Weighing it up - home or residential care?
Sometimes the main reason for needing residential care is the difficulty associated with managing a specific problem at home.
It is important to know that specialist clinics can offer expert assessment and management advice on a range of complex conditions including:
- Memory problems;
- Challenging behaviours;
- Continence issues;
- Falls, balance and mobility problems;
- Pain management.
Usually there is no cost involved. Your hospital doctor, GP or the Aged Care Assessment Service (ACAS) will be able to refer your family member, so don't be afraid to ask. When a specific problem is resolved or able to be better managed, the need for residential care may not be as urgent or necessary at all.
Carefully weigh things up
Even though very dependent people can often remain living at home, decisions about residential care need to be carefully weighed up. Open discussions with the person you care for and other family members are important. Here are some factors to consider.
Your own health
Your own health and any limitations this might have on a caring role should be taken into account. Health and well-being includes physical, mental and emotional health. Talk to someone you know and trust and listen to what your family is saying. Most carers put their family member's needs before their own, often to the detriment of their own health. An objective view can help.
The care demands
The type and amount of care and support that your family member needs must be considered - as well as your ability and willingness to provide this.
Help needed might include:
- Physical assistance: walking, eating, showering, dressing;
- Health: managing medications, health checks, therapy;
- Transport: getting to and from appointments;
- Prompting: compensating for problems with memory;
- Supervision: assisting to remain safe and out of harm;
- Emotional support: calming, encouraging;
- Home care: cooking, cleaning, laundry, shopping;
- Social activities: outings, keeping up friendships.
Community support services can help meet these needs, but most of the responsibility still lies with carers. Think carefully about the level of commitment you can offer, taking into account your:
- Current commitments (e.g. to family or others in your care);
- Financial commitments (e.g. to a mortgage and hence work);
- Future commitments (e.g. to study or a growing family).
Decide what you can and cannot take responsibility for. This helps to identify the gaps and is a good starting point for your discussions.
The support available
Caring can be rewarding and satisfying but at times, tiring and demanding. A range of supports is often needed which may include:
- Respite care;
- Home care and personal care assistance;
- Community nursing;
- Community care packages.
Contact your local Aged Care Assessment Service (ACAS) for information about the range and availability of support services in your area. Phone 1800 500 853 for contact details.
Be aware of the expectations your family has about future care. Some families will never consider residential care. Some make assumptions about who will be the carer. This may stem from cultural, religious or personal beliefs and can make decision making difficult. It's important to make decisions about future care based on the best interests of both your family member and the carer.
Your own resistance
Some carers say they feel like they have broken their marriage vows when no longer able to care for their spouse at home. This is an incredibly difficult thing to deal with and can sway your decision making. The support of family and friends at this time is essential. Another vow often made by carers and families is to always provide care at home and not consider residential care. This may be a difficult promise to keep - even with the best of intentions. Trust you will have done the best you could for as long as you could.