Part 2 covers the pros and cons of Adult Care Homes for older adults needing care. You’ll gain insight into specifics of care provided and the personality of residents best suited to care homes.
Adult Care Homes: The Relational, Non-Institutional Option
Meet Carolyn and her dad, Bill.
Carolyn’s dad, Bill, had a stroke and couldn’t live alone anymore. At first, Carolyn thought about bringing him home to live with her. But she soon realized how difficult caring for her dad would be: she didn’t have the physical strength to help with his transfers, her bathroom wasn’t accessible, and she would have to quit her job; Bill needed someone nearby around the clock.
Carolyn felt bad. She felt she was letting her dad down because years ago her frail grandmother came to live with the family. Her dad and mom made sure grandma’s last years were surrounded by family. Carolyn’s dad always said that’s what he wanted someday if needed. Carolyn felt she wasn’t living up to the family’s expectations.
Guilt, Guilt and more Guilt
Carolyn was racked with guilt. She stressed over thoughts of her dad having to stay in the nursing home. He hated it there and complained non-stop about the noise and food. Carolyn spent hours researching ways to remodel her home, find home care workers and estimating costs. She wanted to meet Bill’s expectations, get the best care for him and use his finances wisely.
Profile of a Care Home Resident
Carolyn met with a referral agency to discuss the options. They recommended an Adult Care Home because this care option matched Bill’s personality and care needs.
The referral agency introduced Carolyn to several care homes nearby. She liked them all but felt especially comfortable with one home and had the caregivers go meet Bill at the rehab center. Bill agreed to “try it out.”
Bill has developed close relationships with his caregivers and the other four residents in the home. In Adult Care Homes the caregivers live in the home with the residents. There aren’t shift workers coming in and out. His caregivers know and understand him because they care for him every day. They anticipate his needs and respond quickly to help with unscheduled care.
Bill isn’t interested in bingo, bunco, and billiards. He prefers quiet conversations in small groups, reading his books or watching his programs. He likes sitting on the deck and watching others work the garden. It reminds him of his gardening days.
Bill’s health care needs are significant but stable and predictable – his caregivers can manage his medical care. He’s confused at times because of the stroke but he’s not up at night or wandering.
Settled In Now
Carolyn feels relieved having her dad close-by, receiving competent, heartfelt care. She can stop by and visit him often, take him on outings or bring him to her home for family occasions.
The funny thing is, Bill doesn’t usually want to stay at Carolyn’s house for long visits. He wants to “get back home,” he says.
Things You Should Consider
If you’re considering an adult care home for someone you love, here are some things to consider.
Medical & Health Considerations
Anyone moving to an adult care home must be medically stable; with blood pressure, pulse, temperature, and respiration in normal ranges for at least 72 hours. Infections must have been treated with antibiotics. Wounds should be dressed and follow up medical care scheduled. Diabetics must have blood sugars under control and predictable.
Because care homes have a higher staff to resident ratio they can usually manage more complex medication management regimes. Also, staff can meet frequent “hands-on,” unscheduled care demands better than a larger facility.
Social & Activity Programs
Care homes are best suited for people, like Bill, who don’t want to participate in lots of group activities. Because care homes are smaller and quieter settings, they’re sometimes unsuited for active, “social butterflies.” If someone would benefit from a robust activities program, then a larger community might be a better choice.
The smaller environment of a care home means people needing close supervision are usually better served. Someone who isn’t safe, unattended, behind closed doors, for at least two hours, should consider an adult care home. The trade-off for closer supervision is smaller personal space: a bedroom versus an apartment in a larger community.
Also, if a person isn’t reliable in recognizing they need help, doesn’t call appropriately for help and won’t wait for help to arrive, should consider an adult care home.
Night Care & Behaviors
Care homes are required to have a caregiver on premises at all times. However, a care home is family-style and caregivers need to sleep at night. They respond to infrequent calls for help and will often do a room check once during the night. Sometimes homes can manage frequent night care because there’s more than one caregiver and they take turns staying awake. But be aware, most homes can’t provide awake staff for frequent unscheduled caregiving. If your loved one absolutely needs frequent night-time assistance, be prepared for extra charges or consider a different type of care setting.
Residents who act out, are combative, exit seeking or exhibit severe social behaviors, may not be a good fit for the smaller setting of a care home. Each situation should be evaluated on an individual basis. Contact a senior referral agent for help.
Care Home “House Rules”
Each home sets their own house rules regarding outside smoking areas, accepting resident pets and visiting hours. If your loved one has a pet they can’t part with, finding a care home will be challenging because most homes don’t accept resident pets. Most larger communities like assisted living do allow pets.
Because care homes are smaller and more intimate, maintaining respect for all residents’ privacy is important. Older people tend to retire earlier so late visits should be avoided. Most homes ask families to avoid visiting at meal times because the residents tend to focus on visitors and not their meal.
If you have an odd work schedule, a large extended family who frequently get-together or want to visit your loved one late into the evening, be sure to discuss these with the provider. Larger communities usually don’t have visiting hours.
Adult care homes are the solution for a non-institutional, relational, family-style environment for care. Making sure a loved one receives personal and medical care in a home-like setting gives family’s peace of mind. It’s the next best option to bringing your loved one home to live with you.
Referral agencies have previewed and pre-qualified the care homes in your neighborhood. Call an OSRAA member today for help.