As parents grow older, their adult children may be called upon to help them make decisions about their future. Those decisions can be complicated with a parent suffers from a disabling health condition.
Parents who need help might remain in a family home with the assistance of caregivers. Parents might instead be more comfortable with the care they can receive in an assisted-living facility. Children can help parents make that choice by investigating the benefits and costs of those competing options.
In many cases, caregiving is provided by family members. Parents may opt to move out of the family home and to live with the family of an adult child. In some cases, an adult child might return to the family home to take care of an aging parent.
About half of all adults who receive help from a caregiver live in their own home, while another 29% live in the home of a family member. When family caregivers do not live with the parent who needs help, they may divide responsibilities for caregiving. Family members who live in the same community can take turns bringing meals to their parents or making regular visits to help them with cleaning, laundry, personal hygiene, transportation, and other issues. Family members who are more distant might help with emotional support and scheduling visits with doctors.
When parents or their adult children have the resources to do so, they might hire one or more caregivers to provide in-home services. Those services may range from unskilled duties (home cleaning, laundry, shopping) to semi-skilled tasks involving personal care (dressing, toileting).
A home health aide must generally meet state training requirements before providing assistance with the activities of daily living. An aide can also monitor vital signs and help parents keep track of medications, although some states require a licensed professional to provide the medications to a patient.
A visiting nurse might be required to provide in-home health care, while other professionals might visit the home to provide physical therapy or massage services. Home-based nursing care is typically intended to help the rehabilitation of a patient who has been discharged from a hospital. A visiting nurse might also act as a care coordinator to assure that caregivers and home health aides are meeting the health care needs of the patient.
Adult children should help their parents determine the kind of care they will need if they decide to age in place. They might want to help their parents make a budget, estimate the cost of hiring caregivers, and help their parents interview caregivers to find the right combination of professionalism and friendliness.
An assisted-living facility provides caregiving services in a residential setting. The facilities maximize the ability of residents to live independently while providing them with the care they need. Depending on the facility, residents might purchase or lease a unit. The cost of housing depends on the size of the unit, the location of the facility, the level of care provided, the meal plan that the resident selects, and the amenities that the facility offers to residents.
Staff members in an assisted-living facility typically provide housekeeping and laundry services. While the units in some facilities have kitchenettes so that residents can prepare their own meals or snacks, facilities typically offer three meals a day prepared by staff members. Residents eat in a large dining area, although some facilities provide room service for an extra fee. Most facilities serve meals at fixed times, although some offer restaurant-style “on demand” meals throughout the day.
Assisted-living facilities are not nursing homes. Residents usually need assistance with the activities of daily living, but they do not need around-the-clock medical care. An assisted-living facility might or might not have a medical director or registered nurse on staff.
Different facilities offer different levels of nursing care. A registered nurse might assess a new resident and develop a care plan. Some facilities might employ licensed practical nurses or licensed vocational nurses to monitor residents who have known health issues.
Caregivers help residents with their activities of daily living. In some facilities, those duties are handled by certified nurses’ aides. Caregivers typically monitor whether a patient is taking prescribed medication. Whether a caregiver can help the patient take medication depends on state law. Some facilities have nurses available to help residents who cannot self-administer medications.
As adult children help their parents choose an assisted-living facility, they should compare staffing levels and determine whether staff members are capable of meeting their parents’ needs. A parent who needs assistance with mobility will probably need less specialized care than a parent who regularly needs to have a catheter inserted. Adult children should help parents ask questions about the availability of staff members who are qualified to provide the specific care their parents need.
States typically regulate assisted-living facilities, although regulations vary substantially from state to state. Adult children should become familiar with the regulations in their state to determine the kind of care that different professionals are allowed to provide. That information will help children identify facilities with staff members who can lawfully address their parents’ health issues.
Adult children should also compare the costs associated with different assisted-living facilities. Comparing those costs to the cost of hiring caregivers to come to the parents’ home will help parents decide whether aging in place or moving to an assisted-living facility is a better financial option.