Advances in health care have made living with disabilities and caregiving in the later years of life both a reality and a challenging responsibility. There are many options of care available today in all parts of the country. It’s important that leaders in the church become familiar with the options available.
Use the following check list of activities of daily living to help determine if the individual is independent, needs help to perform a task, or is unable to do so at all:
Walking: Can the individual move about without devices or help from another person? Yes/No
Transferring: Can he change positions from bed to chair to toilet without assistance? Yes/No
Bathing: Can she get to the bathroom, prepare hot water, get into the tub or shower, and wash unassisted? Yes/No
Dressing and Grooming: Can the individual dress without assistance, put on artificial limbs or braces, and perform grooming tasks such as washing hair or shaving? Yes/No
Medicine: Can she reliably take the correct medication at the proper time? Yes/No
Eating: Can he feed himself? Yes/No
Housekeeping: Can the individual do minimal cleaning in the house and do the laundry? Yes/No
Telephone: Can he use the telephone to communicate with others or to request help? Yes/No
Food Preparation: Can she prepare or heat meals? Yes/No
Security: Can the individual exercise care in locking windows and doors? Yes/No
Toileting: Can he get to the bathroom and use all of the facilities? Yes/No
Shopping: Can she plan and prepare meals and also do the necessary grocery shopping? Yes/No
Communication of Needs: Can the individual make needs and desires known by any means of communication? Yes/No
Safety: Can she recognize and correct hazardous conditions in the home? Yes/No
Orientation: Is he accurately aware of places, people, days, and years? Yes/No
Decision Making: Can the individual make appropriate choices? Yes/No
Medical Needs: Are there conditions that would require skilled nursing care? Yes/No
Nighttime Care: Can the individual be left alone at night and can he call for help if needed? Yes/No
Scoring: If you answered No on 15 questions or more, this may be an indication of the need for 24-hour care such as skilled care, supervisory care, or assisted living care.
If you answered No on 7 or more questions, this may indicate the need for in-home or out of home supportive services such as adult day health care, respite service or home companions, in-home homemakers, or health aides. If you want help in evaluating the patient and family needs, a variety of resources are available for help. Hospital discharge plans should be discussed with the social services department of the hospital. They can make recommendations and will assist in the implementation of the care needed. The case manager can evaluate needs and arrange for the provision of needed services. Nurses employed by home health agencies may assist the individual and/or the caregiver in evaluation and arranging for needed help.
Once strengths and problems are identified, you can begin to match needs with available long and short term care services. If the activities of daily living can be managed independently, the choice may be to remain in the present home with the help of support services.
If you discover that more specialized services are needed, the decision might be to remain in the present home and make use of home health care services. These might include nursing care, home health aides, and therapists.
Even with these kinds of help, remaining at home may not be possible. If some protection, supervision or help with daily activities is needed, the best solution might be to change residence to a supervisory care home where room, board and supervision are provided. Such homes require a resident to be able to care for themselves and to get around without help. If more assistance and 24 hour supervision is recommended, it may be desirable to consider residence in an adult care home.
If health problems or disabilities require around the clock nursing care, the best decision might be to change residence to a health care center (nursing home) where 24 hour nursing and rehabilitation services are provided.
Socialization in a supervised setting can make a long illness less trying for a family. Adult day care provides professionally supervised recreation, socialization, nutrition and health supervision. Adult day care assists families by helping prevent premature or inappropriate institutionalization. Respite is provided for caregivers allowing them to pursue necessary shopping and errand activities while their family member enjoys a safe and stimulating environment.
Hospice services are available both in-home and in dedicated facilities during a final illness. Because of the pioneering work of Cicely Saunders, a compassionate physician in England, the last months of life need not be spent in isolation, pain and fear. Sensitive volunteers and professionals can provide care and support through hospice services licensed by the State. When services are given by a Medicare approved hospice, the costs are 100% covered through the Medicare hospice benefit.
