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Caregiving

When a Loved One Needs Long-Term Care

Introduction

It may be the most difficult decision you ever have to make. A spouse, parent, or other family member can no longer live independently, and the care needed to enable her or him to remain at home is not available. This may be a temporary situation, which can frequently follow an acute illness, hospitalization, or injury. It may be necessary when usual caregivers are drawn away by an emergency or simply need to get away for a break. Or it may be necessary on a long-term basis when the loved one declines physically or mentally.

Types of Care

The array of care facilities now available can be very confusing. Choosing the right one depends on the level of care needed, and on doing a good job of investigating the possibilities.

Assisted-living facilities, personal-care homes, and retirement communities are all names of facilities that provide for people who are nearly independent, but for reasons of either mild physical or mental impairment, need some help with tasks like cooking, housecleaning, or shopping.

Most assisted-living facilities have on-site staff who can assist with medications and are available 24 hours a day for problems that come up. They either have on-site care, or they contract agencies that can provide personal attendants, nurses, and physical and occupational therapists on an as-needed basis. Often they provide congregate meals and a number of social activities. Most residents of assisted-living facilities are able to perform their own self-care activities like dressing, bathing, and eating. Some facilities are either contiguous with, or have arrangements with facilities that provide higher levels of care should the resident become more impaired, but others require residents to move when they become too dependent.

Subacute care units are designed for a patient's continued treatment in a setting where the intensity of care is less than that in a hospital setting, but still provides continuous registered nurse supervision. An example would be the need for extended intravenous antibiotic therapy for some types of infections. The development of subacute care has been driven largely by attention to cost containment and the desire to limit extremely expensive hospital care.

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