Elder Care

The baby generation has begun the march into their silver years, their retirement years. These years in a person's life represent, too, the years when the body's betrayal of the mind, or vice versa, often result in an individual's inability to care his or her self during the post retirement years. These years have come to be referred to as the elder care years, because the care for the elderly often becomes the responsibility of the younger family members, children, or involves the institutionalization of loved ones. In either situation, the problems family members are faced with and the choices they must consider in resolving those problems concerning the care of their loved ones can be difficult and emotionally overwhelming. In some cases, taking care of an aging parent could mean the difference between giving up a career, and even moving to a different part of the country, or going "home" after years of being away. Those are probably some of the less emotional choices that are made early in the process of elder care. Later, depending upon the nature of the elderly person's condition, there may be choices that have to be made as a family concerning bringing help into the home, or placing the loved one in a facility that can help the family cope with the care of their loved one.

When faced with these kinds of decisions, there is a lot of information that a family has to consider before making these choices. This essay is an exploration of the conditions and the information that a family needs to have when faced with the conditions and choices surrounding the care of elderly loved ones. Some of the information dealt with in this essay is emotional, and it will be new and nightmarish information to some people. However, the aging population in America is increasing daily, and they are entering the final years of the life stage. Rashmi Gupta and Vijayan K. Pillai (2002) cite census bureau reports that help put the concern of an aging American population into perspective (p. 565). They say:

One of the most notable demographic trends in the American society today is the fast pace of population aging. According to 2000 census there were nearly 37 million Americans older than 65 years of age. This population is expected to more than double and reach 82 million by mid 21st century. As baby boomers begin the process of attaining elderly status by reaching ages 65 years or older, the number of elderly will nearly double from 40.4 million to 70.1 million between 2011 and 2030 (p. 565)."

The goal should be one that affords the loved one as much love, comfort, peace, and care as possible through the years during which they transition from life to death.

Disease and Debilitation Warranting Elder Care

The range of diseases and debilitating conditions that cause an elderly relative to need care range from debilitating arthritis, dementia, Alzheimer's disease, and other conditions which leave the aging adult in a state where they cannot adequately look after themselves. The activities of daily living (ADLs) are those day-to-day functions which, when the individual is unable to perform them because of physical limitation or condition, require assistance of others in order that the elderly person is able to bathe, dress, and have meals. When unable to perform these functions, elderly people find themselves relying upon relatives, or outside social agencies to help them.

Paula B. Doress-Worters (1994) talks about the role of women, and how their roles in a changing society have been evaluated in terms of employment, marriage and child rearing (p. 597). Doress-Worters says that the concept of elder care as a facet of the traditional role of women, which evolved from the post World War II nuclear family role of marriage, home and children, to the 1960s concept of employment, marriage, family; has now taken on the element of elder care (p. 597). While women probably did perform elder care in prior years, it is perhaps the emergence of the baby-boomers, who represent the overall population in the United States by millions who in the next five to ten years will be moving from employment to Social Security retirement benefits, and, in many cases, will be in need of elder care services as they do so. However, Doress-Worters explains it more succinctly when she says that the roles of women, who were the primary care givers of the family and home prior to the 1960s, were classified by a division of labor, and to include elder care as part of their defined labor routine was, in a sense, mixing apples and oranges by the social definitions that defined the role of women prior to the 1960s (p. 597).

Since the 1960s, the division of labor, by which women were defined, broadened in perspective, that perspective is broader today. However, today there is a myriad of choices and decisions that must be made as a family. Making those choices means facing the hard fact that a loved one is suffering an irreversible disease, and that the sense of the person family members once knew is slowly slipping away from them. These are difficult times for a family as they are forced to consider altering their own lives, in addition to the cost and the intrusion of outside help (Thorslund, Mats and Parker, Marti, G., 1994, p. 29). For many families, resources are limited, and those families must look towards the private and public welfare sectors to meet the needs of their sick family members.

In the United States, managed care has altered healthcare in a large way, and elderly folks are no longer allowed to go in and out of acute hospital care for conditions that cannot be improved upon (Birenbaum, Arnold, p. 59). If the condition that the elderly person suffers from is one like Alzheimer's disease, dementia, or terminal cancer, the patient must seek alternative levels of care, other than inpatient hospitalization, which is reserved for patient care that can be positively resolved. That drastically reduces the choices available to the family for the care of an elderly loved one.

The other options are long-term nursing facility, which is not covered by the elderly person's Medicare (Birenbaum, p. 14). The other choice is homecare, when an individual comes into the home and helps care for the laundry, cleaning, and preparation of food for the individual (Birenbau, p. 23). However, the number of hours the individual can provide the family, and the activities the individual is permitted to perform on behalf of the family is strictly dictated by Medicare and Medicaid (Medicare.gov, found online at (http://www.medicare.gov/LongTermCare/Static/Home.asp).The in home health care assistant, who is not a nurse or a certified nursing assistant (CNA), is permitted a certain number of in home hours doing these responsibilities. The in home assistant does not count toward the hours that can be provided an individual with a debilitating condition who needs an in home nurse or CNA visit (Medicare.gov, online).

Each of the alternatives to nursing home care or long-term care that allow an individual elderly person to receive in home care with the benefit of financial assistance carry with them financial and health milestone requirements that establish both the medical need and the financial need for assistance. In some states, there is a participation in a Medicare supported program called PACE, which allows family members to act as paid caretakers of their family members (Medicare.gov). This is no easy decision, because the family member(s) are giving up much of their own life to become the primary caregiver to an ailing parent, whose own condition is only going to continue to deteriorate, and, if improvement is seen, it will be momentarily, eventually ceasing to occur at all.

Eventually, as the elderly person's health deteriorates, it becomes necessary to consider a nursing home or long-term facility, or even hospice care. Any one of these options can mean the family has less interaction in the care of their loved one, and are less likely to be present around the clock. They then have to rely upon the institutional system of elder care to provide care for the aging and often times incapacitated loved one who is by this time completely reliant upon others for most of their ADLs. In these instances, there is a need to be keenly aware of the situation of elder abuse that is seemingly prevalent throughout the long-term and skilled nursing facility settings, and even in the home are levels of care being rendered by family members.

Elder Care and Abuse

Elder care abuses occur in every facet of elder care, and it often goes unreported by elderly family members whose condition has caused them to have less contact with the world in which they live, and which for the most part in their life revolves around them on the outside of the home, not the inside living areas where the abuse occurs. Even an elderly person living…