Putting a loved one in a nursing home is a difficult decision regardless of the circumstances. In the case of Alzheimer’s, most research shows that at some point in the progression of the disease a nursing home becomes the right decision for the family in Ironia. According to the US Department of Health and Human Services, there are nearly 2 million people currently living in some form of nursing home. Over 90% of these residents are over 65 years old and most require 24 hour supervision due to some physical limitation or dementia.
Seven Reasons Why Seniors Want to Stay Home
Alzheimer’s disease is an extremely sad and difficult condition to work with. This disease is very difficult on the family members in Ironia. Just thinking that as the days slip by your aging loved one will soon become more and more distant. This can be very depressing and an emotional time for most family caregivers. Besides the common emotion of depression, most family members often feel angry, frustrated, and even at a loss for words.
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I think that, as a group, seniors are some of the most surveyed folks out there. Being in the senior home care business I am more acutely aware of the surveys then the normal person and like to see how the results of those surveys match up to my personal experiences.
More times then not the results do not go beyond the numbers to the underlying cause and effect or at least the feelings of those being surveyed. In a recent survey it was reported that over 80% of seniors would rather live out the rest of their days in the own home and not in an assisted living or similar facility. That's really not breaking news but it started me thinking about why the seniors are so motivated to stay in their home.
I started doing some research by going over my notes from prospective client families, care recipients and also our wonderful care givers. So I have come up with seven reasons why seniors want to stay in their home. These seven do not have real defined borders and have branches or even roots in other reasons.
- Comfort. This reason really bleeds over into the others as well but the senior is comfortable in the house where they have lived for many years. The TV is just the right distance from their chair and doesn't have any reflections on it, they know the HVAC system and where it needs to be for comfort, they have spent years getting the furniture the right size and in the right place. So why should they leave.
- Safety. Now at first glance this might be a reason for going into assisted living but most seniors feel safer at home. They know the sounds of the neighborhood, when neighbors come home and when they leave and most can move around their house and even their yard blindfolded. We have a 94 year old client who is almost totally blind and lives by herself but she knows where everything in her house is, even her meds. She has her morning meds in one location and the bottles are arranged in a specific way and the evening meds are in another location. She feels safe in her environment.
- Memories. They have experienced the entire fabric of life in their home. Birthdays, holidays, including dry turkeys, disappointments and celebrations, medical issues, retirement, aging and death. The home has been the foundation of all that has gone on and they don't want to walk away.
- Independence. From pre-teen years we all strive to achieve independence and now that the senior has had it for so many years they guard it with all the vigor they can muster. If the car keys were taken from the senior earlier then this is the last vestige of independence. Note to family: rescinded driving privileges will be the biggest fight but the home is second.
- Cost. Assisted living expenses can run as much as $4,000 plus a month so staying in one's home can be quite a savings. Add to that the possibility of a reverse mortgage and their monthly bills can be reduced but things like a gardener, pest control, etc have to be managed.
- Network. This term might be used with younger folks but even my 94 year old client has a network...a social network of neighbors and friends who check on her and bring her treats. Many times these social networks are shattered when the senior moves to assisted living. My mother-in-law who lives with us still talks about neighbors she had ten years ago. Don't discount these social connections.
- Family. Many times the family home is just that and there are extra bedrooms for visiting family members. Children of the senior can visit and bring their kids and now you have three generations staying connected in a home environment, not just visiting grandma at an assisted living facility.
Back in the day there were only two choices for seniors and that was stay in their home or live with the children. Now there are so many more choices up to and including resort like living where you eat all your meals in a nice restaurant environment. The choice we made was to have my mother-in-law live with us, it just made sense and we felt better about it. But the transition wasn't easy, especially for mom. But over the years she has settled in and knows exactly how many steps it is from her room to the bathroom.
It is important to hold family meetings with the senior included to discuss how it will work and if additional in home help will be needed for a portion of the day. In home care can make everyone more at ease if it is decided that the senior will be allowed to stay in their home.
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Working as a home health aide with mentally ill patients requires a special sensitivity to the needs of the mentally challenged. Too often, people tend to think of the mentally challenged as being somehow inferior and as such, they tend to talk down to them. However, what the mentally ill really need is what anyone else needs - they need someone who will take them seriously and make sure their needs are met while giving them as much freedom as possible.
Just What Is Mental Illness?
Before we can begin to discuss how to work effectively with mentally ill home care patients, it's important to understand what mental illness actually means. Let's start with the most basic definition and then go into a more detailed explanation. At its most basic, mental illness means that someone is incapable of functioning independently in society due to some kind of problems with how they experience the world emotionally. Exactly how this manifests itself and what the issues are do require additional explanation however.
Some indicators that a person may be mentally challenged include:
- Inability to Develop and Maintain Healthy Relationships - Many mentally ill people find it difficult or impossible to create healthy interpersonal relationships.
- Lack of Impulse Control - Another common problem for mentally challenged individuals is a lack of impulse control. Many mentally challenged individuals will for example do things in public or even in private that mentally sound people won't do (i.e. scream out loud at no one in particular, cause damage, public urination, etc.).
- Inability to Tolerate Anxiety and Frustration - We all deal with anxiety and frustration on a daily basis. However, those who are mentally challenged often find that they cannot handle any (or very little) anxiety and or frustration in daily life.
- Inability to Respect Others - Finally, many mentally ill people find it difficult to respect others, in terms of private space and or in terms of regular verbal abuse.
Your mentally challenged patients may also experience changes in behavior which are of a positive nature. Thus, it's important to note when and if such changes occur and to note changes in personality, either for the good or the bad.
While you should note environmental factors surrounding such changes in behavior, it's important not to draw conclusions on your own as to what precipitated these changes. Instead, you should note only the facts and allow mental health professionals to make such diagnoses.
Making Sure Patients are Cared For
It's important as a home health care worker working with mentally ill individuals to make sure that they are complying with their treatment regimen. This means for example that you need to ensure that the person is taking their medication on time and in the correct doses.
You must also watch carefully to ensure that dangerous behaviors do not put your patients in harm's way. When danger does present itself, you should call 911 to get emergency workers to help deal with the problems rather than attempting to deal with it on your own. For example, if your mentally challenged patient overdoses on sleeping pills, you should call 911 immediately rather than try to induce vomiting on your own.
Provide Patients with a Path to Recovery
Finally, your role as a home health care worker is to facilitate the patient's path to recovery. This means that you work with them to ensure that they will have the right kind of support to deal with their problems and that you help to keep the family involved as well in the recovery of the mentally challenged patient that you work with as a home health care worker.