About the SeniorAdvisor.com 2014 In-Home Innovation Scholarship: We started the scholarship program to bring awareness of the unique benefits and challenges of in-home caregiving for seniors to younger generations. The questions posed by the scholarship encouraged our nation’s future caregivers to present solutions for improving home care in the United States. College-aged students were required to answer one of the three essay topics below and provide a short bio as part of their scholarship application. Read the winning essays here.
What is the top challenge facing in-home care in your city, and what is your proposed solution?
Essay response by Maria Pfund
We all know someone who is older, and we can learn a lot from older people, who can share with younger generation the wisdom of their lives. Therefore, it is important to make sure that they are living in a healthful environment while being respected and accommodated for all their needs.
In-home care is a popular option for elders for its flexibility and specialized services, it covers services from house cleaning and shopping to skilled nursing services – e.g.: inserting tube feedings, catheters and breathing devices (Consumer Reports, 1995, p. 660). This is typically the preferred housing option by elders according to AARP which states that nine out of ten Americans older than 50 desire to remain living in their own homes (Philpin et al., 2011). On a positive note this option avoids big transition and challenging adaptation at old age while providing sense of independence and autonomy to elders but at the same time there is minimal regulation of such services, varying level of professionalism in attendants and unreal expectation of it being a cheap alternative. This option is covered by Medicare only if the individual is homebound and need skilled care intermittently (Consumer Reports, 1995, p. 660). Medicare covers part of custodial personal care too, but beneficiaries need to prove the need for a skilled service (Consumer Reports, 1995, p. 660). Also Medicare limits the amount of money per individual and Illinois (where I live) along with other states limit the number of people who can receive this health care benefit. The statistics reported from Consumer Reports (1995) analysis of data from different providers of home care found that 30% of the agencies did not develop a care plan which encompassed all relevant diagnoses, services required, prognosis, nutritional requirement, medications and treatments as well as basic safety measures to ensure the safety of their patients and in spite of this common practice and other careless service, the Health Care Financing Administration decertifies approximately just ten agencies per year (p. 660).
After analyzing the information gathered on In-Home care, it is obvious that there is no perfect match because as everything else, it comes with positives as well as drawbacks. In-home can be stressful for the family and elders may negate the help or get into arguments because they may feel they do not need much help. In-home care supervised by family members and maintaining communication with both the elder and personnel, understanding his/her needs and being present the whole time are the best ways to support people in their older years.
Families need to plan in advance how the last years will be spent instead of waiting for the decision to be at the last moment during the crisis. Irrespective of the housing option selected, nutrition should be enhanced by providing the senior person the foods that he/she can eat and enjoys because food and drink are more than sources of nutrition, they have deep symbolic meanings which could help people stay connected to their roots as well as socialize and enjoy themselves.
To conclude, we need to remember that frail older people have very specialized needs and requirements in terms of long term care services and family caregiving (Hallberg & Kristensson, 2004). Therefore, to decide where to spend the last years of one’s or a loved one’s life individuals need to take into consideration their values and expectations and gather as much information as possible from different places because there are no cookie cut guidelines to determine who belongs where; therefore, as a whole, we all need to be familiar with resources to empower family members to do their own research so as to make intelligent and effective choices.
Maria is pursuing a graduate education in Nutrition/Dietetics.