What To Do When Mom (or Dad) Gets Old And Can’t Live Alone? When Mom (or Dad) gets old and becomes frail, other family members are faced with how to care for her. This isn’t an easy problem to solve, given that today many family members who act as caregivers, usually females, are employed, there are fewer of them to share the responsibility, and many who could provide some care live too far away to help. For those that do try to care for their parents, life can become a tangled mess. Unscheduled trips to the grocery, doctor and department stores conflict with children’s baseball games, other planned activities, and important family events. Frequent telephone calls at the office about unimportant things often mask Mom’s fear of being alone or need for someone to talk to. Although much thought and care is expended on getting the most reliable caregivers, Mom often finds them unsatisfactory, or worse, invents stories of lost items, cash and other things in order to get them fired. So the question becomes one of choices: what is the best thing to do? Mom may want to stay in her home. If she doesn’t need a lot of care, but it is difficult to take care of her needs during the day because the caregiver is employed, it may be possible to arrange for her to go to an adult day care center (about $30-$40 a day: in some cases, may be covered by long-term care insurance). When necessary, meals can be brought in. Transportation and other services that will help keep her somewhat independent can be provided on an as-needed basis. If she needs more extensive care and is willing to have outside help, the other family members may have to agree to chip in and help pay for someone to come in and take care of things that Mom can’t do (costs can run from a few dollars to over $500 a week depending upon the services required: some services may be covered by long-term care insurance). This solution works fine as long as Mom cooperates, there is enough money to pay for the help, and Mom doesn’t need a lot of physical assistance or professional support. But even with all of this, Mom may not be able to continue to live alone. While she may not be so impaired she needs to go into a nursing home, she may need more attention than can be provided in her own home. If this happens, family members will have to search out other alternatives. When the need arises, Mom may want to consider a continuing-care retirement community(CCRC), a congregate living facility, or an assisted living facility. A continuing-care retirement community would provide her with security, the company of others in planned activities, in-house meals, laundry, and other care, including some medical care. CCRC residents, on average, live in a facility for about nine and a half years. But cost (very expensive) and lack of facilities (not available in all communities) may cause Mom to have to forgo this type of arrangement. A congregate living facility would provide a room, perhaps shared with another person, meals, laundry, 24-hour supervision, and some on-call nursing and/or medical services. While this could be a much less costly ($1,000 to $1,500 or more per month) arrangement for Mom, it might fall short of her real needs. On average, residents remain in this type of facility for about three and a half years. An assisted living facility would provide Mom with a safe, homelike environment, where she would be encouraged to be as independent as possible, but would have adequate help with the basic activities of daily living (ADLs) -- eating, bathing, walking, dressing, toileting -- (about 75 percent of those living in assisted living facilities require some assistance with ADLs) and also with medical problems. She could take part in planned social activities, receive her meals together with other residents or, if needed, in her room, have laundry service, and be able to use transportation services if she wished to shop or just get out for a while. In order to become a resident of an assisted living facility, Mom would have to meet certain entry requirement regarding her state of health, finances, and behavioral characteristics. Costs, which average about $70-$80 a day, range from about $1,500 to over $3,600 a month. About 90 percent of the cost of assisted living is paid from private funds. For this reason, many older Americans are buying long-term care insurance, which may pay for needed care in an assisted living facility that meets the policy’s requirements. With more people living into their 80s and beyond, assisted living is fast becoming the most popular of the options we have listed. Perhaps it is growing so fast because it provides residents with a comfortable and homelike surrounding, and helps them remain independent as long as possible. They are not treated as patients, and are able to age with dignity. Larger facilities are often able to house residents with conditions such as cognitive impairment or other special needs in separate wings or residences. Because this is a relatively new industry -- it got its start in the early 80s -- it is hard to find a true definition of assisted living. States have different degrees of regulation, supervision, and quality standards. Prospective residents and their families will want to spend time at a facility and get good recommendations before committing to a living arrangement. The average length of stay for most residents of assisted living facilities is about two years. Over time, about 44 percent of residents do transfer to a nursing home.
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