Unfortunately, it is impossible to create a standardized time frame regarding end-of-life or long-term care since it varies case by case. While there are signs and symptoms that allow people to predict the direction that someone’s health is going, many individuals begin long term care after a sudden life change that leaves them unable to care for themselves at home. One day, they could be healthy and the next, there could be a stroke or fall. In the best-case scenario for a situation like a stroke or fall, patients return home after successful rehabilitation, but more often than not, patients are unable to fully recover. When this happens, depending upon the severity of the person’s impairment, they are either taken care of by family members or moved into an institutional setting.
About 80 percent of seniors receiving long-term care remain within a private home (either their own or a family member’s), and the remaining 20% are moved into facilities. Each situation has pros and cons and what is best for one individual may not be the right choice for another. Those who remain within their homes are often eligible for home-health services to aid family members in their responsibilities. According to the AARP Public Policy Institute, the elderly population in nursing homes has declined over the past ten years with more people receiving care at home, living in assisted living, or being taken care of in group homes. Nursing homes are generally preferred if a person needs 24-hour supervision.
Long-term care, a general term, refers to the type of assistance provided for people with cognitive or physical limitations. Caregivers provide patients with the care needed to complete daily activities. If patients are unable to remain at home, facilities continue rehabilitation to try and strengthen patients and improve their quality of life. Not only does a more functional patient ease the burden of the caregiver, but the more a resident can do by him or herself (eating, using the bathroom, bathing, and changing), the happier they generally are. As age and illness advance, it is important to not have unrealistic expectations since people start to naturally decline.
Typically, long term care is not paid for by insurance companies so cost is definitely a factor when deciding what is best for your loved one. Even with 80 percent of elders receiving care through informal caretakers such as family members, there is still monetary value attributed to this “donated” care. The time spent caring for a loved one could be spent employed elsewhere with wages. There are also transportation costs to think about since an informal caregiver performs duties otherwise performed by paid healthcare aides. It is therefore important to reach out to a social worker as there are benefits that caregivers may not be aware of in their home state. Some states provide a stipend to informal caregivers while other states grant special benefits. Planning ahead and purchasing long-term care insurance can be a good option for many families. Even without this type of insurance, many facilities, especially hospices, charge on a sliding scale. In some states, there is no fee at all beyond Medicaid coverage. See here for eligibility guidelines and a list of Medicaid rules in your home state.
From long-term care, people unavoidably move toward end-of-life or palliative care, and when a loved one makes the transition, it is not about giving up or hastening death. Rather, it is about making death as comfortable and painless as possible. Many people mistakenly believe that admission to a hospice facility is determined by a life expectancy of six months or less, but this is false. Palliative services exist to relieve emotional or physical pain and to manage symptoms.
Before getting to this stage in life, it is crucial to have a written and notarized document, declaring how your loved one would like the end of their life managed in case they become unable to make decisions for themselves. Without preference information available in one’s medical records, it becomes harder on families in a time when things are already hard enough. Thankfully, people live in a time when long-term care and end-of-life care have made one’s later years more comfortable.
Max Gottlieb is the content editor for the Arizona Long Term Care System (ALTCS) and Senior Planning in Phoenix, Arizona, USA. Senior planning is a free service that has helped many Arizona seniors and their families navigate the process of long term care planning. ALTCS and Senior Planning find and arrange care services as well as help people apply for state and federal benefits.