Elder Care Options––

Seniors Explore Ways To Stay In Their Own Homes

By Dottie Evans

“Choices. They are what keep us going.”

Most senior citizens nodded their heads in agreement June 19 as Dawn MacNutt, a social worker with the Bethel Visiting Nurse’s Association, spoke these words to a group of Newtown seniors during a roundtable discussion of elder care options.

The discussion was the fourth and last in a series of health educational programs sponsored by the senior center on recent Thursday afternoons.

The topic was a subject on all their minds. How to stay in their own homes and be as independent as possible for as long as possible, even though there might be physical and emotional issues that arise, as well as health issues that need attention.

 “A lot of times when we need help, there aren’t people around to advise us. You might need to make decisions by yourself, and you’ll need to think about the various possibilities ahead of time –– before you actually think you are ready,” said Ms MacNutt.

As she and the seniors traded questions and answers in an informal setting, it became clear that there were, indeed, many choices out there concerning ways to help an elderly person continue living independently.

The seniors were given handouts explaining the options and Ms MacNutt walked through each case, adding comments and answering questions as they arose.

Home Health Aide

A home health aide assists patients with activities of daily living such as getting in and out of bed, walking, bathing, toileting, and dressing. Some aides have special training and are qualified to provide more complex services with the supervision of a nursing professional.

“What a home health aide does is more like what a homemaker does, as in doing the dishes, cleaning up and helping sort and organize the medications according to necessary schedules of doses, and so on,” said Ms MacNutt.

“This person might assist you in getting up from your bed and into your chair, in taking a bath, and the like. These are not considered skilled needs, where a nurse would be required.”

Homemaker/Chore Aide

These workers may perform light household duties such as laundry, meal preparation, general housekeeping, and shopping. Their services are directed at maintaining patient households rather than providing hands-on assistance with personal care.

“You might need them for only an hour a day, or for four hours a day, and you should find out what the rates are,” said Ms MacNutt.

“Do your homework. Will they be charging $9, $15, or $16.50 per hour? Is there a minimum amount of time per day that this person would have to come?”

She also said that at any time, if the client does not feel comfortable with the home health aide or the homemaker/chore aide, and would like to replace this provider, it is perfectly within the client’s right to do so.

“Don’t feel like you have to continue with someone that you don’t like. If you don’t feel you are getting the services you are paying for, you should contact the agency and tell them,” she added.

“Remember, these aides are not there to make conversation. They don’t do windows but they do a lot else.

“One lady said the health care worker wanted to bring along her baby. Absolutely not! You don’t want to be taken advantage of,” Ms MacNutt noted.

Skilled Nursing

Registered nurses (RNs) and licensed practical nurses (LPNs) provide skilled services that can only be performed safely and effectively by professional personnel. Some of these services include injections and intravenous therapy, wound care, education for disease treatment and prevention, and patient assessments.

“Often, after surgery or medical care, a patient needs help in the home and this is covered under Medicare for nine weeks. Be sure there is an overlap, that you have the homemaker/chore person lined up to start before the nurse pulls out.”

Social Work

Social workers evaluate the social and emotional factors affecting ill and disabled individuals and provide counseling. They also help patients and families identify available community resources. Social workers often serve as case managers when patients’ conditions are so complex that coordination of a variety of services is required.

“This is what I do,” said Ms MacNutt.

“I go out into the home and evaluate the situation for health and safety. Are there grab bars in the bathrooms and near the stairs? Is there a raised toilet seat? Is there a gas stove, and have you checked it for leaks?

“Often family members, working with a social worker, can help solve a lot of these problems.”

Hospice

Hospice is a model for quality, compassionate care at the end of life that involves a team-oriented approach to medical care, pain management, and emotional and spiritual support. Hospice is the belief that everyone has the right to die pain-free and with dignity and that families will receive the necessary support to allow them to do so.

How To Get Help In An Emergency

There are other ways to manage on your own that are available to many elderly people if they simply take the needed steps.

For example, a neighbor who knows your comings and goings should be given the name of your doctor or a person to call if they become alarmed, if they do not see you when you are usually out and about.

Then there is the Lifeline system, which is worn around the neck, enabling a person to call for help if he or she falls. Lifeline may be provided by the American Red Cross, which also has volunteers to drive clients to doctors’ appointments.

CancerCare is an organization that helps people get to and from their chemotherapy or radiation treatments, she added.

“And if you do use Lifeline, be sure you wear it all the time, day or night. And be sure you have a phone near by your bedside or even on the floor. The portable phones are good because they can be carried around, but you’ve got to remember to put them back in their cradles so they can recharge.

“And there is always the whistle. It’s simple to use, cheap and effective.”

Continuing Care

Retirement Communities (CCRCs)

The CCRCs are an alternative options that people who are no longer able to manage at home may want to look into. Each resident pays a substantial entrance fee and monthly fees in exchange for a living unit and services.

The amount of long-term care included in the contract, the type of living unit chosen, and whether one person or a couple occupies the unit can also have an effect on costs.

If a CCRC does not have a health center on campus, it will often have an arrangement with a nearby healthcare facility to admit its residents on a priority basis.

Ms MacNutt concluded the discussion with the observation that “as many services are out there, there aren’t any services out there!”

In other words, there are often areas of service and clients’ needs that cannot be covered all the time and in every circumstance.

“But it could be so much worse. So I urge you to so the research before you get sick. Know what questions to ask. If we put some of these systems or options in place while we are younger and feeling better, we’ll be glad later on,” she added.

Social Worker Dawn MacNutt welcomes inquiries and would be glad to speak with anyone who is concerned about these issues. She may be reached through the Visiting Nurse Association of Greater Danbury at 792-4120.