The number of older American in the U.S. population has risen to new heights in recent years and shows no sign of slowing. The significant increase in the number of older Americans can be attributed to a number of factors including better medical care and improved working conditions.  Americans are not just living longer, they are living better. In other words, the quality of life that a person can expect in their golden years has improved drastically from generations past. 

While it is true that the quality of life for seniors has improved over the past several decades, new challenges have emerged. Specifically, America's growing population of seniors is accustomed to a lifestyle that includes independence, disposable income, and good health. However, despite improved medical prevention and treatment, physical ailments and memory deficits often pose unique challenges to the families left to care for their elders. Suddenly, seniors who have lived generally healthy and independent lives must trust a family member with treatment and living decisions.

One of the most common struggles that families face when caring for an elderly adult is determining the appropriate level of care. This decision is further complicated by the fact that the elderly adult would likely prefer to remain in their primary residence with familiar surroundings. While this is preferred, it is not always a feasible option. Some of the more common options regarding level of care are:

Live- In Support: The option of live-in support has also grown in popularity over the past several years. This hybrid treatment solution allows the elderly adult to remain in a familiar surrounding but provides them with the treatment that they need from a skilled caregiver. This may be the preferred solution for many aging adults; however, it is not without its limitations. One of the most common challenges to this model is the financial commitment it requires. These costs can go beyond that of the caregiver and into the installation of medical equipment and safety features in the home to ensure proper treatment. The cost factor is sometimes mediated by asking the skilled caregiver to come only at critical times of the day or specific days of the week.

Facility Treatment: Not surprisingly, as the number of older adults has increased, so have the options regarding residential living. These facilities range from the traditional nursing home model to luxurious condos that can provide medical treatment or general assistance at a moment’s notice. Many facilities have adopted a full continuum of care model. These facilities allow an individual to move into the independent living program while they are still relatively healthy and then progress into more intensive services, as they are needed. In addition to having a full continuum of care available, most of these facilities provide services to address every domain of one’s life including social activities, opportunities for worship, hobbies/games, crafts, exercise and psychological care. There are programs to meet almost every need and budget; therefore, a thorough investigation of the options in your area should help you narrow your focus.

Living with a family member:  Historically, when a person began to age and was no longer able to care for themselves, they would move in with a family member who could provide them supervision and oversee high risk activities such as bathing and medication dispersal. However, this has become a less common solution with both adults in many households working outside of the home. Additionally, the proliferation of facilities designed specifically for the treatment of older adults has challenged the traditional model of moving in with a family member. With other options for the person’s care, family members might be reluctant to take on the additional stress that comes along with caring for an aging adult within their home.

Before a family does choose to bring an aging adult into their household, they will need a good understanding of the challenges they will face regarding the person’s physical and emotional health:

Physical Well Being:  When an individual begins to experience confusion and dementia related symptoms, they become higher risk for injuries and illness. For example, persons suffering from dementia might take their medications incorrectly, wander into dangerous situations, or even forget basic activities of daily living. Caregivers can reduce the potential for physical harm by completing some of the following:

• Keep walking areas clear of hazards
• Install safety devices on appliances to prevent injuries
• Provide careful oversight of medication storage and distribution
• Store cleaners, solvents, knives, and scissors in safe place

Emotional Well Being: In addition to physical concerns, caregivers must also be sensitive to the emotional functioning of the older adult. Many persons with dementia are aware that there is a change in their cognitive functioning. Not surprisingly, this awareness can lead to frustration, fear, anger, and aggressive behavior. It is the responsibility of the caregiver to mediate these emotions and provide gentle redirection and support. Caregivers can limit the emotional distress of an older adult by:

• Reducing distractions such bright lights or distracting media
• Keeping surroundings familiar
• Assisting the individual in developing a daily routine
• Utilize visual or auditory cues to keep individual on task

When it comes to caring for our aging friends and family, one size definitely does not fit all. Each situation will require a review of the available resources and specific needs of the aging adult.  Making such drastic changes on behalf of another adult can be disconcerting and lead to feelings of guilt and helplessness. However, such decisions are often necessary to ensure that our mothers, fathers, relatives, and friends, are given opportunities to age gracefully with respect and compassion.