Home Health Care

It seems quite academic. An elder person needs care but wants to stay in her home. Home health care providers are ready to serve, either part-time or live in. Simple.

Enter the human psyche, and particularly the proposition that one's home is her castle, and the route to a happy and productive outcome becomes less clear. And so the battle lines are often drawn between adult children and their beloved but aging parents who understandably want to maintain dignity, health and control over all aspects of their lives. Particularly what goes on in their homes.

Envision the Course Ahead

Perhaps you have watched the Olympic Winter Games, and noticed the alpine ski racers before descending the mountain. They crouch in their stance, mimicking the route to a successful finish. Preparing for home health care is much the same. Start with the psychological.

Whether home health care is a necessity because the house cannot be sold, or a choice as an American Association of Retired Persons 2007 study reveals, adapting one's attitude must precede the spatial and behavioral changes. Just reaching the point where the elder is both aware of a need for care and the family can agree on how to provide it takes communication skills.

The Devil Is in the Details

Assuming the elder person likes the home health care provider, having someone in your home creates an intimate relationship that strains even close family relations. You can avoid many pitfalls, and gain an open relationship between the elder and his family by considering all facets of daily life, such as:

• Where does the provider park?
• Where & when does the provider eat?
• Can she watch TV when you nap or go out?
• If she's live-in, can her kids visit?

Establish ground rules to minimize uncertain expectations and miscommunication.

It is crucial to remember that if a health provider becomes a friend, or even a "part of the family," she should not be allowed to interrupt your true familial relations. And also that she has a family of her own which deserves respect and separation from your own.

Nepotism in the workplace does injustice both to the friendship and to the business relation. The same is true here. A friendly but skilled, competent provider who is also a good house guest is best.

Go Slowly

Aside from the psychological adjustment that should precede introduction of a care provider into a home, the physical change itself should be approached with as much caution as time permits.

Unless a physician orders a certain at-home regimen or other circumstances dictate an all or nothing approach, try phasing in the care. Any new routine takes acclimation, and it is more difficult for us to adapt as we age.

The patience and understanding shown will pay great dividends for adult children in particular, who may otherwise be ready to make the decision and be "done with it."