Going Home Again

A typical situation an older couple may face is that one of them has a serious medical event that puts them into the medical system for treatment, rehabilitation therapy, and then discharge to home. In a large number of those cases, the spouse going home needs help with the activities of daily living (ADLs) such as bathing, dressing, eating, toileting, and safely transferring from bed to chair. They may also need support with meal preparation, medication management and mobility around their home. From long experience a huge majority of those folks want to do it on their own, with help from their spouse, and believe they can do it. For many, that is not reality and increases the chances that both will end up needing help for long term care. Here are some thoughts.

First, the healthy spouse, who is also up in years, will be worn down by the constant physical and mental effort of giving care. That is no good for both spouses, because if the healthy one suffers from the physical and mental strain, the result may be both spouses needing care and forcing one or both of them into a nursing home. The answer, which is not always easily accepted, is to get help from an outside source. That help may be with housework, physical care, or simply monitor the ‘sick’ spouse, daily routines and movements so that the ‘healthy’ spouse is not constantly on alert and doing a full load of household tasks and giving care which over time will wear the healthy spouse out. Accepting the fact that one person cannot give all that care is the key to keeping both spouses at home.

A home health aide can relieve the physical stress of trying to feed, bathe, dress and monitor the daily needs and movements of a spouse with physical or cognitive problems. And in many cases, the issues are both physical and cognitive. There are many providers for such care, and in Connecticut there are also many programs that can help pay for that care. Don’t get me wrong that the rules for eligibility are simple, as they aren’t, but for the typical husband and wife, it is doable and the care is there. Most people think they can do the care by themselves, but day after day of the stress of doing all the work by themselves, constantly giving care to a spouse, will take its toll. It’s been said that the only worse thing than one sick spouse, is two sick spouses. No one is immune from the idea that they can do it alone. For a while, they can, but the clock will be running and getting care into the home is the answer.

That does not mean it has to be a live in caregiver, as in many cases daytime coverage may be enough. But if the sick spouse does not sleep through the night, that means neither spouse is getting the rest needed to function well and stay healthy. That is when an agency or live in caregiver is critical. If you are the healthy spouse, you must be realistic about the need for help to keep yourself healthy, so that neither you nor your spouse will have to go to a nursing home. If you are a child of such an elderly couple, use every ounce of perseverance to get your parents to accept in home healthcare, for both their sakes. That is a great return for all the years of love they gave you.

Attorney Stephen O. Allaire is Of Counsel and Attorney Halley C. Allaire is principal in the law firm of Allaire Elder Law, members of the National Academy of Elder Law Attorneys, Inc., with offices at 271 Farmington Avenue, Bristol, (860) 259-1500, or on the web at www.allaireelderlaw.com. If you have a question, send a written note to either attorney at Allaire Elder Law, LLC, 271 Farmington Avenue, Bristol, CT 06010, and they may use your question in a future column.