One of the joys in living is being independent. As fully-functioning adults, we are able to pay our bills, grocery shop, clean our own homes, garden at leisure, and participate in activities that bring us pleasure.  As we become older, we may lose the ability to care for ourselves, due to chronic arthritis or other conditions. We may not be able to answer the phone, we may not be able to climb stairs to get to the bedroom, and cutting the lawn and or tending to the garden may become difficult due to the inability to push the lawnmower or get down on our knees. Sometimes a little help is all that is needed in order to remain living independently.

In the past, care of the elderly typically fell to the extended family. Now, with smaller families, older adults living longer, and families living further apart, care of the elderly is not only falling to (often long-distance) family members, but also to independent caregivers, the state or charitable organizations.

Whether caring for an elderly family member or an elderly client, caregivers often have multiple challenges to overcome. As our needs and abilities change throughout the years, there are issues that may arise -- health challenges (physical and mental), housing concerns, transportation needs, financial issues, and end-of-life decision-making are some of these, and planning will be important.

Good Mental and Physical Health

Good mental and physical health is something we can easily take for granted until it begins to decline. Our memory may not be as adept due to the aging process, or we may have been diagnosed with memory issues due to Parkinson’s, Alzheimer’s or any one of a number of other diseases. Our ability to make adjustments can be exhausting, but also very empowering.

Housing

Housing may be one of the adjustments that are necessary. There are some things you can do to stay in your own home. Physical alterations, such as handles for getting in and out of the shower, non-slip flooring, a different telephone, or a lifeline emergency medical alert system may make it possible to stay in the home. Home health care may be another possibility for those faced with more challenges. When independent living is no longer an option for elders, there are several other housing options available. In Michigan, there are adult foster care homes, assisted living homes, adult day care centers, respite care, nursing homes, and other options. It’s extremely important to recognize that the cost of each facility is different, and methods of payment vary from place to place. In order to get specific financial information, contact the owner or admissions coordinator of the facility you are interested in.

Transportation

Because our transportation system is built for the average person’s sight and abilities, as we age, transportation issues will eventually arise. It is a difficult choice -– put yourself or others in jeopardy by driving unsafely, or give up the freedom and privilege of driving altogether. Although not being able to drive impacts our lives in a big way, by planning ahead, the transition can be less traumatic for us, and safer for those around us.

Financial Well-Being

Financial well-being is an important component to be addressed when making adjustments due to age, and especially if someone has a disease that will get worse over time. You can be more prepared by becoming familiar with any insurance you have that concerns illness and long term care. Government programs such as Medicare and Medicaid also have programs that you may want to learn about ahead of time.

End-of-Life Decisions

End-of-life decisions are never easy to make. It’s a discussion that all family members should be part of. Questions regarding end-of-life decisions should be made before a crisis arises. Designation of a medical patient advocate and implementing hospice care are two important issues that should be addressed.

• Designation of a patient advocate allows the chosen individual power to make medical treatment decisions, and personal care and custody decisions, when the patient is unable to make their own medical treatment decisions.
• Hospice is a type of care given to someone facing the last stages of a terminal illness. To be enrolled in hospice, a physician must write an order. Hospice includes palliative care (comfort care) and can be provided in various settings.  Hospitals, a hospice facility, nursing homes, and the patient's own home are some of the environments that hospice care is given.
• Palliative care (comfort care) can help people coping with any stage of a disease, whether curable or incurable, and focuses on relieving and preventing the suffering of the patient.
• Caregivers needing a break from care giving may want to learn more about respite care. This allows an older adult to be placed in a temporary facility, so that the caregiver can attend to whatever needs they may have -- whether that be a much-needed vacation or dealing with other issues.

There are many issues concerning aging. When we were children, we were gaining control over things. Even though things were difficult because of our physical or mental limitations, things got better. Aging is part of the process of living. We get wisdom and experience -– yet are asked to give up independence.  By doing research, planning ahead, and making small changes, we can try and maintain an equilibrium that we need in order to thrive.

Other Areas of Concern

Along with the aging process comes additional challenges such as memory loss, elder abuse, and hoarding.

• As people get older, some memory loss and forgetfulness is common. It doesn’t necessarily mean that they have Alzheimer’s disease. In the past, forgetfulness was called “senility.” Now that word has been replaced by the word “dementia.” Although Alzheimer’s disease is the most common form of dementia, dementia is a symptom that can be present in many other conditions. Some thyroid conditions or vitamin deficiencies can cause dementia. Learn more about Alzheimer’s disease and other diseases that can cause dementia by referring to the Alzheimer's Association.
• Elder abuse and neglect may consist of the following types: physical abuse, exploitation, violation of basic rights (opening mail, making phone calls), psychological abuse, self-neglect, sexual abuse, neglect and abandonment. It is important to be attentive to older adults who could be victims of abuse.
• Hoarding is a psychological disorder which causes a person to collect a large number of possessions. Hoarding is estimated to affect 1.4 million homes in the United States, and it is believed that only 10% of all the cases of hoarding gets the attention of public officials. Hoarding involves more than just hanging on to junk, and can become a health hazard for the one who suffers from the disorder, as well for as their families and the community.

Planning for elder care involves much more than just a few phone calls or emails. You will need to know the answers to specific questions when talking with family members, health care providers and others involved in the care of your loved one, especially in emergency situations. Below are questions to consider as you plan the care of your loved one. Try to involve others who will be able to take an active role.

Getting Started with Planning

What information do I need to gather? Who do I need to involve? Which family members and friends can take an active role in providing care? Who are the professionals (doctors, lawyers, financial institutions and advisors, etc.) that we need to contact? Who will take care of important things during a crisis, e.g. spouse or partner, pets, mail, bills, messages, plants and flowers, other outdoor maintenance? 

Where do I find help? See Elder Care Resources.