How to Decide Between Aging in Place at Home Versus a Skilled Nursing Care Facility

One of the most frequently asked questions I hear is about what to do with mom or dad. Often individuals and family systems are conflicted.?

I recall standing in court while the judge asked questions of two different families that would not agree on how to care for their elderly mother. As the professional, I was able to provide proper care for her and resolve the conflict by focusing on the care needs of my elderly client.

In another situation, I solved the problem of the care needs of an elderly couple by creating a customized plan which involved multiple services and allowed them to remain at home.??

Moving into a skilled nursing facility can offer several advantages for individuals who require specialized care and assistance with daily living activities. Here are some tips to help you decide what is better for your situation.

Key benefits include:

1. Professional medical care: Skilled nursing facilities are staffed with trained medical professionals, such as registered nurses and licensed practical nurses, who can provide round-the-clock care and monitoring. This mainly benefits individuals with complex medical needs or requiring regular medication management. This decision is usually made because care at home has become expensive and untenable, often because of emotional costs and physical exertion. Care at a facility relieves the family of these burdens. Depending on the facility, you may still have to monitor their care, especially if you live far away.?
2. Specialized services: Skilled nursing facilities often offer specialized services, including medication management, physical therapy, occupational therapy, and speech therapy, which can help residents maintain or improve their functional abilities. Skilled nurses on staff 24/7 is another service, as well as regular doctor visits.
3. Social isolation: This is mitigated by regular activities, often including visits by therapy dogs, musicians, and speakers. Stimulating group activities diminish cognitive decline and combat feelings of isolation and loneliness.
4. Safety and security: Skilled nursing facilities are designed with safety and security in mind, with features such as handrails, wheelchair ramps, and emergency call systems to ensure that residents can move around safely and receive prompt assistance if needed.
5. Support for family members: Moving into a skilled nursing facility provides peace of mind for family members who may be unable to provide the care their loved one requires.

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Relocation Disadvantages:

1. Cost: Skilled nursing facilities can be expensive, with prices varying depending on the level of care needed and location. Many individuals may need to rely on Medicare or Medicaid to cover some or all costs, which can be complex and time-consuming. Insurance service professionals can help with this process.?
2. Loss of independence: Moving into a skilled nursing facility can be difficult for some individuals, as it may require giving up a certain degree of independence and autonomy. Elders are often resistant to leaving their homes and relocating to a facility.?
3. Limited privacy: Skilled nursing facilities are communal living environments, meaning residents may have limited privacy and personal space.
4. Quality of care: While many skilled nursing facilities provide high-quality care, others may need more staffing or subpar care issues, which can lead to poor health outcomes for residents. A professional can help guide and point out these differences.
5. Emotional impact: Moving into a skilled nursing facility can be emotionally challenging, particularly for individuals leaving behind their homes and communities. This, more often than not, leads to feelings of isolation, depression, and anxiety. If a caring family is involved, they can be informed and not be completely unprepared for this significant life adjustment.

I remember a client who was considering moving into an assisted living facility, thinking she needed a high level of care. After consultation with medical personnel, family, and my client, we determined that she would be happier at home with daily caregivers and regular home visits by nurses. She is now stable and doing well.

It's essential to carefully weigh the potential advantages and disadvantages of moving into a skilled nursing facility before deciding and researching different facilities and options to find the best fit for individual needs and preferences. Working with an informed professional who is knowledgeable about the pros and cons of different facilities will make this difficult decision easier.? ??

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Advantages of remaining at home:

1. Independence and familiarity: Staying at home allows older adults to maintain their independence and stay in a familiar environment, which can be especially important for those who have lived in their homes for many years.
2. Personalized care: Staying at home allows older adults to receive personalized care from family members and/or caregivers who can tailor their care plan to the individual's needs and preferences.
3. Lower cost: In some cases, staying at home can be more cost-effective than moving into a skilled nursing facility or other care facilities.
4. Emotional benefits: Staying at home can provide emotional benefits, such as a sense of security and comfort, and may help older adults maintain connections with friends and family.?

Disadvantages of remaining at home include:

1. Limited access to medical care: Older adults who remain at home may have limited access to medical care and monitoring, which is an issue for those with complex medical needs or chronic conditions.
2. Home environments may not be optimized for safety and accessibility, which can pose a risk of falls or other injuries, especially if older adults live alone.
3. Isolation: Staying at home may lead to social isolation and loneliness, especially if older adults have limited mobility or lack social connections in their community.
4. Caregiver burden: Family members or caregivers who provide care to older adults at home may experience high levels of stress and burnout, especially if they have other responsibilities or live far away.
5. Home upkeep: Older adults may have difficulty maintaining their homes and completing daily tasks due to physical limitations, which can add to the burden of staying at home.

It's imperative to carefully consider the advantages and disadvantages of staying at home before deciding and exploring different options for home-based care and support services to ensure that older adults can safely age in place.

Having done this work for so long and seeing all angles of decision-making, including dealing with my parents, I know this process can be emotionally draining. My knowledge and experience help to make these stressful decisions manageable and relieve my clients of unnecessary worry.

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