Deciding to place an elderly family member in a nursing home is often the hardest decision an adult child can make. Sandwich generation caregivers with children or grandchildren at home who are also taking care of an aging parent can reach the end of their rope, forced to choose who has to leave. I am sympathetic with the struggle yet feel I must contribute to the dilemma with information that can only make it harder. Two news items this week are factors. The Wall Street Journal reports that 15 states are cutting IHSS funding. This is the Medi-Cal (Medicaid) funding that pays for caregivers to come to the clients home to provide for the activities of daily living that they are unable to do for themselves. This includes cooking, cleaning, bathing, toileting and medication management. Folks with just a little need may only get a few hours per month, while someone totally disabled can get fulltime care. It lets those who choose to age in place get the help they need to do so. Family members are often the provider and so it can help extend the extended family living situation. It costs less than half as much to keep a person at home with this level of care than to go to a nursing home.
The other article was a study done in the city of New York on older adult suicides. Apparently the rate of suicide is dropping among community dwelling older adults.
The surprise was that the rate of suicide among nursing home residents did not decline from previous surveys. There is a difference in method among the two groups, community living elders are more likely to use guns, where as nursing home residents, who may have access barriers to firearms, die from ”long falls” most often. I had been under the impression that carbon monoxide was more frequent than jumping, but at least in New York it isn’t.
So it is becoming harder to keep a failing senior at home, and the risk of death is even greater in skilled care settings. These are reasons that I recommend a care giving family member make use of resources like Leeza’s Place and the Alzheimer’s Association. Feeling like you are all alone and desperate make it all the more likely that the choice to place will be made earlier than if a caregiver has a support system.
Los Angeles Caregiver Resource Center at USC: (800) 540-4442, www.losangelescrc.org
Alzheimer’s Association: 24 helpline (800) 272-3900
Leeza’s Place: ywyte@leezasplace.org