Before an older adult moves in, consider her health and whether you have enough space
When an older relative or close friend needs daily care, moving her into your home can be a good solution. But home care is also a huge undertaking -- for you and for her. Before you commit to being a home caregiver, you need to realistically assess what's involved. Here are some essentials to consider beforehand:
- Start with a medical consultation. Before you make any major decisions about home care, the person's doctor should weigh in. He can tell you what kind of care she will need and whether it's practical for her to live at home.
- Factor in emotions. Leaving her own home and needing care from others is a significant loss of independence that can be depressing. It's possible she'd prefer to stay in her home and hire a caregiver there if she can afford it.
- Do you have enough room? If you're moving someone in you'll need a bedroom -- or at least a comfortable place for her to sleep or rest. If you don't have a spare room, can you move family members or furniture around to make space? Is it feasible to build an extra room or an in-law apartment? Talk with her beforehand about what the arrangements would be.
- Consider space for equipment or supplies. Do you have room for a hospital bed (which is bulkier than a regular bed), commode, oxygen tank, or other medical equipment if needed?
- Think about accessibility issues. Do stairs and narrow hallways make maneuvering a wheelchair or walker difficult or impossible?
- Plan for bathing. For safety reasons, older adults who are weak or have balance problems might only be able to bathe in a bathtub. Others need a freestanding shower stall with handholds. Adaptations can often be made.
- Is there peace and quiet? Is your home calm and quiet? If not, can she tolerate all the action?
- Assess needs for privacy. Will the new arrangement give everyone in the family enough privacy?
- Can you accommodate overnight caregivers? Is there sleeping space for a paid overnight caregiver if needed? This can usually be in the same room as the older adult if need be.
Dealing with finances and support when an older adult moves in
Before you invite an older adult to share your home, it's important to consider what expenses will be involved, whether you'll need to work fewer hours if you're the primary caregiver, and whether you can hire enough extra help or get unpaid help from others.
- Will you have to cut back on your work hours or other commitments? In some cases, providing home care is only possible if you, your spouse, or another family member leaves a job, works reduced hours, or gives up other commitments. Can your family afford that?
- Consider paid caregivers. Caring for someone in your home is sometimes only possible with the help of paid caregivers, which can be expensive. Factor this into your budget or the budget of the person you're caring for.
- Plan for home upgrades or accommodations. Consider the costs of remodels or expansions, safety-proofing, or making your home wheelchair accessible.
- Assess caregiving support needs. Daily care requires hours of labor. Many people use a combination of family members, friends, and paid caregivers to handle it. Are you comfortable building and managing a network of caregivers? Will friends or family members pitch in and help you on a regular or occasional basis? This is especially important if you can't afford hired help.
- Consider the impact of outside caregivers in your home. How do you and the person you're caring for feel about having paid caregivers in your home? Some people are fine with this; for others it's uncomfortable.
- Plan for breaks. All caregivers need time off, and sick days are inevitable. Any care plan should include backup for caregivers, including you.
- Can you get private time in your house? Many people need regular downtime in their home. This can be tough when an older adult lives with you. How important is this to you? Is there backup care for her from time to time?
Emotional and scheduling issues when an older adult moves in
It's easy to underestimate how exhausting caregiving can be if you've never done it for an extended time. It's also unsettling for an older adult to have to give up her way of life and adapt to someone else's, no matter how close she is to the family whose home she shares. If you think carefully about these issues ahead of time, it'll help you decide whether sharing your home is a good idea.
- Consider your own feelings. Caring for an older adult or relative can be draining, especially if she's very sick or experiencing dementia. Add to this the stress of changes in schedule, routine, and finances. Do you think you can handle all of this emotionally, and do you have the support you need?
- Consider the older adult's feelings. Include her in decisions as much as possible. How does she feel about moving in with you? What will make it easier for her? Pay close attention to her opinions and ideas. Make sure she feels included and as in control as possible. Her participation will go a long way toward making home care work.
- Think about family dynamics. Spouses, kids, and grandkids are all affected by this kind of major family move. Having a relative or other older adult live with you is usually a mix of rewards and challenges. Think honestly about what might change for your family. How will your spouse deal with it? Consider holding a family meeting or two to discuss changes, fears, and expectations.
- Face up to the reality of intimate care. Daily care can include personal tasks such as bathing, dressing, toileting, and feeding. Some people are more comfortable with this than others. You may want to hire paid caregivers for some or all of these tasks.
Time and schedule demands
- Does home care fit your daily routine? Consider your work and leisure activities. Do you have wiggle room in your schedule? Are you OK with cutting back on your activities if necessary, including volunteer work or what you do for fun?
- Plan for getting the person out and about. Will you be able to manage getting her to medical appointments, to the senior center, or to visit friends and relatives? Will you need to drive her everywhere or can she use public transportation or paratransit? Are there reliable senior transportation or paratransit services your area?
The choice is yours -- and hers
It's important to remember that there's rarely one perfect solution for providing daily care. For every family it boils down to weighing and balancing many factors to settle on the best option. Most families adjust to change over time.
Moving an older adult in is a great choice for some families and simply not workable for others. If it's not for you, you can still help her find a workable solution. Other options to consider include providing care in the person's own home or assisted living.