Anyone who has ever been involved in eldercare knows it is a journey filled with ups and downs. Our family’s bumpy eldercare journey has been set in the unique times of COVID-19.
Of course, the journey started years before with the many small ways we took care of our elderly father. However, he was fairly independent–at least physically. Dad lived in an Independent Living community for several years and alternated time there and at his partner’s apartment. His memory was worsening, but he managed well with his set routine. As we started seeing more weight of care being put on his partner, we brought in some help to check in on him and his medications. But, generally our interventions were of the practical variety, handling his bills and overseeing things.
COVID and an Eldercare Crisis
Well, the coronavirus pandemic coincided with Dad’s own crisis. He’d likely been having mini-strokes (TIAs) and the start of vascular dementia. However, it seems he had another (bigger?) TIA and he also fell. Suddenly, his partner was calling saying she could not get him out of bed. And, of course, being the early days of the pandemic lockdown we could not fly there to check on or arrange things. Dad could not return to his Independent Living Facility due to restrictions (and would have needed extra care anyway).
We realized we had to get in some help pretty quickly. We contacted a home care agency and connected with their Care Coach. They were able to quickly arrange some morning caregivers for Dad. Immediately, this was an improvement as he was finally getting out of bed. At first, we only had caregivers a few days/week but we all quickly realized Dad needed help daily. He started gaining some strength back as he began getting up and eating better. Based on our timeline/information, our Care Coach suggested a visiting physician that could help evaluate Dad. They found he had a UTI and started treatment.
Putting Together a Plan
We began formulating a longer-term plan with our Care Coach. Clearly, the burden on Dad’s 90-year-old partner was not sustainable. And, the situation was not ideal as she complained a lot about the caregivers being in her space. He was isolated–of course, everyone was at the moment–but wouldn’t be in the long run, hopefully. Ultimately, we determined the ALF associated with Dad’s ILF was where he’d need to be.
It was so helpful to have a sounding board outside of the family, and with expertise in all aspects of eldercare. She listened and gave us valuable input. Even the smallest suggestions often made a huge difference. Plus, she immediately knew the types of resources available.
Additionally, she saved us a lot of time not going down unnecessary paths. For example, we heard about some programs that might help financially. She quickly explained that Dad would qualify medically, but also needed to meet financial criteria. Oddly, when we had called the program they had told us Dad would not qualify medically but mentioned nothing about the financial criteria. The person we spoke to had not really listened to us and seemingly was too embarrassed to bring up finances (or made assumptions). Our care coach sent us some links and we quickly confirmed it wasn’t worth pursuing. At some point, it may be but it was something we didn’t need to spend time on when other priorities were more helpful for Dad.
We began talking to the community staff about how to manage the transition. Everything was a bit different due to COVID. Dad could now go back to his original apartment, but without any family there to visit/help. He’d need to quarantine in his apartment. Then, he could be evaluated for admission to the ALF. Clearly, he would need continued private caregivers during this period. He actually needed more care, even when he was with his partner, but certainly now that he’d be alone.
The agency did not cover this area but our care coach was able to continue helping us. She assisted in finding an agency and setting up the 24-hour care at his apartment. Dad’s partner’s family drove Dad home. Since no one could come in with him anyway, his partner did not go. We debated about this, but our care coach brought up the fact that this may actually work out for the best. And, it did.
Dad did pretty well back at his apartment. Our Care Coach, along with the agency staff, helped us manage the 24/7 care. She made some simple suggestions that helped things go smoothly. From how to be sure information was communicated amongst different staff and to us to ways to simplify his routine.
At one point Dad started having extreme back pain. We all determined he really needed to go to the hospital. We were nervous. How would it go? Would Dad become more confused or agitated? How would we get information and be sure staff understood his memory issues?
Fortunately, our Care Coach was there to help. At first, a doctor mentioned the idea of some surgery. But, our Care Coach helped us ask the right questions and seek alternatives. At age 95 and with his medical status, surgery just did not make sense. But, we didn’t want him to live in pain. We conferred with the doctor, who was in agreement and made some recommendations. Dad did surprisingly well in the hospital and returned home in less pain. But, he needed to quarantine for 14 additional days.
The Transition to Assisted Living
Our Care Coach helped us arrange the evaluation day. Dad’s caregivers took him down to the ALF. She arranged a call beforehand so we could give information to the ALF staff. She gathered a comprehensive report from his various caregivers. We (me, my brother, our care coach and the ALF manager) reviewed Dad’s current status and needs. Together with their in-person evaluation, they understood what he would need. They suggested starting with his current schedule of caregivers for the first week and then re-evaluating his level of care.
Next, we wondered how we would logistically handle the move from afar. Not to worry, our Care Coach suggested a senior move manager. If we’d been able to be there, we probably would have just assumed we’d do all this. But, what a difference it made to have a professional. She set up Dad’s room at the ALF so it felt like home and knew just what would fit. She went through items with us to determine what to store until we could visit to go through it, and arranged the storage unit. When she sent photos, I teared up with relief as it looked so nice and familiar.
Dad’s caregiver took him to the ALF and helped him settle in. He was a bit agitated that evening, complaining about the meal and a bit confused. But, most likely he was just exhausted. He never really complained about the move…to him, it seemed sort of like another hospital visit. He mentioned something about “being at the hospital” once to us. From the 2nd day, he never brought that up again or ever wanted to “go home” or anything. We call him every day. His memory varies, but he is always in good cheer.
Steering through the Challenges
But, this is reality. Though things have gone surprisingly well, there have been some bumps all along. A couple times Dad has been pretty unpleasant with the caregivers in the mornings. After one particularly bad morning, we began to worry the facility would kick him out. I called our Care Coach and she reassured us and helped us come up with a plan. We asked the caregivers to adjust the schedule slightly. And, we told them they didn’t need to push him if he was tired or grumpy, though we preferred he got up and ate meals with others (though currently in a small room and distanced) when possible.
We also found that a couple new caregivers seemed to have little information about Dad. They were not putting his back brace on and didn’t know his routine. Our Care Coach arranged a quick call with the home care agency to confer about his care. She suggested some of the things she usually recommends and got everyone on board with using their electronic portal properly to manage the care plan. We found that things that were supposed to be happening were not. Fortunately, having such a strong care team, we find and can troubleshoot these issues early.
We also didn’t get the communication we were expecting from the ALF. We had not heard from them about possibly reducing his caregivers’ hours. So, we reached out to them to schedule a care plan meeting. We actually got a letter in the mail about his level of care when this was supposed to be discussed at the meeting.
Though we are strong advocates for Dad, we sometimes don’t know what to ask and how much to push. We appreciate the care staff and want to handle all of this with understanding. It has been a relief to be able to run everything by our Care Coach. And, we are lucky that we get along as a family and can divide up tasks. I imagine her help would be even more necessary if that were not the case.
Eldercare Success=Dad Being Content
We are realistic about Dad’s situation. He is declining and will have ups and downs. Dad may have bad moments and rarely remembers what happened earlier in the day.
But, we recently got to visit after almost 6 months (an outdoor, distanced visit with masks). Dad looked good. And, most importantly, he seems happy. He plays Bingo, despite some hearing problems. And, he enjoys his meals. As the facility becomes less locked down, we hope there will be even more socialization opportunities. Though socialization has certainly changed for him. He does now eat meals with an old friend who lives there. But, when we ask him if they chat, he tells us, “No, he doesn’t say much.” He talks to his partner on the phone briefly, but they both don’t bring up visiting right now.
The best move we made was finding the right professionals to help us. As I’ve shared, this does not mean they are always perfect. But, we know they have our family’s best interests at heart. And, this whole situation has been so much better for the help they’ve provided.