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Live-In Care: Adjustments Along the Way

Live-In Care: Adjustments Along the Way

Long ago I learned that if something happens to one our clients — it’s happened to millions of other people too. Hope this story answers some of your questions.

Keeping Dad home safely

Last week Devon and I met with a daughter of a 94-year-old client with a live-in caregiver. She lives hours away and calls Dad twice daily, every day. “Jane” adores her father and his recent decline has been difficult for her. Jane wants to keep him home until he dies — she knows the familiarity of his home will be a comfort. We are working with her to accomplish this kind ending to his life.

Jane’s dad has been our client for over two years. Until recently he was forgetful but knew he was home, he was continent, slept through the night and enjoyed going outdoors. His emotional and physical needs were a perfect fit for live-in care. He wanted to stay in his home and not move to a facility. He needed someone in his home 24/7 to get him meals, help him with hygiene, make sure he took his medications and be there in case something happened. Hourly people running in and out was not an option — too confusing and difficult for him to make relationships. He needed the consistency of a live-in caregiver.

Adjusting to each stage of the journey

This summer he became incontinent; he didn’t want to go out and was having intermittent “spells” which kept him and his live-in caregiver up at night. Exhausting for both of them, being up through the night made it difficult for the caregiver to be emotionally present during daytime hours — the hours of greatest enjoyment for him. This caregiver has a gift. She connects with Dad despite his drifts deep into dementia and she thoroughly enjoys him. He enjoys her and feels safe and loved. It came time to change the care to match his greater needs.

An increase in dad’s cares needs – adding overnights

The addition of overnights came when Jane visited. Dad was up several nights in the two weeks prior to Jane’s visit AND all night preceding her visit. Dad’s caregiver was exhausted but Dad seemed his bright former self; day two dawned on a confused and cranky man who didn’t know his beloved daughter. He’d given Jane his all the first day and his mental reserves were gone. This was so hard for Jane to accept but it matched her experiences of him on her twice-daily phone calls. Her dad was having lots of mental ups and downs and Jane knew her dad needed his caregiver to be bright and loving during the day; it was an easy decision to bring in hourly caregivers to cover the overnights.

Acknowledging a decline

Jane’s visit confirmed the reality of how much his condition varied. He had good days but bad days were intermittently and increasingly occurring. Jane reached out to her dad’s primary care doctor who in turn felt this deterioration warranted closer oversight to ensure her dad’s comfort at home. He suggested Hospice; a Medicare benefit that would pay for weekly nursing visits, medications, a hospital bed and other various needs.

The transition to hospice happened but Jane found that she didn’t feel on the same page as the hospice nurse’s declaration of an increased decline; she was uncomfortable with some of the medication suggestions so Jane hired a nurse geriatric care manager,   Mary Kay Krokowski. Mary Kay assessed her dad’s situation and made suggestions regarding medications. She understands the situation and is now available to Jane to help negotiate the labyrinth of her father’s end of life care.

Dad is stable for now

Dad is still safe and comfortable at home. He has good days and bad days. His caregiver adores him and he feels the same way about her. They “get” each other. His caregiver can sleep every night knowing Dad is safe and someone is there to re-direct him if he wants to get out of bed. Other nights the overnight caregiver stands out of his sight while he rustles around in bed. Will he get up?? There aren’t any plans to move him to a facility for a higher level of care.

If you’d like to know more…Call us at A WAY TO STAY Home Care. We happy to talk about your home care needs and point you in the right direction if we can’t help. A WAY TO STAY is a home care agency providing In-Home Care in Yardley – Newtown. We are Live-In Care Specialists.

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Our Contact Information:

A Way to Stay
1596 Quarry Road,
Yardley, PA 19067
(215) 321-5100

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