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Elder Care Experts

Home Care Or Assisted Living ? – A Difficult Choice in Elder Care

Possibilities are that at some point of time you may pull apart If you or a loved one are facing this decision.  Is it wise to stay back at home receiving ‘proper’ care, or would it be best to move into an assisted living facility that can meet your long term care needs. This is a question that many of us will be asking ourselves as we get older and infirm. The answer depends on many factors, among them how infirm you are and how independent. No simple straight answer. However, remaining in the home is not the best choice for everyone. To make the best decision possible, you should consider a variety of different factors from the condition to the ability level to finances and the available support network.

We as social gerontologists, come across this issue very often. It’s a dicey question, and before we suggest something, we do a thorough study of the client’s situation. We consider the client’s disease progression and the current ‘disability’, prognosis and the possibilities of rehabilitation, available support systems and financial Implications. In this article, we are collating few instances where our clients had the dilemma of choosing between ‘staying at home’ or moving to a care facility. Listen to these concerns.

‘I had tough time convincing my aged parents to go to an elderly home rather than staying alone. They did not heed to my words and continued to stay alone supported by a number of personal and many a time I had to rush for emergencies. But after my mother died 3 years back my father himself came to me saying that he is ready to move to elderly care home. I guess after my mother passed away that he felt lonely.  He lives at a elder care home now. Initially He complains about everything, especially about the food and the noise but I know that eventually he is going to be happy there. That’s what happened. Today he is much healthier, happier and loves his company.’ This is how Renuka explained her father’s institutionalisation.

‘My grandmother has been relying on my aged parents for her care since she lost the ability to walk last year. I was on a short visit to my native place in Hassan. My parents were planning to admit her in a care home in Bangalore but I don’t want them to because I know she’ll be unhappy and it is against her wish. But my parents prevailed upon me with cogent reasons. That’s when  I took your help. You did a comprehensive study of the physical, social and financial aspects and recommended institutional care. Though I was of the opinion that in-home Care is the best way to grow old in a place where they are surrounded by their friends and family. But for all practical purposes, we need to discard our priorities. Since I live in US, I can’t be of any physical help for my grandmother and I cannot tax my aged parents. Every week I talk to my grand mom through video calls. She has not complained about anything and seems to be very well adjusted’. Sunanda Ram who lives in Arizona explains how the initial predicament turns to a happy situation.

‘My wife’s father who is 82 year moved to Bangalore at age 78. He lives in a senior residence where he receives a lot of support and has many friends, activities, helpers and so on. As he retired from Bangalore he thought Bangalore is a better place to spent his last days moreover his elder brother’s family is settled there. Ever since he lost his wife to cancer, he wanted to live  independent and not asking help from his four daughters. He moved to Bangalore after a fall, mainly for rehabilitation but later decided to sign up for permanent residency. However none of my wife’s family lives near there – all of them live in different cities (at least 600 kms away). None of his family has any plans to move to Bangalore any time soon (all working, not retiring).’

‘Now he misses his family (predictably) and is trying to figure out how to “come back to Hubballi”. None of us are equipped to provide all round support,  plus he would need caregivers to round the clock as he has no strengths in legs. Personally I begged him  not to leave Hubballi, but he left anyway and scuttled the care arrangements. Now I think it is best he stays where he has many friends and he will be in comfortable surroundings. He does not realise it, back to Hubballi, he will be very lonely and isolated. Our family members can visit Bangalore from time to time. At least he has the constant companionship of his peers (all older and retired) and lives in a comfortable and supportive environment. He is not isolated. Just family is far away (his choice).’ Govind, the youngest son-in-law, met us for a counselling and we were able to convince his father-in-law to stay back.

Working with the senior population for many long years is  heart-wrenching sometimes because we may have to go against the clients priorities, hurting their feelings. But we give suggestions after the weighing the pros and cons of both home care and institutional care. It can be against the clients wish. These seniors would like to stay in their familiar environments as long as possible but the condition warrants and when the support systems crumbles, we may have to opt for institutional care. We, as social gerontology practitioners, prefers seniors to stay in their own homes as long as he or she  can manage independently. The moment, infirmity start showing up, it is time to review and take a call.

When the time comes to decide how to help an elderly loved one through those difficult days when they aren’t physically able to care for themselves, the decision can be a difficult one. How do you know what’s right for the senior in your life? In this article, we don’t recommend institutional care, but it  depends on the various factors that serve as a sign post to either way. A comprehensive assessment of the client’s needs is the base to conclude which way to go. By understanding the benefits and drawbacks of both home care and nursing homes, we can make a wiser decision.

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