As we age, we enter a time of transition. The baby boomers are on the cusp of assisted living, and they are researching options along with their families in hopes of achieving the most pleasant outcome for the golden years. It’s rapidly becoming a significant issue in southern California, where this particular generation located in large numbers for jobs and pleasant weather.
While there are quite a few options for seniors, the most common two for those not requiring acute care are nursing homes and home care in the residence.
The process of settling on a path, whether you’re deciding for yourself or for your parents, can be very complex. There are many different considerations to make as you weigh whether to go a with long-term care facility or community caregivers to work in the home.
How The Bills Are Paid
Of course, it’s a tragic irony that it’s cheaper–and better covered–to stay in someone else’s facility instead of your own home, but the fact is that home care is far more expensive. Bear in mind that even a very sick patient doesn’t require nonstop attention throughout the caregiver’s entire shift. As a result, there is considerable downtime that must be paid for just as the active time. In a nursing home, that cost is spread among multiple patients. Advantage: Nursing home.
Accountability of Staff
But the flip side of the staffing coin is the span of care for nursing home staff. In a nursing home, the ball can be dropped. A patient’s care can be handled by any of a variety of people, both within the course of a single day and across any number of days. Despite generally good habits of charting medication and tracking other health data, things get missed. A dose of insulin is omitted. Undergarments don’t get changed. Less mobile patients don’t get moved around to help reduce bedsores. Whatever the misfortune that might befall the patient, it can be difficult to place accountability–or when necessary, blame–for the omission.
In the home, there is usually one person with the patient at a time. His or her relief at the end of the shift will include a discussion about the patient’s day and a review of steps the caretaker has made. When something goes wrong, there’s no question who is responsible. But with only one patient to care for, it’s rare that mistakes are made. And elder abuse or neglect can be easily detected, particularly in homes with video surveillance, other residents, or frequent visitors. Advantage: Home care.
Availability of Outside Resources
Nursing homes are heavily self-sufficient. Certainly they depend on outside suppliers for things like food, personal care products, and utilities, and in that regard they’re no different from home care. But in either case, there will be outside requirements like doctors’ appointments.
In more temperate areas, snow and ice removal can complicate patient movement. Given the climate in San Diego, that isn’t a problem. Other than excessive heat, there aren’t any climatological restrictions on transportation in and out of the home that make it any less desirable than a nursing home. It is rare that snowbound highways prevent arrival of direct-mail prescriptions or other supplies, but should your family live in a more snow-prone area, this could be a major factor. Advantage: Toss-up–depending on your thermometer.
The Wild Card: Surroundings
By the time many patients require around-the-clock care, many are in the throes of dementia. As a result, they are well-served to stay in familiar surroundings. Pulling someone from their residence of 40 or 50 years is traumatic enough, and when they are experiencing confusion and memory loss, the transition can only exacerbate the problem and accelerate their decline. Advantage: Home care.