Dear Adia, My Mom Wants to Stay at Home
My Mom Wants to Stay Home! Long Distance Caregiving
Q
Dear Adia,
I was a long time resident of the South Bay until 2006 when I moved my family from Manhattan Beach to Bend, Oregon for an amazing job opportunity. My only regret was leaving my 91 year old mother who lives alone in Torrance at the home my parents bought when i was a young boy. “This is my home…it’s the only place I know” says my mom every time I call and visit. I feel there was nothing I could do to convince her to move north. Over the past few years, I try to visit often. My daughter lives in Redondo Beach and checks-in on her at least once a week. In addition to the changes in my mom’s body due to advanced age, her muscular dystrophy (MS) has not completely confined her to a motorized wheelchair. I am concerned about the revolving door of independent caregivers and their random schedule. I discovered in my last visit that often times they leave my mom home alone for several hours. The most recent incident was learning that my mom would be home along on Thanksgiving Day and weekend. OOhhh NOOOO!!! I quickly flew back to Los Angeles with little more than a day’s notice. This was the last straw! I was livid and very, VERY concerned to face what was going on at my mom’s home. Our family feels frustrated, worried and vulnerable but need to respect my mom’s desire to stay home. What reliable and safe options do I have for Mom?
Sleepless in Oregon
A
Dear Sleepless in Oregon,
The task of caregiving by long distance can be difficult, stressful, and time consuming. The natural questions that creep into the mind are, “Can I deal with the problem over the phone or do I need to be there in person?” Answering these questions without being physically presents are often one of the most difficult aspects of long-distance caregiving. Emergencies obviously require a trip. However, other situations can be too difficult to judge over the phone through mom or even, a friend. Being miles away from your mom also means being miles away from local phone books, hospitals and caregiving companies whose purpose is to help older adults. There is no magic formula, but there are a number of steps you can take to make the task more manageable.
1. Understand Geriatric Managed Care: Geriatric Managed Care involves a manager, whose primary job is to prepare, plan, coordinate, manage, report and oversee all aspects of care for an older adult, including schedule and back-up management, employee management as well as care plan management. When screening prospective caregivers or caregiver companies, ask about their systems, structures, protocol and procedure of managing care and employees. This is important because it will affect the quality, continuity and reliability or care which is most valuable for sons and daughters trying to care by long distance. A “revolving door” of unmanaged, unsupervised caregivers is dangerous and puts the health and safety of older adults at tremendous risk.
2. Know the Caregiving Vocabulary: Live-In or Live-Out are widely used terms in caregiving. “Live-In Care” is provided by a caregiver who lives at home of the care recipient and earns a wage for the “day.” Typically, the live-in caregiver provides assistance with the activities of daily living (ADL) and/or instrumental activities of daily living (IACL) during the day and sleeps at night. The ideal situation for a live-in caregiver is when the older adult sleeps through the night without the need for assistance. “Live-Out Care” also includes ADL’s and/or IADL’s but it’s broken down by hours and shifts. A team of caregivers work 1 – 12 hours per day. When older adults require 24 hour care, the shifts are split (day shift & night shift) into three-8 hour shifts or two – 12 hour shifts. Often times, the two terms are mistakenly used interchangeably; however, ensure you understand the difference. If mom is incontinent and needs assistance to the bathroom many times during the night, the caregiver should be awake, alert, able and willing to assist mom when she needs it, not expect mom to wait until the caregiver wakes up in the morning to help her. You need a caregiver prepared to work through the night to prevent the risk of falls by the older adult. Know the needs and behavior in the night hours before making a decision between “live-in” versus “live-out” care.
The adult children of aging parents may feel they’ve entered into the Atlantic Ocean on a small raft when caregiving by long distance! Make the best decision by working with a team of professionals focused on geriatric care management and wellness services. You will experience peace of mind and the assurance that mom can stay at home! ….safe and comfortable.
Yours Truly,
Adia LLC
www.adiacares.com