The first steps in finding help on the rollercoaster of caregiving can be the most stressful ones. This month Elder Voice describes sixteen of the most common types of services and support available.
There are two main “streams” of help available to caregivers: the public and the private systems. In the public system, services are provided through your local health authority or health unit. In the private system services are available for a fee and not covered by subsidies. There is a much wider range of services available privately if you are able to afford it.
The following describe some of the many services available. Where we at Diamond Geriatrics provide those services, we describe what we do:
Assessment: Start with talking to your physician about why the changes you see are occurring and if they are reversible. After a basic investigation, he may refer you to a specialist or clinic for further assessment and treatment for the condition he suspects. If he suspects dementia, options include refferal to a dementia clinic, a hospital inpatient or outpatient assessment unit, a geriatric mental team or a geriatrician or geriatric psychiatrist. These are medical assessments, rather than an assessment of support and service needs.
Needs Assessment and Care planning: Either through the public system or a care management company such as Diamond Geriatrics, you can engage a care manager who will do a needs assessment. This will help you determine what kind of services you need, where to find them, and how to implement them. As a private care provider, Diamond Geriatrics’ comprehensive assessments look at the full range of your needs. We explain the system, the options, and will help you find and coordinate all of the services available both for the present and in the future. We work closely with the public system.
Companionship and personal care: Home Care companies provide services such as help with bathing, dressing, medication, shopping, cooking, and housekeeping. You may be eligible for some home support through the public system. You can also hire a company privately or combine the services from both streams. Home care companies provide hourly or round the clock help. Some have minimum hours per week or per shift, most have a two hour minimum per shift but not per week. They also vary according to price and quality. Before contacting a home care company, make a list of what you or your loved one needs help with. We recommend that you interview at least two agencies. Remember, you are the employer–you get to ask the questions and set the boundaries of what you want. Diamond Geriatrics helps you choose the agency and monitor the care they provide.
Adult Day Care: These are mostly publicly funded programmes that pick up participants in the morning, bring them to the programme, provide a meal and recreation and bring them home in the afternoon. They are staffed with a minimum of a nurse and recreation staff.
Mobility and home safety: Home health equipment companies provide equipment such wheelchairs, walkers, or commodes. They can retrofit your home with railings, lifts, ramps etc. You can rent, buy, or rent to own the equipment. It is often helpful to have a physiotherapist or occupational therapist do an assessment before you call a home health equipment company.
Seniors Housing: When you investigate seniors housing, you may hear terms such as independent living or supportive living, assisted living, nursing homes (complex care) or extended care. The terms and meanings vary but basically they refer to the amount of help available in each setting. Think of it as being a continuum from least amount of help to full care. There is seniors housing in both the public and private sector with a tremendous variation in quality, size and cost. An expensive private residence is not necessarily better than a public facility. Some of the best and most compassionate care we have seen has been through the public sector. Diamond Geriatrics will guide you in assessing what you need and choosing what is best for you. We will help coordinate your move and follow up with you wherever you move for as long as you need us to make sure you are getting the best care possible.
Rehabilitation Services: Physiotherapists and Occupational Therapists help people to recover after some kind of loss of functioning, either from a fractured hip, long hospitalization, or changes in cognition. Hiring private rehabilitation therapists can make the difference between being able to live at home, or having to go into seniors housing. We work with our own physiotherapists and OT to provide assessment and treatment.
Downsizing and Moving Services: Downsizing and moving services help to take away the stress and worry about moving by doing everything. They will pack up what you want to take, dispose of what you do not want, help plan for space usage in a new place, and deliver and set up your belongings.
Care monitoring and advocacy: Care or Case managers track the services you receive for quality, reliability, and effectiveness. Public case managers may have 150 or more individuals under their watch and are only available during work week hours.They control access to all public services and housing. Diamond Geriatrics Care Managers also track services, but as a “boutique” service we follow only 20-25 clients per care manager and are available 24/7, 365 days a year. We follow up and work closely with family members when your relative is either at home or in a residence, monitoring progress, recommendations for care and revising care plans and approaches. When you are far away, we are there in the same way you would be.
Drivers: Companies that specialize in driving seniors and people with disabilities cost more than a taxi but they also do a lot more–taking people in for an appointment, accompanying them for shopping, unpacking groceries. With repeated outings, they build a relationship with their clients. Sometimes this service is also available through a home care company.
Meals: There are several companies that provide nutritious and tasty frozen meals that can be ordered by phone or online. Public programmes such as Meal on Wheels deliver food, while others like Wheels to Meals brings individuals to a centre to have a communal meal. Many senior centres provide inexpensive and nutritious hot meals. We sometimes recommend the frozen meals available in any supermarket–they have come a long way from the tater tots and frozen peas of the 1960’s TV dinners!
Safety Monitoring and Alarm systems: There are several companies that provide alarm systems that can be activated by pressing a button or are automatic in the case of a fall. Some companies also provide visual monitoring, or can monitor if medication is taken. When there is a problem detected in any area, the monitoring company will alert you.
Problem Solving and Counselling: Counsellors are sometimes available on a limited basis through the public system and non profit agencies. Professional counsellors from Diamond Geriatrics can help you work through the tough decisions you have to make to find solutions. We help you with emotional issues such as grief, loss, stress, coping, guilt and transition or practical issues such as mediation and family meetings and care planning.
Online support and information: There are dozens of sites that focus on advice to seniors and caregivers with a range of information. Several of these have forums where caregivers provide support and information to each other.
Support Groups: Caregiver information and support groups are available both through the public system and through all of the “disease specific” organizations such as the Alzheimer’s Society, Parkinson’s Foundation, Diabetes, and Arthritis Society. They are essential in helping caregivers cope and have excellent up to date information on the disease, all in addition to providing emotional support.
By now you have the picture – There are dozens and dozens of different services available to seniors and caregivers. You can find many of the types available from Elderpost.com These include money managers, personal historians who will make a book or a video of your life, hearing and vision companies, elder law attorneys, financial advisors and personal money managers and more. Diamond Geriatrics can help you find them and put together a care system and plan which suits you.