As couples age together, the older they get the greater are the chances that one will grow more frail than the other, needing more care.  This will represent another phase of their relationship that will have to be negotiated and will present difficult choices. Naturally, the hope is that they will grow old gracefully in good health and be able to live out their days in the comfort of their own home.  Even if one isn’t faring as well as the other but the healthier of the two is able to manage caring for them both, they will both be better off staying in the home.

But what happens when the load gets too heavy?  At what point does the healthier of the couple decide they can no longer care for their spouse at home? There are no easy answers to these questions, and it will vary from couple to couple depending on a variety of factors.

Ideally, they will be able to hire assistants to come in and help. Managing the assistants will be a job in itself and will require financial resources, but is the best solution if circumstances allow. However, when the time comes that a decision will have to be made about placing the spouse in a residential care facility it will be necessary to know what the options are, and how it will affect the relationship.

Together or Separately?

Inevitably, one of the factors that will have to be weighed is whether or not the abler of the two will want to remain with their spouse. This will partly be determined by what kind of care the other needs, what kind of facility will be appropriate, and predictably, what kind of resources are available.

Options: Board and Care

We spoke with Shay Williams, owner and director of Accent on Seniors, an assisted living community in San Clemente, California. Discussing the different types of assisted living options, she pointed out that aside from skilled nursing, there are roughly two types of assisted living facilities, ranging from large resort-style communities to smaller board and care types.

Recognizing the Need

The older you get and the longer your parents live, the higher are the chances that you will someday have to assume the care of your elderly parent (or other elderly loved one).  You will be faced with the decision of what kind of care will be best for them, and it will have everything to do with your own life’s circumstances. To be sure, it will be one of the most difficult decisions you’ll ever have to make.  But armed with knowledge and a little foresight, the process will be far more successful and smooth.

When an elderly parent reaches a point in life where they are no longer able to care for themselves, they may or may not realize the time has come. This is a person who has lived an entire life making decisions for themselves, has raised children, and even owned and cared for a home of their own.  The inability to carry on with the tasks of daily life represents the loss of independence in a person who has for a lifetime prided themselves on their ability to manage the complexities of modern life—something most of us take for granted.

This realization is frequently met with denial if not outright hostility when the parent is confronted by an adult child who feels a transition needs to be made. In this situation, it is very helpful to have the backing of the parent’s doctor or medical team who can act as an intercessor and make the recommendation. Elderly people will often respect the opinion of a doctor before they will heed the advice of a well-meaning child.

Considerations for Decision-Making

When the time comes to make the decision about what kind of care will be best (in-home care, assisted living or a nursing home), it will depend upon a huge variety of factors. Among the contingencies are the health issues of the elderly person, their financial condition, whether or not they are married and the health conditions of their spouse, and their location. Will they need full-time, 24/7 supervised care, or are they able to be on their own for short periods of time? What is the condition of their mental state? These considerations will intersect with what your realities are. Do you work full time? Do you have children? Are you married (meaning do you have extra support?)? Can your home accommodate your loved one?

One Woman’s Tale

Suzanne Calhoun was faced with these questions after her 78 year old single mother went through a failed back surgery and subsequently received an Alzheimer’s diagnosis. The anesthesia from the surgery left her mother in a severe state of dementia, and after six weeks in a rehabilitation hospital/nursing home, it became clear that she would be unable to care for herself. A decision had to be made quickly about what would happen to her mother.