Q: Dear Regina, My mum has dementia and cannot be left alone. She lives with my sister who takes care of her well. We have a close relative who is very ill and who we need to go and see as he is near his time. We cannot take Mummy. We wanted to put her in a home for a month but we find it to be too expensive. We are not sure how to find someone to stay with Mummy. What should we look for when trying to make these decisions?
A: This is a good question and a difficult one as the answer is individual and on preferences. However, there are some guidelines that you can take into consideration for both options.
For the community home most will offer: three meals a day; laundry and housekeeping service; management of medications; security and supervision 24 hours; assistance with personal care needs such as bathing, dressing, toileting and grooming. Some communities also offer activities and transportation. The benefit of this is that the community home usually has trained caregivers there. Ask about how they get their training. Most communities do in-house training. Not a bad thing, just ask what training programme they use. I would ask what dementia programme is used. Also give them as much information about your mum that will help them care for her. Take your mum there to stay for a night or two before you go so you can see how she does. If this decision has to be an emergency have a couple of friends check on your mum daily.
The cost can vary but think of how much it costs to run your own home between electricity/power, water, gas and all these little things that it takes to maintain a home including housekeeping and gardening. All these things take money and time to maintain. The charges are not unfair; however, it is unfair that a person cannot earn a decent wage to be able to pay for it. Here in the Caribbean the wages are below the average cost of living. It is unfair that a family has to sell “their parents” homes or assets to pay for health care or deplete their own income to pay for care. This happens all over the world. I do think there should be a better system to help with these costs.
When deciding to choose between community home or hiring private care with regard to cost, consider if your mother needs 24 hour care. In her case she does, so you then would calculate the cost of private care around the clock. Then decide if she needs medical assistance to determine if you need to hire a nurse caregiver or just a caregiver. I suggest you have at least one nurse involved to help keep things organized while you are gone. Make sure the nurse is well trained in dementia care so she can coach the others. How challenging is your mum? Can these carers care properly for her? Check their references or use an agency to help with finding good care. Interview everyone.
If you are doing this in a rush it is wiser to use a community home as everything is in place.
It is always best for people living with dementia to stay in their own environment however this sometimes is not possible. Choosing private help takes time. I do see benefits and challenges for both choices. I hope these suggestions will help you make a comfortable decision for your mum. It is not easy but do ease your mind that you are doing your best and that is all anyone can ask for.
What are the reasons someone would use respite care? There are a few reasons such as needing to take an emergency trip away from home. Others can be: you are so burnt out and desperately need a break from caregiving; a family event and vacation; your own health crisis and need time to recover before going back to caregiving duties; a trial for a permanent placement and the person you care for needs higher level of care to recover from a hospital stay before safely returning to your home.
It is also recommended that in stressful situations with chronically ill or dementia care, regular respite breaks gives you a chance to recharge your batteries. It will help you sustain your cargiving for a longer period of time. This is also a better way to keep your loved one home longer over a period of time because you are taking care of your health and social needs.
Your life and mine should be valued by not what we take, but by what we give. – Edgar Allen
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