Why Nursing Home?
According to the
Alzheimer's Association, nearly 15 million Americans are taking care for people
with Alzheimer's. At the certain stage of the disease development, these
patients may require around the clock care and monitoring, which is exhausting
to the caregiver, and may be simply impossible to carry on in the personal and
family circumstances. Also, it is quite challenging for you to be there for
your loved one and provide high quality of care if you are physically fatigued
and emotionally burned out all the time. It's also possible you'll spend so
much time caregiving and worrying that you won't be able to enjoy spending time
with the person.
In addition, it
is quite common for caregivers to ignore their own health and wellbeing, which
can have serious negative consequences. In its most recent report, the
Alzheimer's Association states:
Caregivers not only suffer emotionally but also
physically. Because of the toll of caregiving on their own health, Alzheimer's
and dementia caregivers had $7.9 billion in additional health care costs in
2010. More than 60 percent of family caregivers report high levels of stress
because of the prolonged duration of caregiving, and 33 percent report symptoms
of depression.
According to the National
Family Caregivers Association, family caregivers experiencing extreme stress
have been shown to age prematurely. This level of stress can take as much as 10
years off a family caregiver's life. The Alzheimer's Association report states
that caregiving may also have a negative impact on the employment, income and
financial security of caregivers.
Many families who have loved ones with Alzheimer's disease or other dementias are extremely reluctant to place them in a long-term care facility. The vast majority of the caregivers don't want to do it, and many refuse to even think about it. Some feel it's the most cruel, shameful thing they could possibly do to their loved one, even if they have access to a high-quality facility nearby.
Standing back and
looking at the situation more objectively, however, it becomes clear that in certain
cases, nursing home placement is the most loving course of action for the
patient because caring for the person at home may actually deprive them of
the amount, quality and level of care and safety they need.
Nursing home
placement should be of special consideration for patients in the late stages of
the disease. These patients desperately need so much more care than a single
person or family unit -- even with some paid help coming in -- can provide.
Types of Care Nursing
Homes Provide
There are two types of care provided in nursing homes:
- Skilled Care (also known as "sub-acute" or "Medicare occupancy")
- Long-Term Care (also known as "Intermediate Care")
Skilled Care entails services that can be rendered
only by a doctor, licensed nurse, physical therapist, occupational therapist,
speech and language therapist, social worker or respiratory therapist. It
usually follows a hospital visit involving a short-term stay, during which the
patient receives nursing care and/or therapy until he or she is stable enough
to return home. Due to the skilled nature of the care, it is covered by
Medicare and secondary insurance for up to 100 days. Beyond that length of
time, it must be paid for privately.
Long-Term Care is appropriate for the individual who
can no longer take care of him or herself and will continue to require a high
level of care for the remainder of his or her lifetime. Such care may include
help with any "activity of daily living," such as bathing, dressing,
transferring (moving from one place to another), toileting, eating and walking.
Medicare does not cover this type of care. However, when the individual's
financial resources are exhausted, the state-funded source (Medicaid) will
supplement the cost. If the nursing home does not accept state funding, you
must find another long-term care facility that will. Unfortunately, most
nursing homes have waiting lists for people entering the facility under state
funding. Planning ahead with an appropriate strategy may help the patient and
family avoid these conflicts.
Services Nursing
Homes Offer
The services
nursing homes offer vary from facility to facility. Services often include:
- Room and board.
- Monitoring of medication.
- Personal care like dressing, bathing,
and toileting assistance.
- 24-hour emergency care.
- Social and recreational activities.
Key Points in Making your Decision
The decision to put a relative with Alzheimer's disease in a
nursing home is often a difficult one. Caring for someone with Alzheimer's
disease at home requires significant social, financial, and personal
sacrifices. Every family has different needs, preferences, and constraints to
think about.
Consider the following when making your decision:
·
People with Alzheimer's disease need a safe,
healthy, structured environment. Some families are able to provide this at
home; in other cases, nursing home placement is a better choice.
·
People with Alzheimer's disease usually need an
increasing level of care and assistance as time goes by. Many of those cared
for at home eventually have to be moved to a long-term care facility.
·
Adult daycare programs and part-time help,
whether hired or offered by other family members and friends, are options for
some caregivers.
·
Your physical and emotional health is as
important as that of the person you're caring for.
·
Deciding to put your relative in a nursing home
is not a sign of failure in your role as caregiver.
Reasons to consider
putting your relative in a nursing home:
·
Relative's behavior has become dangerous or
disruptive to you and your household.
·
Your own health is at risk.
·
Burden of caregiving is too great and you have
no one to help you.
·
Nursing home may offer a safer, more controlled
situation for your relative.
·
Relative has other medical problems that require
skilled nursing care
Reasons to consider
keeping your relative at home:
·
Risk of rapid decline in nursing home.
·
Less individual attention for your relative in
nursing home.
·
Risk that your relative may receive poor care in
the nursing home.
·
You will feel too much guilt or anxiety about
relative in nursing home.
·
Nursing home costs much more than caring for
your relative at home.
·
Facility may have a waiting list if you have not
planned ahead.
Sources and Additional
Information:
