discuss alternatives, the safer and happier everyone will be in the long run. If you know your loved one is in the early stages of physical illness, cognitive decline or emotional distress, it’s important to have someone help them collect the right paperwork and make critical decisions, whether it’s a friend, family member or physician. Planning ahead, getting informed, and involving the appropriate persons in the decision will ultimately help ease the process when it’s time to move your loved one into care.
The best way to be there for your loved one is to know that they are in the proper setting and getting the care that they need. From understanding a health center’s capabilities to learning how to pay for services, do some research and talk to your physician or staff at a local facility such as one of the Alaris Member Health Centers in New Jersey to help you navigate through each step of the process. Visit several nursing homes before choosing one, and make sure they have activities and medical support appropriate to your loved one’s needs. Many nursing homes also offer support groups and other resources for families. These resources can help you come to terms with the idea that sometimes the best decision for the health and happiness of both parties is putting your loved one into someone else’s care.
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Kevin E. Lukenda, D.O., is Medical Director at Alaris Health at Riverton in Rahway, N.J., and has specialized in Family Medicine for more than 25 years. Dr. Lukenda graduated from the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine in 1989. He grew up less than a mile from his Linden, N.J., practice and takes pride in the fact that he has been able to build life-long relationships with his patients and their whole families.
