October 2008 | Web Exclusive
Life  |  Aging Parents

Caring for mom and dad

Choosing eldercare for aging parents. by Eileen White

	* Tip Many times the emotions involved can be overwhelming, and Burdsall recommends caregivers seek help. Many long-term care facilities provide support groups for caregivers and the patient’s family. This is especially important when dealing with individuals suffering memory loss, including Alzheimer’s. RELATED CONTENT Checklist: Evaluating your eldercare Sidebars: Life choices and advice

We all difficult face choices in life, especially when it comes to our aging parents. How do you find the best care situation available for the one who has cared so lovingly for you?

Professionals in the eldercare field say early planning and communication are vital. According to Deb Patterson Burdsall, RN, MSN, C, CIC, nursing expert and infection preventionist for Lutheran Life Communities in Arlington Heights, Ill., talking to your parents or loved one early on regarding their wishes is of prime importance.

“Just getting the person’s feelings about their wishes are important, especially if the child has durable power of attorney for healthcare for that individual. If someone has given you the power of attorney, you need to know their wishes,” she said.

Eldercare options

When people think eldercare, many automatically think “nursing home.” But this is not the case…there are many options open, and they fit specific stages of function. See the article "What are my choices?"

Considering all the choices, it can take an average three to six months to search for the proper care, and it’s probably good to familiarize yourself ahead of time with the facilities in the area and the different services they offer, according to Burdsall. One way to do this is by asking others.

“Sometimes word of mouth is one of the strongest forces in long-term care,” she said. She recommends beginning with your doctor or healthcare professional, and even checking with non-healthcare professionals including family members or neighbors. She advises caution when consulting friends or family, although non-professionals can give names of places where they have had unfavorable experiences. See the article "When does outside advice come in handy?"

Keep them involved

But many times there is no such luxury of time. Often, Burdsall pointed out, the decision is a forced one, the result of a crisis situation. This can occur, for example, when family members are told to find placement for their loved one, generally within 24 hours. Whatever time is allowed for preparation, Burdsall stressed the importance of including your loved one in the decision-making process. See the article "What should we look for?"

“It comes back to clear, honest communication,” she said. “The individual is not a child...he or she is an adult with a whole life experience behind them, and they have legal rights themselves,” Burdsall said, adding that when the parent has a sound mind, the placement should be their decision.

 “You simply can’t make that decision for another person. You’re dealing with an adult with the right to make choices. Sometimes those choices aren’t the best, but before a child steps in, they have to understand whether they have the right and that their parent has the ability to make the decision for their own care.”

Turning point

Burdsall noted that the decision for care likely presents the greatest emotional conflict.

“The child comes in to make the decision, and they really don’t have the right to make that decision…. This doesn’t mean the child can’t help their parent, but sometimes the best help is to step back,” she said. “Unfortunately, it means that it can take a fall before the parent realizes they need more help. But that’s why you need to include the family members, the parent and the healthcare provider. Keep the lines of communication open, and allow the person to feel as if they have some control over their destiny.”

The pivotal decision-making point is whether the individual presents a danger to themselves or to others.

“At that point, the individual has no choice…but you still need to respect the individual’s rights,” Burdsall said, describing the process as the “elegance of risk.”

She explained, “As adults, we all take risks everyday, such as getting out of bed and going downstairs. When professionals assess whether an individual is at risk, it must be very carefully assessed whether this individual actually is at risk…and whether they can keep functioning they way they are.”

Often the individual must reach a crisis, such as a fall, before family members can deal with the situation. In such cases, the family not only should consult a healthcare provider for advice, but they also should talk to the loved one. Burdsall cautioned that extra care should be taken in cases when the individual suffers memory loss.

“When they have memory loss, it’s a totally different issue,” she said. “But that doesn’t mean shutting the elder out of the decision process; they should be included at least to the level they can participate. In some cases, because the individual can’t decide for themselves, the family and the professionals must make the decision for them,” she said.

reports vs. instincts

Recent media reports claim that more than 90% of nursing homes in 2007 had been cited for violations of federal health and safety standards. Access the full report here.

Burdsall cautioned not to over-rely on the Web site’s information.

“Although the site lists nursing homes that supposedly have problems, there are some homes on this Web site that actually are very good—the staff cares; and there are some homes that are not on this Web site who are very skilled at making it look like they provide above-average care. So you have to do your homework, but don’t rely on the list alone…you have to get out there and visit, and trust your own judgment,” she said. 


Eileen White is an associate editor for Modern Hygienist. She may be reached at ewhite@advanstar.com.

Photo: Getty Images