The “frail elderly” utilize significant health care resources in the US. What, in your view, is the best approach for caring for this unique population?
With the baby boomers coming off age, the elderly population is growing quickly. Our frail elders often cannot take care of themselves anymore and have trouble completing their activities of daily living (ADL). Especially with the downfall of the economy, many family members are not able to stay at home and take care of their elderly family members because they have to work. In other cases, many of the elderly population may not even have any family members close by who would or could take care of them. The elderly population is often seen as a nuisance and many elders are dropped off at a retirement home and forgotten about. Our elders still deserve respect as anyone else does. They took care of us while we were young and now it is time for us to take care of them. It is a continuous cycle that should not be broken.
My grandfather, a strong, independent man came to the age where he started forgetting things and in addition to that he was diagnosed with prostate cancer. After his surgery and the successful removal of the cancer, he needed his family members to help him with his daily activities. Even though we were all holding full time jobs, my uncles, aunts, mother, sister and myself made a schedule in which each was assigned to different times, so that he was entertained and taken care of throughout the day and parts of the evening. Once we were not able to manage my grandfather’s care anymore, we decided to go with hiring a visiting nurse who would be able to help him with his ADLs and keep him company. Granted the visiting nurse was not inexpensive; however, we did not want him to have to go to a retirement home or other facility where he would feel forgotten and neglected by his family. Sadly a year later my grandfather passed away in his sleep at home. Although this was a sad event, we were happy and confident he went in peace knowing that his family stood by him and loved him deeply.
Our elders need our support but sadly there are too many elders that do not have the support of family, friends or even caring neighbors. Another example that currently indirectly affects me is the case of a very close family friend of mine who lives in Germany. Helga is a 72-year-old female who lost her husband two years ago due to a brain tumor and her mother passed away a year ago expectantly. Helga has always been very dependent on her husband but also very strong-willed and often difficult to cope with. Since her husband and her mother both passed away, Helga is alone with a physical impairment due to a brain nerve infection. Although, my mother works more than 50 hours per week she tries to help Helga out wherever she can; however, Helga can be very exhausting and demanding. Helga will call my mother during all hours of the day and night, often to speak to her but more often to demand for my mother to come visit her, pick her up and drive her somewhere or bring her cigarette.
Even though long-term care facilities should be the last resort, in many cases it is inevitable and the best option. In Helga’s case it would be best for her to be transferred to a long term care facility as she does not have family member or friends, other than my mom who are willing to help her on a regular basis. Although Helga does not need help with all ADLs, she does not have control over her bowl or bladder movements anymore, which causes great sanitation concerns sometimes. In addition, Helga still remains forgetful at times and once almost burned down the house because she left a plastic bowl on the stove and forgot to turn of the stove. After this incident, she was temporarily admitted to a retirement facility; however, after 2 weeks she was released again on her own free will. Thanks to the medication she has received, she can now walk and think clearly again; however, she should not be living by herself anymore. It is difficult to be so far away and not being able to help. Helga needs someone to take care of her, someone who will help her keep her house clean and cook for her. Since Helga refuses to move to an assisted living facility because she does not like the restrictions set forth in these facilities, her case worker decided to hire a cheap live-in aid that will cook for her and clean the house. However, since the aid is a Polish citizen, she can only come for 30 days at a time and has to go back to her country for a period of time. During the in-between time Helga again is by herself. It is hard to see how my mother is struggling with trying to help Helga out, bringing her groceries and other necessities and having to endure Helga’s un-appreciativeness and demanding nature. Even though it is hard to admit loved ones to a permanent long-term care facility sometimes if there is no family or other individuals around to help care for the elderly, it may just be the best decision.
There are so many different possibilities we have to assure that our elders are taken care-of properly. There are nursing homes, assisted living facilities and continuing care retirement communities. In Helga’s case I would suggest an assisted living facility as it will still give Helga her privacy while also providing her with help with her activities of daily living and if necessary can provide her with minor medical care.