Caregiving needs have never been more complicated. Perhaps due to health care advancement or due to lifestyle, the fact is people are living longer. This longevity has never been as astounding as right now for some populations which just twenty or thirty years ago were given a guarded outlook on life. As we think of this situation, we cannot just look around it and say ‘not my problem’. The longevity makes it everyone issue and we need to plan now. We will look at just one of these cases but when you think about the parameters, you will certainly think of more.
Beginning with a happily married couple with three happy and healthy children, become parents of a fourth child. The fourth child has Down’s syndrome and is moderately affected by the chromosome malfunction. The parents are determined to take baby home and raise this child the same as the other children in their family. The fourth child was born in 1961 and was given marginal education and was thought to have only a small chance of survival until age twenty. (Today individuals having Down’s syndrome are surviving into their eighties and nineties, in relative good health.) No planning went into how or where this fourth child would live if something happened to Mom and Dad. But then Dad had a heart attack.
Dad is now retired and Mom is his caregiver and also the caregiver of their last child. This child is always happy and excites easily. However the recession has come and money is tight. Mom has discussed going to work, but she and Dad have decided they need some clear family planning for the future. At this point they look for a good Geriatric Case Manager and find one willing to take on this double edged problem. Initially, discussion and plans are made surrounding Dad’s situation and how to best meet his immediate needs. This is a fairly easy process as money was saved for retirement and they own their home. Certainly the rise in the cost of living has diminished their savings, but this is still salvageable.
The situation surrounding needs and care for their fourth child is another question. First they are told to apply for Medicaid benefits for the child who is now 32 years old, still living at home with few skills to provide employment. Getting the benefits was the easy part, now looking for employment and living arrangements. This is a very emotional task for all concerned. Have we forgotten about the other children of this family, all adults with multiple responsibilities of their own? Now is the time for this family to unite in discovery, finding solutions and helping each other. Sometimes this is possible and other times not, when there are so many weighty decisions to be made. However, one thing is certain, Mom and Dad need the help of family and friends at this time in their lives.
Keeping all the family’s wishes and responsibilities in mind, this family and community must come together to provide the best outcome for Mom and Dad. The first question at this point, with economic issues aside for the last child; how can we meet the goal of living arrangements? There are many possibilities to think about and work together to understand. We can offer housing within our own home or look to a group home. The group home can be found through DSHS in our community. We must as we accomplish this part of the puzzle, remember that all human beings need to feel they are valued and their self-esteem is going to be met. And so our problem is really a two-step process; (1) finding safe and comfortable living arrangements, and (2) looking for job training possibilities for this person, to boost self-esteem and provide a goal to continue living a meaningful life. The job training center can also be found through DSHS or community outreach organizations. An important element to keep in mind is the person while easily excitable is also easily frightened and recent health concerns for Dad and changes in Mom’s role have created a feeling of anxiety. It is quite possible this person will begin to act out in frustration. This can be eased with showing concern and empathy.
In the months and years ahead there will be ample time and work as a family member you will get to participate in. The community will help and certainly all members of the family will have suggestion and resolutions to help get through each crisis. This is the best time to look at all the legal ramifications which will need addressing in very short order. Consult a Family Practice legal advisor or your family attorney, but see one soon and begin the preparation for handing off the legal baton, so to speak. This will be the most important step you make toward maintaining some semblance of a calm foundation in the years to come. It would be wise to meet as a family to discuss all the new information and determine what as a family you need to do.
My next article will discuss the title Geriatric Case Manager. What their role is and how you can locate one.