Syndicated columnist Hy Gardner once said, “You know you’re getting old when everything hurts. And what doesn’t hurt doesn’t work”. Although funny, it is also true. As we age, we experience changes, our heart works harder, our skin gets thin and feels dryer, harder to see and hear, and bones become more brittle. It’s a reality no one wants to face but yet cannot stop. Along with the typical declines that come with aging, deteriorating physical and mental health can play a factor in whether an individual can live completely independent. For families, this is a challenging time. First, seeing the decline of a loved one is difficult and sometimes is replaced with denial, questioning the reality of what is happening. Watching the slow deterioration of an aging loved one can bring stress and fear for the family, as well as anxiety and depression of the loved one. Second, the family wants the best for their loved one and knows something must be done but doesn’t know what. When is it time for home care? What are the benefits of home care? And is home care affordable? Answers to these questions can provide relief and guidance during a stressful time.
When is it time for home care?
Seniors fear the loss of independence more than they do death. Therefore, they might not be honest about the challenges they are having at home or with driving. It’s essential to know the common signs someone might be struggling with typical daily routines. Here are seven signs a senior might need help with home care:
- A Decline in Personal Hygiene. Going a week or more without bathing, forgetting to brush their teeth, untrimmed nails, and unkempt hair may indicate the person has challenges with taking care of their personal hygiene.
- Change in Eating Habits. Any changes in eating habits, including disinterest in food, barely eating, or an empty fridge can be a sign that help is needed. Proper nutrition is critical to support wellbeing and can slow declining health.
- Unexplained Bruises. Bruises in older adults frequently occur because their skin has become thinner with age. Another reason may be from vitamin deficiencies or certain medications. It is a good idea for the older person to seek medical advice to determine the root cause. If the bruising is from typical aging, the reason may be from changes in mobility or indicate falls.
- A Change in the Condition of the Home. A significant change in housekeeping routines, stacks of unopened mail, or a buildup of trash could indicate that the person cannot complete these tasks independently.
- Under or Over Medicating. Over 55% of seniors do not properly take their medications. Studies indicate up to 30% of all hospital readmissions are due to medication non-adherence. If a loved one forgets to take their medication or take incorrect dosages, this could cause adverse effects on their health.
- Change in Reasoning, Memory, and Judgement. A senior may show signs of increased confusion or loss of reasoning skills when asked a question or in a light conversation. Normal age-related memory loss is typical as we age. Memory loss that disrupts a person’s ability to function in daily activities can be early signs of something more serious. Cognition is a process in the brain that includes learning, remembering, and making judgments. When cognition is impaired, it can impact a person’s health. Cognitive decline can range from mild cognitive impairment to dementia.
- Decreased Mobility. Walking, balance, and mobility are typical concerns with seniors. A fall can trigger many health problems. According to a study in the Journal of Clinical Epidemiology, one out of three older adults (65+) falls each year, but only half talk about it with a healthcare provider. Decreased mobility can be one of the most challenging problems that older adults face and create many challenges for families.
This is not an all-inclusive list but should provide enough information for families to start asking the right questions on what is best for their loved one.
What are the benefits of home care?
First and foremost, home care can assist with all seven signs mentioned above, plus more. In-home care services include personal care, meal preparation, light housekeeping, medication reminder, companionship, mental stimulation, and assistance with transferring and walking.
Since the pandemic, home care has been highlighted as an option many had not previously considered. To be able to age in place has always been the desire of senior adults, but often they are not aware it is truly an option. The comfort of home has long been proven to create a better healing environment and promote a sense of continued independence. Home care allows the family and the aging loved one to make independent choices about their own care. The home care agency and family can work together to provide a positive experience for everyone and the best care plan for the loved one.
Is home care affordable?
Genworth’s Cost of Care Report estimates the national median monthly cost of in-home care (40 hours per week) is 8% less than an assisted living facility in 2021. As a comparison, home care agencies assign a dedicated caregiver to the client, providing 1:1 care compared to assisted living which is designed for individuals who require little assistance daily. Individuals in assisted living facilities needing long-term daily care could be elevated to a nursing facility which can be up to 49% higher than home care. In-home care is less expensive and allows individuals to stay in their own homes with their own caregiver.
There are many options for paying for home care. Private pay is an option for the client or family member(s) who have the means to pay out of pocket for the care. Long-term Care Insurance and Medicare Advantage can also help pay for home care. For low-income seniors, Medicaid waiver programs are available to provide funds for needed care. The VA’s Pension with Aid and Attendance is a benefit for low to moderate-income war-time Veterans and surviving spouses. This lifetime earned benefit can also help pay for home care. Veterans Care Coordination assists Veterans and surviving spouses through the application process, has a program to get the care started sooner, and once approved, continues to work with the recipient so they can keep the benefit for as long as needed.
A couple dealing with an ailing parent was once told, I am sorry you are being forced down this journey. For most families, this is how it feels. Aging family members who are struggling with activities of daily living can be a scary journey but does not have to be one traveled alone. Recognizing signs that a loved one needs help, understanding the options available to pay for the care, and reaching out to experts to help navigate the journey provide the best possible outcome for the aging senior.
 CDC, Subjective Cognitive Decline – A Public health Issue