Long Term Care is a reality that everyone will eventually confront—either for themselves, a loved one, or both. Unfortunately, Long Term Care is a topic that people avoid and don’t understand until one day a crisis situation throws them into a world for which most people are completely unprepared. The good news is that you are not alone. Not only are most people unprepared, but when a Long Term Care crisis hits it tends to bring together and involve multiple family members.
In many situations the need for care will creep up on a family. Oftentimes, family members are acting as caregivers without realizing it. As the need for care increases, it can either seem like a normal part of aging or people are just not willing to admit that the ability to live independently is no longer possible—or safe. But there are warning signs you should be looking for that will help you recognize when the time for professional Long Term Care has arrived:
- Physical Deterioration: Look for signs such as significant weight loss, balance issues and falling, loss of strength and stamina, and other losses of “Activities of Daily Living” (ADL)** such as ability to shower or toilet, dress, or eat independently.
- Mental Deterioration: Do not blow off loss of memory or confusing names, dates and locations as just a “senior moment”. Cognitive deterioration is an important warning sign that you should be on the lookout for dementia and Alzheimer’s. These conditions can worsen quickly and can lead to many physical breakdowns and safety issues.
- Lifestyle Deterioration: Is the home not being kept as neatly as in the past? Are things oddly out of place (a house plant in the fridge, pots and pans in the bathtub), or do you see signs of physical damage (the car crashing into a fence or the wall of the garage, burn marks on the kitchen wall from a flash fire)? Long Term Care is both a matter healthcare and safety.
Look for these warning signs when you are with your loved ones when you suspect they may be finding it increasingly difficult and dangerous for them to live alone.
**Basic ADLs (ADLs) consist of self-care tasks, including:
- Bathing and Showering (washing the body)
- Dressing
- Eating/feeding (including chewing and swallowing)
- Functional mobility (moving from one place to another while performing activities)
- Personal Hygiene and grooming (including brushing/combing/styling hair)
- Toilet hygiene (completing the act of urinating/defecating)
If based on these warning signs the family decides it is time to make the move towards professional Long Term Care, the best next step is for the family members to put in place an LTC Action Plan. Start by making sure that the siblings and in-laws, as well as a surviving spouse are on the same page about the need for care and how you will work together to move forward.
- Who lives close enough to be “hands-on” to help with driving and appointments?
- Is there a need to establish a Power of Attorney or Conservatorship? Who should that in the family and who is the attorney?
- Who is the right person to assess the financial situation? Are there available savings, assets and insurance that can be used to help pay for care? Will Medicaid be necessary and will they qualify?
- Should a professional care manager be called in to help assess the health situation and devise a care plan?
- Will the care be at home or should it be in an assisted living community or nursing home?
- Should an elder law attorney be hired?
Once the plan is in place and everyone is on the same page about their roles, it is time to sit down and have “the conversation”. This is a conversation that must be handled with compassion and delicacy. You don’t want to be aggressive or jump too quickly to the end result. People are naturally fearful of losing their independence or admitting that they are aging and becoming frail. But if you handle the conversation correctly, what may first start out as a negative situation can be turned into a positive.
Emphasize that not only will you be able to improve their health and safety, but for many, long term care can change their world from isolation to engagement. There are numerous opportunities for social activities, games, art, entertainment, and great food! Also, the doors to new and old friendships can be opened—and even romance can bloom.
The key is for the family to come together. Look for the signs that care is needed, formulate a plan, communicate effectively with your loved one(s), and change the perspective about Long Term Care from negative to a safe, healthy and enriching experience in the continuing journey of life.