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One of the most common questions families ask is when to start home care. As a professional in the elder care field, you probably address the issues of knowing how and when to advise families on the right time to bring in home care. At Home Care Assistance, we have seen it all-clients needing home care immediately due to being discharged from the hospital and family members living far away and unable to help support their loved one. We also regularly experience the spouse caring for her husband, or the daughter caring for her mom, and due to the emotional and physical toll day in and day out, both are burning out and need to bring in an in-home caregiver to provide respite and relief.

There is a great deal of variability among families on how they approach hiring a home care agency for a loved one and their reasons for beginning care or delaying it. Sometimes it is financial, and other times there is resistance from the senior in allowing a caregiver in the home. Our advice in most cases is this: start sooner rather than later. We will explore the benefits of starting home care as soon as possible and provide some examples. As a professional, making allowances for in-home care costs can give families the peace of mind to pursue this service when they need to.

After Hospitalization or Rehab

The reality of rehabilitation is that it is a valuable Medicare benefit for people who meet the criteria. But, when patients leave rehab, they usually need continued care at home to stay safe and build on their progress. If a patient goes to the hospital due to an illness or other accident but doesn't qualify for rehab, they will be discharged home.

Betty was living independently in her own home for several years after her husband died. One day she falls and breaks her hip requiring surgery and subsequent rehab. Betty does well in rehab, but reaches the number of days her insurance will pay for, so she is discharged home. Her family is alarmed that she still needs help with bathing, dressing, and the laundry room is located on the lower level of her house. Before discharge, the family hires Home Care Assistance to provide caregivers in the morning and evening to help Betty get dressed and bathe three times a week. The professional caregiver also does Betty's laundry and cooks nutritious meals until Betty gets to the point where she can do these tasks independently.

Dementia and Other Forms of Cognitive Impairment

Dementia is a progressive disease with a downward and debilitating trajectory. Safety is the primary concern for people living at home with dementia, and Home Care Assistance can help keep someone safe. For clients with dementia, it is critical to start services as soon as possible. Resistance to the idea of home care usually gets worse as dementia progresses. Also, putting home care services in place early on can keep someone mentally engaged, socially active, and might even improve their cognition.

Frank's family started to notice that he was becoming more forgetful, leaving the stove on, and wandering. After taking Frank to his physician, he was diagnosed with early-stage Alzheimer's disease. Frank's family decided to act quickly and arrange for a home care company and caregiver to come in and prepare his meals, provide companionship, and keep Frank engaged during the day so that he would not be as agitated at night. Frank's family understands that Frank will eventually need overnight care and will be much more accepting now that he is comfortable with caregivers coming into the home.

Chronic Medical Diseases

As people age, they are more prone to chronic medical diseases that impair their functioning. Heart disease, diabetes, arthritis, kidney disease, sight, and hearing impairment can lead to a gradual decline. This decline can accelerate quickly, and if someone isn't driving, the family takes on many of the responsibilities of care.

One of the benefits of home care that is often overlooked is an improvement of functioning. For someone who has had medical home health, professional caregivers can reinforce physical therapy exercises and other healthy behaviors. When Home Care Assistance develops the care plan, specific health-related tasks might include daily exercise, hydration, and proper nutrition.

Social Isolation

Loneliness and social isolation are getting a lot of attention lately. We know that loneliness can have devastating consequences, including depression and anxiety, impaired immunity, and cognitive impairment.

Home care can significantly improve situations where a senior is social isolated, and not just by the caregiver's companionship. The other notable and growing interest from families is technology. Social media and conferencing platforms allow families to stay connected. And now that telehealth has cemented itself as a permanent part of our health care system, older adults need to learn how to use these platforms. Many older adults are not comfortable with technology and require repeated exposure and instruction. In-home caregivers can help facilitate this valuable activity by helping older adults learn and become familiar with ways to stay connected with the outside world through technology.

Caregiver Relief

Sometimes focusing on the client, we tend to forget the enormous financial and emotional impact of family caregiving. The economic cost is projected to be about $67 billion and will double by mid-century. According to the AARP Policy Institute, about 41 million family caregivers in the United States provide an estimated 34 billion hours of care to an adult with limitations. The estimated economic value of their unpaid contributions was approximately $470 billion. And this was in 2017.

Women are disproportionally affected by the loss of income, but the financial impact affects caregivers of all ages and genders. Returning to the workforce after caregiving can prove to be a challenge. Starting home care early can give relief to family caregivers to continue to work and support their families. In financial planning, families may balk at caregiving costs without considering the economic costs associated with reduced or lost employment.

Home Care: The Foundation of Support for Families

Talking with your clients about the benefits of home care should be part of any estate or long-term plan. The decision to start home care can be hard for families, but understanding the future consequences of delaying that decision can help put things in perspective.

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About the Author(s)

Manager of Business Development

As the Home Care Liaison/Business Development for Home Care Assistance of Pasadena, I assist clients and their families with aging in place. I have many years of experience in Business Development and care management for home care, hospice, and continuing care retirement communities (CCRCs). At Home Care Assistance, we care for those with dementia and partner with Silverado Memory Communities and the Alzheimer's Association. I am a resource for any senior care services with my network of referral sources.

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