Home Care or Care Home—A Caregiver’s Decision

Hamlet may have contemplated life and death in his famous phrase, “To be or not to be,” but dementia caregivers often find themselves pondering choices that, at times, seem just as severe:

To bring their loved one into their home or to look for someplace else for them to receive care?

In my new book, Caring for a Loved One with Alzheimer’s or Other Dementia: Everything I Wish I Had Known, I delve into a variety of things to consider before committing to provide home care. The list is extensive.

Effects on the Caregiver’s Own Family

• What’s the impact going to be on the caregiver’s spouse if “Mother-in-law” or “Father-in-law” has to move in and requires full-time care?
• If the caregiver is part of the “sandwich generation,” how are the caregiver’s own children going to feel about having a grandparent with dementia living in the home?
• For this to work, everyone in the house needs to be in agreement

The Caregiver’s Duties

• If you bring a parent into your home, or if you’re trying to care for your spouse in the home, you can wind up being on duty 24/7
• You will need to “dementia proof” the home as much as possible
• If your loved one can’t be left alone, you must make arrangements for someone to stay with them when you need to be gone
• If your loved one can’t drive anymore, you become the chauffeur responsible to take them to—
  • Doctors’ appointments
  • Dental appointments
  • Physical therapy appointments
  • Hair appointments
  • The bank
  • The grocery
  • Church
  • And the list goes on…
• According to Caregiver.org, 70 percent of caregivers who work outside the home suffer work-related difficulties because of their dual roles (being both company employee and caregiver). Just taking a loved one to all of those appointments could be brutal on a work schedule.

Medical Issues

Medically speaking, there can be a lot for a caregiver to do on any given day (and these don’t even include the activities of daily living such as bathing, grooming and dressing). On the medical to-do list, the caregiver might have to:

• Clean and bandage wounds
• Clean up after incontinence
• Check blood sugar levels
• Use hypodermics to administer shots
• Administer eye drops or clean out ear wax
• Deal with the dementia patient’s Sundowning mood issues
• Perform CPR—and do you even know if your loved one’s bones are strong enough to withstand chest compressions if they were needed?

Caregiver Health and Wellness

Are you aware that the Alzheimer’s Association’s “2019 Alzheimer’s Disease Facts and Figures” report indicates that in 2018, caregiver healthcare costs were impacted by the stress of the caregiver duties to the tune of $11.8 billion? It’s not uncommon for caregivers to get so wrapped up in providing care for their loved one that they actually stop doing things to care for their own health. This can spell disaster for the caregiver’s loved one. Consider this: who will take care of the dementia patient if something happens to the caregiver?

I urge would-be caregivers to consider the “cost” of caring for a loved one in the home in order to decide what is ultimately best for everyone.

• Have an honest discussion with anyone who lives in the house with you; allow them the freedom to express how they feel about bringing the loved one with dementia into “their” home
• Talk with your loved one’s doctor to determine exactly what kind of care you’ll be having to provide in order to safely keep your loved one in the home
• Examine your budget to see if you can afford the cost of adult daycare so you can get the breaks that are necessary to keep you healthy

Caring for a loved one in the caregiver’s own home can be a wonderful thing to do, but it must be started out on the right foot. The caregiver needs to understand all that’s involved before making the bold statement, “Sure, I’ll do it!”