Wednesday, 26 September 2018

Care Partner Wednesday--Never Say Never

"I'll never put my mother in a home."

I've heard these words many times over the years. They're often said with conviction and a
sanctimonious air that doesn't invite dialogue. There are many hidden messages in these eight words, and although not all of them may be intended, some definitely are.

In some cultures, it's considered dishonourable to not care for your elder in your home, and anyone who chooses a different route could be shunned by their relatives. Disapproval and anger may result. I understand that. I'm not referring to cultural differences, but the unspoken message in those words:

"If you put your elder in care, you are abandoning them."
"My choice is better and more honourable than yours."
"Caring for an elder at home is always the best choice."

Whatever the conclusion a care partner comes to, you can bet agonizing hours went into the decision, so let's stop judging each other.

When Home Care Is Best

Home care has the benefit of the familiar. The elder can stay in surroundings and with people who are well-known and not have the upheaval of moving. It works best when there is plenty of family, friends and other supports for the primary care partner. It's helpful to have a combination of respite care, such as a program or regular classes that the elder attends every week, or care that comes in. Help with bathing and other routines keep the tasks from becoming overwhelming. From the care partner's perspective, there must be plenty of support in various forms.

From the elder's perspective, they must not be isolated. This is one of the greatest hazards of home care. Often care partners still need to make a living, families are busy and the elder has no opportunity to spend time with their peers. Mobility and other health issues may make it difficult to get out, even with help. Their world shrinks and what was supposed to be the best possible choice becomes a prison.

As they come to the end of their lives and reach a palliative state, there are more challenges. Palliative doesn't necessarily mean they are end-of-life, but they aren't going to recover, and there are often multiple physical challenges. Doctor's appointments, specialists, treatments--how are these accomplished? Bringing in nursing care is exorbitantly expensive. As the bills and the worries mount, what is the care partner to do?

When Community Care Is Best

By community care, I mean living in a community in a situation where medical help is always present. This might be long-term care or a private care home. In this situation, medical support is always available, and your elder has the benefits of a community where they can connect with others of their generation.

Long-term care as I know it leaves a lot to be desired, but if this is the only option financially, the care partner can and should still be active. Advocate for care that is person-centred. Be there often to provide not only companionship but alternative activities. Get to know the professional care partners and join in with whatever is happening.

My dad chose to move from the home he had always known and the community he lived in for all his adult life and moved in with my sister hundreds of miles away in Manitoba. Although it was his choice, it wasn't the best one. He never saw his friends or many of his family again. I was only able to visit him once a year. My sister worked full-time, and although her family reached out to him, he was isolated. As his dementia and care needs increased, it became evident that this wasn't working. A new care home opened a few miles away, and she moved him there. She was able to visit often, and when I visited, I entered into the life of the home and helped peel potatoes for dinner! He was a favourite among the staff, and when he died in his sleep about a year later, everyone missed him.

The message is clear. Care needs and deciding what is best is complex. Sometimes the decision needs to change. There are many factors.

Don't judge.

Care PartnerWednesday--Never Say Never

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