Most of the help provided to people in long term care situations is provided by family, such as a spouse, a child, even grandchildren, nieces and nephews. However, this can be at substantial cost to the relatives’ quality (and quantity) of life.* Sometimes adult children have to give up their jobs, scale back to part time, and/or spend more time away from their own families in order to be able to provide long term care. Additionally, it often creates bitterness and conflict among siblings when one or two individuals carry a disproportionate share of the burden. This can occur for a variety of reasons such as geography where the closest one carries most of the burden. It can also be due to differences in capacities or skills to provide long term care, the caregiver’s role in the family, or how well the caregiver gets along with the parent.
In Home Care
Alternatives to having family provide care, family are much better suited to manage care and perhaps give some of the care themselves with assistance from others so that the care responsibilities they undertake do not mean they need to rearrange their entire lives. In-home care can be purchased privately with people you know, by placing advertisements or through agencies. A good agency will have all their staff licensed and bonded, may provide them some training and may even go so far as to provide some oversight of their staff. This can make the process alot easier than trying to hire someone off a craigslist ad, though I have seen people have moderate success in this way as well.
Day Care Facilities
Day-care facilities are another way to give family care-givers the time to manage the other demands on their time and tend to their own personal needs. Day care work much the same way that it works for children, except its for the elderly. You bring the elderly person to a day-care facility, where they care for them during the day and usually give them lunch & snacks. At the end of the day you pick them up. You pay a fee for this which normally goes by the day and usually there aren’t any requirements or commitments of time required on your part. You can use them on an as-needed basis.
Assisted Living Communities
Assisted living facilities (RCFEs) vary widely by size (2 or 3 on the low end, vs hundreds on the high end), price, services rendered and populations that are catered to. For instance, there could be an Asssisted Living community that specializes in memory care, while another might have a small assisted living section attached to a rather large independent living community so that nobody has to move very far if and when their health deteriorates.
Nursing homes are usually a last resort and only used when someone requires medically skilled care on a regular basis. This can also be the most expensive type of care, though medicaid (in California Medi-CAL) may pay some or even all of the costs of this type of care.