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  • Writer's pictureLisa Cox

"She wants to get me out, but I will die right here."

Updated: Jul 5, 2023

Last week's New York Times reported "Breaking News" that "America's population is older than ever, with a record high median age of 38.9."


On Wednesday I visited a home care client for my final time. She was scheduled for an interview with the local independent living residence that afternoon. I know how this goes, having been through the process with my father. A nurse and the director, in this case, will visit the client to assess her mobility and mental acuity. If she can ambulate on her own, that's a thumbs up. This woman can do so minimally at this point in time.


Last evening I had a discussion with a friend who lives overseas about his uncle, who just moved into assisted living in California. His view of why this would be better than home care, because "You just don't know who you will get," struck me, as an elder care home provider. "And the cost!" suggested another friend, to which the first noted the cost of assisted living is $9,000 a month- and who can afford that long-term? (That is in the median ballpark. The research I have done shows a range of roughly $5,000 to $13,000 a month.)


These are questions many of us ask as we find our aging parents, friends and family members needing more than they can provide for themselves at home. And there are more of us aging. And we are often farther apart physically than in the past.


There are a number of issues to consider as we face this continued aging of our people in the US- and Europe, but my familiarity is with this country, so I will stick to that for now and welcome my European friends and colleagues to educate me.


Let's begin with "You don't know who you'll get."


One of the first questions I asked in a recent interview with a home care company was, "What steps do you take to make sure your clients are getting consistent staffing?" This was an issue when I hired a company to send someone to my father's home on occasion after his second major stroke. Dad did not want a bunch of strangers entering his home. And he was not alone. Most of my home care clients have complained that the company sent too many different people in, and they could not keep track of them all, much less help each one become acquainted with their routine, needs and preferences.


On the other hand, a major concern for care givers I met at shift changes was their own lack of consistent scheduling with clients. Some were in a groove, and some were not. One woman who had been with a company for a year and a half said she had spent time with the same client for several months, and had been with that client when the client passed from this life. The care giver had decided to take a bit of time off to process and grieve and prepare to provide good care for the next round. When she returned, she was told she must pick up odds and ends schedules for a while, rather than a steady client to work with as before.


My friend's concern with not knowing who would be coming into his uncle's home might be summed up better on the other hand as expressed by another friend who recently noted, "Some of these people just go in and sit down and watch TV. They are getting paid to do nothing." That's another side of the story.


So, what about my former client who insists she will die right where she is, living in her retirement community apartment of a decade? She too must contend with different people coming into her home twice a day- and has been vocal about not appreciating that, though she knows she needs help.


There is room for consistency in staffing to develop. However, one challenge with which home care companies must contend is that staffing shortages are very real for the demand, and often clients come needing help right away, so filling in is a necessity.


Care giving is a difficult job. And I state firmly that in this country, care giving is not respected at a pay grade for which it is deserving (so those who don't care also come into the system, the chaff with the wheat not really separated.) In fact, I did not take on a full-time position with the company I recently worked for because, despite the wages being higher than other health and home care organizations in the area, 40 hours a week would barely pay my rent and bills. And the schedule turned out to be so chaotic, I felt as though I were working full-time, though my on-site hours were far fewer.


Quite a conundrum. And we have not even begun to discuss the price tag for either home help or that of independent living or nursing care. Let's save these other issues for another time. It's Sunday morning, and the sun is shining in a cloudless sky, after a week of stormy weather. It's time to go outside and enjoy the day. Have a beautiful one, and please feel welcome to be in touch with your knowledge and experience. We are all in this together. We are One.




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