By Barbara McCann
I ran into an old friend, Joyce, at a college reunion a few years ago and she looked so worn out. She shared that her mother-in-law, an active, vibrant 85-year-old, had come for a visit, fallen and was briefly hospitalized. Her return to Joyce’s home started a cascade of exhausting events that Joyce and her husband, Jim, were absolutely not prepared to handle. With their own demanding jobs and active family life, they were at their wits’ end, largely because they lacked the knowledge to navigate the health care system.
Unfortunately, as an in-home health care expert and chief industry officer for Interim HealthCare, I hear stories like Joyce’s every single day. People tend to avoid these tough “life conversations” and not get details about their loved one’s health care plans. But if families talk now, they will be far better prepared to care for an elderly family member when required. Here are four tips for being financially and emotionally ready at the precise moment you may be at your most stressed and vulnerable.
• Ask specific questions about all insurance policies: Where are they stored? What contact information would you need for them?
• Research now what's covered by insurance—and, more importantly, what's not. Someone who has been hospitalized, for example, will need physical and emotional attention 24/7 when they get home.
• Plan (and even save) for extra help at home, around-the-clock if necessary. Ask specific questions about when and how long nurses and aides paid for by insurance will actually be there. Think about how you'll handle unattended time, including nighttime hours, when family caregiver rest is essential.
• Anticipate a loss of muscle strength after hospitalization. Activities of daily living (getting in and out of bed, toileting, getting dressed and fixing meals) may require significant help.
For my friend Joyce, the conversation with her mother-in-law never happened. Life was busy and Mary was healthy—until that fall. After three days in the hospital, Joyce's mother-in-law returned to the couple's home with bruises, a sprained wrist and significantly reduced muscle strength. Joyce and Jim thought Medicare would cover everything, but it didn't. Mary needed help all night long, and Medicare only covers an aide a few days each week and doesn't provide for nighttime assistance. Jim would help Mary to the bathroom but it was uncomfortable, so Joyce was needed too. All three were up nearly all night.
Jim spent hours collecting information from insurance companies and private agencies about in-home care. But when we bumped into each other at the reunion, I was able to talk to Joyce about options available through Interim. In less than six months, Mary returned to independent living with regular care through us.
Even if Interim isn't your first choice, know that studies show 82% of senior citizens want to age in their own home and 8 out of 10 patients have improved clinical outcomes with in-home care. It’s far more cost-effective to age in place as long as there are no around-the-clock medical needs.
Families need to discuss now exactly what they want and can afford before emergency strikes, blindsiding them with the emotional, financial and physical toll of caregiving when they are least equipped to handle it and make sound decisions. The trick to a successful caregiver experience is advance planning.
An in-home health care expert and industry source, Barbara McCann is chief industry officer for Interim HealthCare. A former chief clinical officer, she currently represents the company with national and local health policy and health care quality organizations to support the highest standards for quality care delivered in the home.