You know that taxes are due in a few days, right? OK, just thought I’d mention it.
And, no. I’m not so easily distracted that a minor hiccough like “taxes” could derail me from the true purpose of what we’re doing! Yeah … OK … Here’s what we’re doing:
The question was, “Who will do all the stuff that needs to be done, if/when I can’t do it (and there’s no family)?” And it seemed to me that the “stuff” came down to three things:
1. Medical decisions, in case you can’t make your own;
2. Long-term care/help at home, and …
One crisis at a time; and the next crisis is No. 2, so a reasonable question could be, “What does that even mean?”
Well, “help at home” could mean exactly what it sounds like it means: I need some help to get something done, that needs to be done, like vacuuming — laundry is another perennial favorite — but it could be cooking or shopping or housecleaning or fixing that sagging cupboard door or, or, or …
Help at home.
It might also mean things like help with bill-paying. Or managing multiple medications. Or eating. Or transferring, or dressing or … very “personal care.” These kinds of things are generally referred to, in my world, as “long-term care,” and here’s why:
Generally, folks who need help with these kinds of things (and many others) are going to need them “long-term,” meaning simply that they aren’t going to get better and jump back into the daily fray of daily life, with a vengeance; true, many of us might just need some help like this for a little while, as we recover from this-or-that surgery or what-not, but most of the time, you’re in it for the long-haul.
And, by the way, the vast majority of “long-term care” is provided at home, as opposed to nursing homes, so don’t scare yourself – And that’s what we’re talking about here: At home.
Is help like this available? Sure — just think through what you really need (or want): There are cleaning services and professional “handyman” businesses and taxis and, and, and…
There are also “homecare agencies,” which are HUGE in my world. These are agencies who recruit, train and employ homecare aides who will come to your home and help you with the things you need help with. They are businesses, so they’re trying to do business in America, so you will pay for the services you receive. Is that bad? No! Just don’t be shocked by it.
Time out: If you are receiving services under a Medicaid in-home care program, this whole picture could look very different, and that is NOT the situation I’m talking about here. I’m talking about folks who need help on a private basis — the code-word in my world is “private pay.”
The very good news about homecare agencies is that their aides are trained and supervised; plus, if a particular aide has the gall to get sick or whatever, they can send someone else to help you. AND, if you have a problem or a complaint, you have someone to complain TO!
Are they perfect, all the time? No, this is Earth, but they do pretty darned well an awful lot of the time.
Some folks are dead-set against paying homecare agencies’ rates, so they go in search of private individuals to help them do this-or-that; sometimes, they find a gem and everyone lives happily ever after!
Sometimes, they don’t; what they find is a predatory or abusive or exploitive scam artist, and very bad things happen, very quickly.
There are also services like “home health,” which provide skilled nursing services in the home, and other variations on themes, but I think you get the drift. What all of these resources/entities have in common, from our perspective, is that they have to be “managed;” someone has to make the contacts and get things going and sign contracts and supervise and pay bills and … supervise. So, I think that’s the question: Who is going to do that, if I can’t?
Are there local entities/businesses/agencies/individuals who could manage that for me? Yes. Will I have to pay for it? Sure. Will I tell you they are? No. And, again, I won’t do that because I’m correctly forbidden from doing that, so that you-all don’t become victim of my biases and preferences. If you call any of the numbers at the end of the column, decent people can help you think it all through, and provide you with lists of folks who are in that business.
Here are a couple of common scenarios:
1. Daughter and family live in the Midwest, but manage local care/help for Mom by phone/Internet/email;
2. Daughter and family live in the Midwest, but engage a local care manager to be the local “eyes-and-ears” and take care of the daily details;
3. Daughter and family live in the Midwest, but are smart enough to know that Mom needs to manage what she can manage and make the moment-to-moment decisions that she can make, because it’s her life; then reconsider numbers 1 and 2 above.
This can all be done, and is being done all around us, every day. The trick really isn’t to find the “whos” and/or the “hows.” The trick is to carefully think through what’s needed, wanted and/or will be accepted, rather than over-thinking a hypothetical.
And to remember that life doesn’t usually go from one extreme (FULLY FUNCTIOING) to the other (DEATH). What’s more likely to happen is the space in-between — gradations, nuance — levels, phases and changes.
Accommodation and adaptation, because every single situation is different.
Think about who you are and what you want, and remember the word “negotiation.”
Life doesn’t change, just because we get older. It’s still an exercise in approximation.
Mark Harvey is the director of Information and Assistance for Olympic Area Agency on Aging. He can be reached at firstname.lastname@example.org or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information &Assistance.