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Elder Care - Choices and Options

Make the right choice in elderly care for your loved one.

Make the right choice in elderly care for your loved one.

Senior Care

Senior care and elder care are growing problems in the United States today. In general, people are living longer, and when they get to the point that they can no longer live alone, they often have to leave their homes or turn to family members or adult care agencies. I know from experience this can be a heartbreaking experience. The families are faced with some tough decisions. To see your mother or father leave a home they’ve known and loved for years is truly painful. Of course, it’s tragic for the senior citizen, but it’s also sad for the entire family. In many cases, the senior’s home has served as a “gathering place” for family functions and celebrations over the years, so it’s like the concept of “going home” is gone forever. Fortunately, today there are several choices in adult care and elder care. Each type of senior living has its advantages and disadvantages. With my grandmother and both my parents, I’ve had experience with in home care, assisted living facilities, and nursing homes. I hope this information helps you make a prudent choice for elder care.

Senior Home Care might require a few safety features.

Senior Home Care might require a few safety features.

In Home Care

If your senior citizen doesn’t require specialized medical care, he might be able to stay in his own home by taking advantage of in home care. Elderly home care might be the best option for everyone involved. It’s usually much less expensive than assisted living facilities and nursing homes, and the senior gets to stay in familiar, comfortable surroundings. If you have enough family members and friends who are able and willing to share the responsibilities, that’s wonderful. If not, you can hire outside help for senior home care.

There are many agencies that provide in home care. If the elderly care agency is reputable, they do a thorough background check on the adult care givers they employ. You make an agreement with the agency for them to send someone to your senior’s home. Depending on the specific elder care agency, the caregivers might do laundry, cleaning, and cooking. If the caregiver doesn’t work out for some reason, most agencies will allow you to try a different one. Don’t be shy about this. Some personalities just mesh better than others do, and seniors can be pretty selective about who takes care of their personal needs. It’s best to take on any caregiver on a trial basis.

Hopefully, the agency or caregiver will meet with members of the family to discuss elderly care options and show you ways to make the home environment more senior-friendly and safe. These might include installing grab bars, de-cluttering, and/or removing tripping hazards like throw rugs and long electrical cords. This is also the perfect time for you to discuss exactly what you expect of the caregiver.

We used in home care with my dad, and we went through three caregivers before we found one who was acceptable to my father. Yes, it was frustrating and even a little embarrassing, but we “bit the bullet” and honored Dad’s wishes. We were glad we did, as the third caregiver worked out wonderfully.

Another option to in home care is to hire a private sitter. Some of these adult caregivers are unskilled, while others might be LPNs or even registered nurses. Of course, the more skilled the adult caregivers are, the more they charge. If your senior citizen just needs someone to help with bathing or running errands, you don’t need to pay the extra cost of a skilled adult care giver.

Before you hire any type of in-home adult care, you need to assess the needs of your senior realistically. What can he do for himself? What can family members help with? Do you want 24-7 adult care? Or would just a few hours a day of elder care suffice?

Most assisted living facilities encourage family visits.

Most assisted living facilities encourage family visits.

Assisted Living Facilities

Another choice in adult care is assisted living facilities. Some of these are very nice. My mom was in one for two years, and it was beautiful. It looked like a large plantation home, and it was situated on a small lake. The grounds were landscaped, and there were outdoor sitting areas. The inside was furnished with antiques and quality reproductions. Senior citizens had the choice of a room or suite. The rooms had a bedroom, a bathroom, and a small kitchen. The suites had a bedroom, a bathroom, a living room, and a kitchen. Many assisted living facilities offer these same options.

With most assisted living facilities, residents are allowed to use their own furniture. This makes their new room feel homey and provides a sense of familiarity. Most senior citizens are happier when they can keep their most precious belongings. And a big part of adult care should be about the happiness of the recipient.

The better assisted living facilities provide regular entertainment and activities for their residents. These might include games, live music, special speakers, and arts and crafts. Some assisted living facilities even take the residents on day trips. Activities are important in keeping senior citizens involved and stimulated. In some assisted living facilities, guests can have their own automobiles and keep a pet.

Most assisted senior facilities have a common dining room. Meals and snacks are served there. If a patron is ill or doesn’t feel well, he can have his meal in his room. Some facilities also provide a private dining room where patrons can entertain guests. Mom’s had one, and it was a nice place for family members and friends to share a meal with her when visiting. Visitors are usually charged a small fee for a meal.

The disadvantage of assisted living is mainly cost. They are expensive, and they’re not covered by most insurance policies. Assisted living facilities are not covered by Medicaid, either. Prices for senior facilities in my area average about $3,000 per month, depending on how much assistance your senior needs.

Another disadvantage with senior assisted living is that they do not provide nursing care. They’ll help with bathing, dressing, feeding, medication monitoring, and some other aspects of senior living, but they’re not nursing homes. If your senior needs more adult care than that, assisted living is probably not an option.

My mom had Alzheimer’s, and once she began trying to escape her assisted living quarters, she had to be moved. They could not take the responsibility for her safety any longer. We had to find another place for eldercare. We found a wonderful assisting living home that included an Alzheimer’s wing. The unit was locked down, so Mom could no longer escape. She didn’t require medical adult care, so this was a good option for us. This assisted living home was just down the street from me, so it was easy for me to make regular visits.

Some nursing homes are much better than others.

Some nursing homes are much better than others.

Nursing Homes

Another choice for adult care and elder care is nursing homes. Typical nursing homes are bare-bones adult care, as far as any luxuries are concerned. Nursing homes do, however, provide medical care. If your senior citizen needs more care than assisted living facilities provide, nursing homes might be your only choice.

Nursing homes often get a bad rap, but some are well run and well staffed. My grandmother was in one that was run by the Presbyterian Church, and we were always impressed with the care she received. On the other hand, my nurse-daughter has worked in a couple of nursing homes that were terrible. Patients were often neglected, and some were over-medicated. Nursing home abuse and neglect are very real, so you need to monitor the situation carefully and regularly.

If you feel that your senior needs medical adult care, visit several nursing homes before making a decision. Nursing homes near your residence would be convenient for you, but is it the best choice for your senior citizen? Don’t let location be your only criterion for choosing nursing homes. When visiting prospective facilities, observe the patients. Do they appear well kempt? Are they kept active? Are entertainment programs provided? Is the facility clean and well run? Is there an adequate number of staff members? Schedule a meeting with the nursing home director, and don’t be bashful about asking questions. You might want to meet with the activities director, too, to get a better idea of provided activities. It’s not a bad idea to have a meal at the facility, either. Food and nutrition are usually very important for senior citizens. Some seniors don’t have much appetite, and getting them to eat properly can be a problem. If the meals provided aren’t very palatable, the problem will be compounded. If there are certain foods your senior won’t eat, is the nursing home willing to make substitutions?

The disadvantages of nursing homes have been covered. Advantages of nursing homes include round-the-clock medical care. Another advantage of nursing homes is that they’re covered by Medicaid. If your senior citizen has a special extended care insurance policy, nursing home expenses might also be covered by that.

Put a lot of thought into your decision!

Put a lot of thought into your decision!

Choose Elder Care Carefully!

Elder care is something we might all have to face sooner or later. Before making a choice with any type of senior care, weigh your options carefully. Where would your loved one be happiest and best cared for? It’s prudent to investigate any adult care givers, assisted living facilities, or nursing homes first. Don’t make a rushed decision – unless an emergency requires it. Even then, however, you can always move your loved one to another facility once you’ve had a chance to do some research. I’d also like to add this: wherever you place your senior citizen, stay on top of the situation. Even if you’re sure he or she is receiving excellent care, it’s not the same as being with family members and close friends. Even the best adult caregivers are strangers to your loved one, so be sure to make regular visits, and encourage other family members to do the same. Make sure you do the right thing. Remember that you’ll actually have to live with your elder care choice for a long time.

More about elder care and senior citizens:

  • Get Help from the Alzheimer's Foundation
    I've seen Alzheimer's disease. I know it well, though I certainly do not consider it a friend. I watched as it took my grandmother. Its voracious appetite was not sated, however, and years later, it came back...
  • Nursing Home Neglect and Abuse
    Nursing home abuse and nursing home neglect are all too common in today's society. The average life span has increased, and today there'a huge population of senior citizens. Many of these seniors cannot live...
  • Important Vitamins and Supplements for Seniors
    Its amazing the power some vitamins and minerals have. Funny, these things have been around forever, but thanks to the multitude of scientific studies, scientists and doctors are just beginning to unlock...
  • How to Prevent, Treat, or Delay Alzheimer's Disease
    Alzheimers disease. Just the mention of the word is scary. And the condition is devastating. It robs victims of their mental functions and can even erase precious memories. It can totally change the...
  • Alzheimer's: Tips for Coping
    I know all too well the heartbreak known as Alzheimer's disease. My gandmother had it, but at the time, I was too young to fully understand the condition. But when my mom developed the disease, I got to know...
  • How to Recognize the Symptoms of Alzheimer's
    Alzheimers is a terrible disease. In fact, Im convinced that its just about the worst fate that can befall a human being. Not only is Alzheimers tragic for the person who suffers from it ...


Holle Abee (author) from Georgia on February 12, 2013:

chamilj, that's often the best option for everyone involved, but it's not always possible. When the senior requires extensive medical care or 24/7 monitoring, in home care might not be an option. Thanks for reading!

chamilj from Sri Lanka on April 09, 2011:

In my country (Sri Lanka) most Adults prefer stay with their family. Not in Adult care homes. Great hub with useful information.

Holle Abee (author) from Georgia on November 11, 2010:

I agree - both of the ones Mom was in were like resorts for old folks!

SJ on November 02, 2010:

Nice. I love assisted living facilities, best of the bunch to me.

Holle Abee (author) from Georgia on October 26, 2010:

My prayers are with you, Schooolmarm!

schoolmarm from Florida on October 20, 2010:

Very useful information for me at this time. I am facing some difficult decisions for a family member and appreciate this hub. Thank you.

Holle Abee (author) from Georgia on October 04, 2010:

Nancy, I hope she gets to go home soon!

Holle Abee (author) from Georgia on October 04, 2010:

Wow, caregiver - thanks a bunch!

nancy_30 from Georgia on October 02, 2010:

Great hub. My sister works for an eldercare agency. Like you said she cleans their house and runs errands for them. Just recently my Grandmother got put in a nursing home. My aunt couldn't get her to eat or get out of bed and she became dehydrated. They decided to put her in the nursing home. My mother and I weren't happy about it. They said they would bring her home if she would start eating and do her physical therapy. So far my Grandmother doesn't like it. She misses home. I hope she gets better soon so she can go back home.

Caregiver on August 30, 2010:

Thanks a lot for another great article. I am always searching for fantastic caregiver tips to suggest to my own readers. Thank you for creating this article. It's just what I was trying to find. Truly fantastic post.

Holle Abee (author) from Georgia on August 27, 2010:

Very good points!

Yes, Alzheimer's is hard on everyone involved.

Thanks for reading!

oldbooklover on August 27, 2010:

Thanks Habee,

As you say, it is very important to consider all the needs of the older person. It can be hard to find the right balance.

Everyone wants to keep their independence as long as possible. So no-one should go to a facility that restricts their current abilities. This suggests moving on to a different 'home' that offers more services as the old person's abilities decline. Yet people function much better in a familiar environment when their sight and memory fail. So it can be much better for them to stay in their own home with family and professional caregivers coming in. If plenty of friends and family are nearby; you can get a Doctor to make house calls; and there are services for sending in Occupational Therapists to help you choose equipment like a wheelchair, I'd vote for in-home care to the end.

I'd like to recommend "A Bitter Pill" by Dr. John Sloan. It tells more of why we should allow a fragile old person a dignified life in their own home. www.sunshiners.ca

Alzheimer's is a terrible disease, I have lost three dear ones to it. It is so hard on the families too.

elf_cash on August 24, 2010:

Good info on adult care!

Holle Abee (author) from Georgia on August 24, 2010:

Ethel, you're right - it is a scary thought.

Holle Abee (author) from Georgia on August 24, 2010:

HH, my mom was really awesome! Before the symptoms of Alzheimer's, she did a lot of volunteer work to help others.

Holle Abee (author) from Georgia on August 24, 2010:

Buckie, I think Bob might need to look at nursing homes just to protect you from yourself! lol

Holle Abee (author) from Georgia on August 24, 2010:

G, eldercare is expensive everywhere in the US. Gosh, girl, you had your hands full! Glad it worked out.

Holle Abee (author) from Georgia on August 24, 2010:

Thanks, Wendy!

Holle Abee (author) from Georgia on August 24, 2010:

Loves to read, kudos for sharing your talent with Alzheimer's patients!

Holle Abee (author) from Georgia on August 24, 2010:

Sligo, I fear we're in that boat together, my friend. I really try to keep my mind active.

Holle Abee (author) from Georgia on August 24, 2010:

Thanks, Suzie. Good to see ya!

Holle Abee (author) from Georgia on August 24, 2010:

Ouch, Melinda! Nursing homes are more expensive here than are assisted living, but Medicaid covers the nursing homes. Thanks for reading!

Ethel Smith from Kingston-Upon-Hull on August 22, 2010:

Unless we are to die young it will come to us all. Scary uh.

Hello, hello, from London, UK on August 21, 2010:

It is such a sad and devasting illness. I sure you are helping a lot of people in raising the point and giving good advice. Your mum looked so lovely and lovingly - just like you.

Audrey Kirchner from Washington on August 19, 2010:

Is it too early for Bob to start shopping for care for me? It should be the other way around come to think about it - he's the one that lost Griffin!

Good points - and a really big problem in our country.

GPAGE from California on August 19, 2010:

habee...this is a very good and informative hub. Elderly care is very expensive in California and I have also heard some horrific stories about below standards care at particular facilities......it is very difficult when a family is faced with this issue and they can not afford it. I had to deal with both of my grandmother and father at the same time. It was very difficult. Thankfully it all worked out. Best, G

Wendy Henderson from Cape Coral on August 19, 2010:

Great information. Thanks.

Loves To Read on August 19, 2010:

Alzheimers is becoming an epidemic here in Oz Habee. My mother and i do volunteer singing in our local elderly homes here and about 95% of the residents are there for that reason. It is of course a very real problem but i personally believe that it is being caused by our diets and environment. Additives, preservatives, colourings, medications, chemicals and so on.

It seems like everyone i talk to has problems with remembering things. Anyway great article.


sligobay from east of the equator on August 18, 2010:

Thanks Habee, for this useful article. My Dad and his brother, Chris, both sufferered the ravages of Alzheimers Disease and I fear a similar fate, genetics being what they are. Thanks for the links relative to delay, avoidance and progress in disease research which has furnished a glimmer of hope for me. Cheers.

suziecat7 from Asheville, NC on August 18, 2010:


suziecat7 from Asheville, NC on August 18, 2010:

I agree with Msorensson. This is a very relevant Hub. Great info.

msorensson on August 18, 2010:

Very relevant, habee, for these times. Wow..the assisted living in Colorado are a bit more expensive than what you mentioned.

This is very important for us in the age range when our parents are requiring care. In the Philippines, the children and their children take care of the old but here it is not so easy to do. A good nursing home is very important. We have lots of those here in the city where I live.

It is a great place to be for your families and for the really old people.

I think when I am old and ready to die, I will just walk into the ocean so that at least the fishes can use my body. I hope I will be lucid enough to do that. Thank you for the hub.

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