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The transition to a long-term care community can be an especially difficult decision to make on behalf of a loved one. Many families are often tempted to hold off as long as they possibly can, only taking steps to admit into care when it becomes absolutely necessary. However, in many cases, delaying such a decision can be costly for both the elder and the family caregivers. It is important that families understand how to manage this decision proactively, when possible, to best set their loved one up for success. While some families battle feelings of guilt or a sense of failure, others simply do not recognize how dire the situation has become. Let's explore the signs that your loved one may need long-term care to help alleviate these negative feelings associated with such a decision while also raising awareness on what to look for.
Significant Changes in Mobility
One's ability to move around with confidence can change suddenly after a health event. These types of rapid changes in mobility are often apparent to all and can be considered somewhat temporary with the possibility of improvement during recovery. However, it's the changes over long periods of time that families often miss. Because they see them every day, they may fail to recognize how dependent the elder has become on them for movement, especially when compared to the recent past. Elders who live a more sedentary lifestyle will begin to lose muscle mass as well as confidence. Both are required to maintain the type of mobility that supports independence. Also, it is important to note that this more gradual loss of mobility is less common to reclaim without a rigorous plan for rehabilitative therapy, with a concentrated time of daily intervention by therapy professionals who are often found in partnership with long-term care communities. Many family caregivers will push themselves to their physical limit as they support their loved one's mobility needs until they themselves begin to suffer with back pain and other ailments. Placing their health at risk ultimately puts the health of the elder at risk too. This is not a sustainable plan and a sure sign that it is time for change.
It is important to note, a physical therapy plan is not a standard part of every elder's care plan, however, their needs can be evaluated regularly to engage these therapy professionals on an as needed basis. Be sure to ask about therapy programs when you conduct discovery visits to local communities. Also, consider how the living spaces within the community may be more accommodating to your loved one's limitations. Simple things like wide doorways, high seating toilets, adjustable beds, lower counters and helpful staff nearby can make a huge difference to an elder in need.
Limited Participation in Incontinence Care
A major milestone in recognizing when more care is needed should be the elder's ability to manage or fully participate in their incontinence care. Many families are surprised to learn that this is a major deciding factor at the time of assessment between placement in Assisted Living or Long-Term Care. Once there is a regular dependency on the caregiver in this area, long-term care will be the most likely recommendation from the healthcare professionals conducting the assessment. This change in care can also be a major stressor on family caregivers and should be considered a sign that it is time to reevaluate the sustainability of the arrangement at home.
Poor Hygiene
Bathing and grooming can become another daily hardship between the caregiver and the elder. An elder with poor hygiene may be an indication that the caregiver has surpassed their ability to provide this on a consistent basis, not because there is a lack of compassion or love, but because they are coping with exhaustion or squaring off with an unwilling participant. Whatever the reason, skipping daily hygiene may open the door to other serious complications for the older adult. Bathing is an opportunity to regularly evaluate the elder's skin condition which can be a critical element to their overall wellness.
Medication Mix Ups
The more medications that are prescribed, the greater the chances that a mix up can occur. Caregivers are managing daily stress which can result in a lack of organization and a dulled mind. If there have been one too many medication mix ups at home, this could be a sign that it's time to look at getting help.
Trouble Maintaining Healthy Weight
Nutrition is a critical part of an older adults aging process. It is common to struggle maintaining a healthy weight, either needing to lose weight or gain weight. Either way, a care community provides a dietician who reviews the elder's care plan and weight management, along with a medical director and team of nurses for oversight. The dining program is dedicated to providing well-balanced meals with the right mix of nutrients, even offering pureed options to those who are need, or other supplements when called for. Simply put, the complexity of proper nutrition can be especially difficult for home caregivers to get exactly right without this expertise in their background. Even going to the grocery store can be an overwhelming chore, not to mention the task of cooking three fresh meals a day. Let's face it, it is all too tempting to provide easy microwavable, processed foods rather than the fresh food approach found within a care community. Also, if your loved one is gaining or losing weight suddenly and without explanation, this is an urgent sign to get a health evaluation to understand what may be going on, and potentially a sign that more care is required.
Changes in Emotional Well-being
While there are 101 emotions your loved one may experience in the course of a day, the most damaging to watch for are signs of loneliness, boredom, and helplessness (lack of purpose). Each of these symptoms can ultimately be traced back to significant deficits in meaningful activity. Each person needs regular social interactions to chase away loneliness, interesting activities to push away boredom, and a sense of purpose to maintain a vibrant spirit. Communities provide a robust calendar of activities as well as socialization and opportunity to give back. This is invaluable to their overall wellbeing!
While this may be one of the most difficult decisions families will ever make, it is a necessary discussion that shouldn't be put off, avoided, or stonewalled. Talk openly and honestly with each decision maker, as well as the elder, involving the advice of the elder's physician when the time is right. Don't miss the signs that your loved one may be ready for long-term care.
