How can we coordinate a care plan for my parents who have vastly different caregiving needs?

1 answer | Last updated: Jul 19, 2010
Worried daughter asked...

My parents are in their 90's. My mom has dementia, is blind, and wheelchair bound. My dad has prostate cancer and severe vertigo. Their care needs are not the same, so in order to avoid separating them, they have continued to live independently (in an apartment with daytime sitters to care for mom, cook, and clean). Now, they are facing a financial dilemma since they have depleted their nest egg (the profit from the sale of their home). This nest egg had bridged the gap left by my dad's social security and mom's retirement income.

Most of their income goes to paying for the sitters/caregivers. They face separation due to my dad's lack of nursing needs. My mom qualifies for a nursing home and then some. Still, my mom knows when my dad is there and is greatly disturbed by his absence. What do people in their situation do?

Expert Answers

Mary Koffend is the president of Accountable Aging Care Management (AACM), an eldercare consulting and care management firm that works with elder clients and their families to find the best care providers and services to meet their needs.

Dealing with the different caregiving needs of couples is often a very difficult situation. The needs of each spouse for medical and social services makes placement in a single type of facility often impossible. Couples who have been married a long time usually do not want to be separated under any circumstance and this again complicates the decision and options.

Many families do keep their parents in an independent living environment with paid caregivers in order to keep them together. Often one or both members of the couple suffer with unmet social needs, but the desire to be together takes priority. There is usually a medical crisis or issue that precipitates a change.

When the change event occurs, one option to consider is to move the couple to a facility that offers multiple levels of care on the property. This is not a continuing care community in which the person must usually move in when still able to live independently. The type of property to consider is one in which there are rental options for independent, assisted and nursing care all in one area. These properties often offer their own caregiver company who will provide services in increments of one to two hour increments at a very reasonable rate. This allows one spouse with the assistance of a caregiver to go and visit the other spouse at least once or twice daily. There are also some nursing care centers who will allow both members of the couple to move into the same room.

Obtaining the assistance of a geriatric care manager as a coach and expert about the services, facilities and costs can be a great help in navigating these options. A Geriatric Care manager is usually paid privately for their knowledge and expertise. The persons who are part of the national association in your area can be accessed through the Gilbert Guide from this site or go to .