VS Assisted Living?

The Case for Assisted Living (From an In-Home Caregiver)

It is a week now since Thanksgiving and I am still exhausted.  Traveling with an aged invalid is never easy but for the treat of ten precious days in my own home it was well worth the effort.  Back at Mom’s now for three days, I am assessing:  we have erected this life for her, supported by me.  What would I say to someone facing the decisions I had to make four years ago when I decided to come to my Mom’s and try to help her with living at home?

These thoughts are partly precipitated by the case of a couple of my family people who found themselves, through a series of crazy events, hitting “the wall” and ending up in assisted living long before they ever thought they would.

We noticed he had started to get confused about appointments and what day of the week it was.  In June he fell and broke his hip. Just a slip starting his lawn mower. He had to wait a couple of days for hip surgery because it was the weekend.  They kept him on strong pain medicines while he waited. After the surgery he awoke confused and combative and after a couple of days of trying to deal with that he was placed in a medical coma.  This medical procedure has repercussions but apparently there was no choice.  His mild dementia was exacerbated by the sedation and by the end of two weeks he was in and out of a reality none of us could recognize.

His wife of 67 years refused to leave his side for the first few days of his hospitalization.  She did not eat or rest.  When he was admitted to post-surgical rehab she went home but her physical status declined rapidly and she was admitted to the hospital herself within the week. They never went home again.  He died just before Thanksgiving and she remains in the assisted living facility they finally landed in after months of topsy-turvy placements and re-admissions to the hospital.  She told me this week that she can never go home. The kids won’t let her and their house is in very bad shape after all this time being closed up and uncared for.

I find I am glad for all concerned. 

The place where she is staying now is very close to her home property.  She has a nice suite and although she does not have “all her things” she has a clutter of personal possessions around her and heaps of knitting projects at her side.  Her meals are provided in a dining hall, not to her preference or timetable but nice and in an environment where there is an opportunity to be social which I think is a BIG advantage. When she needs help she can push a button and someone will eventually come.  The facility takes residents shopping and on other outings.  It is close enough to home that her friends and family can go by and see her anytime.

Assisted Living is expensive-beyond the means of many.  It is restrictive-residents find that they have to adapt to living patterns unlike those they followed at home.  There is less personal privacy-the care staff comes in and out to clean and attend to meds and bathing and all manner of things. And contrary to what many families believe, assisted living does not replace family support for these old ones.  As Mom’s care aide with hospice says, “you can’t just drop them off and leave them there”.  Their personal care products and medical concerns, wardrobe changes, all kinds of needs will not be addressed in the way family support does.

On the other hand, assisted living offers a zone of separation which I can see now as a benefit to both elders and offspring.  The supportive family can step away for a time.  Regroup.  Rest. Recover their goodwill toward the occasionally cantankerous and immovable oldies.  They can take care of difficult business decisions without a whole lot of painful conversation.  After my experiences as a home care giver I can testify to the advantages of these.

Mom and I have not always gotten along well.  We have had huge challenges beyond those of daily living.  I was always willing and able to handle cooking, cleaning, bathing, household matters. I was never made for being in charge of another adult and that has led to some pretty dicey moments between us.  Dealing with financial and property issues has been crushing.  There were many issues I would have loved to hand off to someone else.  But in this past year, since receiving her dire diagnosis and having been on hospice care, Mom has let down some of her long held defenses. I have been able to get to know a softer version of my mother and I would not trade this time together for anything.

I will continue looking at the advantages and disadvantages of home care and facility living in the future as I continue this exploration of the season of ageing beyond our ability to remain independent.  I remain optimistic that there is a better solution than either one of these alone can offer. 

So what would I say to someone who is facing this choice for their elderly parent?  I would say that no matter what you decide to do you will not be prepared for everything that arises.  You must forgive yourself for your errors.  You must forgive them for not recognizing your graces.  No matter what you do, do it with love.  As a friend tells me regularly,  you will never regret that!  Amen.