Home Care Compared to Nursing Home for Your Loved One

As we grow older so do our parents. Making the decision to have home care for your ailing parent or to send them to a nursing home can be difficult to make. Many times elderly people don't know what to do when that time comes and they leave the decision to a single child or to all their children. Making such a big decision is a personal choice and to be made independently, not by the advice of others, but some thoughts and suggestions can be made in the decision process.

First I will review hospice, because this is my first choice. I have worked both fields and cared more for home care. Every person's situation is different and this may or may not be the best choice.

How Hospice Works: When your elderly parent is terminal, usually from cancer, heart problems, or liver problems, hospice provides nursing staff to come to the home of the patient. Besides registered nurses hospice provides caregivers, some are even volunteer caregivers. The registered nurse will set the patient up with their medications and treatment. They will help the patient by providing comfort care during their final months. They will teach family members and caregivers how to provide medical treatment and personal care when hospice is not available.

Advantages: The dying patient has the comfort of having the comfort of being in their own home or the home of a loved family member. There also tends to be more family and friends who can come and visit. Small grandchildren can come and say goodbye without family worrying about their children catching a communicable disease from another patient. If the child becomes restless, as they typically do, there are other rooms in the house for children to go into and would not disturb the patient. Many people don't like to visit hospitals and nursing homes because they have an overwhelming feeling of death and that is hard to accept. In the home, the atmosphere is more relaxed and tends to bring more of a celebration of life feeling. Family can come and enjoy a meal next to their loved one, play a record, watch a movie, or just sit and talk with them in a quiet room. The patient's children feel confident that they have a sense of control because they are a part of the dying process. Even when they have round the clock caregivers they still have choices as to the direction of care they would like to see. Each family member can come to a private room without disruption to say their good-byes. The patient sometimes needs to say their last thoughts and feel more comfortable and confident in doing so in the home. There is the ability to do so because there is more one-on-one care given and there is someone there to listen and hold a hand. For the family members, hospice provides death and dying social workers to help family members cope with the process of death and they can walk you through the process. When the patient finally deceases, hospice will provide post-mortem care. This allows the family member to grieve without feeling embarked with necessity. Plus, sometimes it is too much for family members to see their loved ones exposed and revealing through the cleaning process when the patient is no longer alive. It can feel like you're violating their privacy because they are no longer alive to reject.

Disadvantages: Hospice and home care is expensive and time consuming. Family members are required to put their life on hold. They have to either take a leave of absence from work or are required to find caregivers to come and take care of the patient when they can't. Your life is always on-call. You cling to your cell phone when you are away waiting to know whether they passed away or something happened to them. Sometimes, it's a matter of getting a certain food or a re-fill of medication. Taking care of an elderly parent is exhausting. If there is no caregiver at night then you are up throughout the night changing briefs, providing a bed pan, providing water, emptying a catheter bag, or giving medications. There is no less work at night as during the day. Many times, family members hire home caregivers to help with the care. But when they live in the home with the patient, the anxiety and stress does not allow much time for relaxation. There is the constant need to provide care even when there is someone else to do so. Sometimes, the pressure of home care can be so overwhelming that family members become angry. This is more typical than many people realize. The family members become angry at their dying parent, other family members, and caregivers, anyone whom they can redirect their feelings towards. Depending on how care is provided, home care can be expensive. Many times, hospice care is covered by insurance but when the need for extra caregivers is required the cost increases. If family members can arrange a schedule to sit and care for the patient the cost will be decreased when in comparison to a nursing home.

Nursing homes are meant to be for family members who are ailing but not terminal, although, the patient may remain there when they become terminal. Nursing homes vary in the type of care needed. There are skilled nursing facilities where the patients range from rehabilitative care, assisted care, and terminal care. The age varies among the patients some may have health conditions such as early dementia, drug overdose, and car accident recovery. Some patients are mentally disabled such as mental retardation and some are quadriplegic. Assisted living homes are meant for patients who are no longer able to care for themselves in entirety but are able to care for their own personal care. They may suffer from Alzheimer's or dementia, and may just need some reminders on eating, toileting, and bathing.

Advantages: The elimination of personal responsibility and stress is a major factor in considering nursing home care. Family members can resume their daily living routine without the disruption of caring for a loved one. Family members can rely on a variation of competent staff members, a clean and safe environment, and appropriate medical care. The nursing homes provide care such as personal care, spirituality, physical exercises, and social atmosphere. There are many activities that are offered to the patient in the nursing home which is usually not provided to them in home care. Patients have an increase of stimulation which decreases depression. There are also many people whom they can talk to without feeling burdened or embarrassed as to when they communicate with family members. Nursing homes provide clean linens and clothing laundering, food preparation, and medical care. There is always a nurse available and a physician a phone call away. There are spiritual counselors to comfort them with their upcoming death or the death of a friend.

Disadvantages: In the nursing home environment, the patient's caregivers are overworked and underpaid. Some may be disgruntled with the fact they have to care for someone else's family member. Some caregivers feel a sense of comfort in knowing they are helping someone who is unable to help themselves. In the nursing home atmosphere, the choice of caregivers is determined by administrators and not by family members. There are usually too many patients and not enough caregivers that particular care is overlooked. There is not always enough time for the caregivers to complete their tasks and care for the patient appropriately. My advice with nursing home care is to be actively involved to make sure all needs are being met. Many of us would like to think that nursing homes are great for both the parent and the family members but this is not always the case. When in a building with many other sick people the chances that your parent will get more than what they came in for are more likely. Some caregivers look as the patients as inhuman just as soldiers look at the enemy during war. Although, the caregivers don't treat the patients like the Nazi's treated the Jews or the Japanese treated the Chinese during World War II, many personal and mental care issues are overlooked. Making sure you have a good and decent nursing home is expensive. The cost will be worth it in the end. Many family members tend to also neglect the fact they have a loved one in a nursing home and tend to visit infrequently. This leaves the patient feeling abandoned and betrayed by their family. When this happens, it tends to stay with the family members throughout the rest of their life. They realize their betrayal of abandonment and personal neglect and it can leave them with a sore spot on their own death bed.

You have to understand that even though this option may be your only one. They are in the nursing home to die, just as they are with home health care. Some people decide to use the nursing home as an alternative until they are terminal and then to switch to home care. Whatever your choice, and it is your choice, I hope you consider these options thoroughly with whatever choice best fits the needs of you, your family, and your loved one.