When it’s time to find care for an aging parent, most families jump right to looking for facilities or someone who can come stay with them. But what really happens then? Everyone gets overwhelmed by options that don’t make sense, prices that boggle the mind, and advice from people who have never actually done it.
The care “industry” throws around ideas like “assisted living” and “memory care” and “respite services” but no one thinks to tell you what that really looks like. Meanwhile, families must try to decide if Mom needs someone 24/7 or if two times a day is okay.
It’s never easy, and the stakes are incalculably high.
What You’re Paying For (And What You’re Not)
To start with the most basic things: what are you paying for? Many people assume that expensive care means good care. Not necessarily.
You can pay $6000 a month for a facility where your loved one has a new aide for every shift. You can also arrange for care at home that is significantly less money but that gives your parent the attention they deserve.
And here’s the thing, consistency is worth everything when it comes to an aging parent with changing needs. Someone who is there at the same time every day who knows what hip hurts, who knows Dad gets confused after lunch and needs extra attention then and who notices when things are not right is worth their weight in gold compared to a facility with nice common areas and activities no one goes to.
Sadly, most families only figure this out after they’ve made a decision about where to go. They tour somewhere that looks nice and hear about amenities and assume this is good care. Three months later they realize that their loved one hardly knows anyone anyway and spends most of the day in their room.
The Questions People Don’t Ask Until It’s Too Late
When interviewing potential caregivers or touring facilities, people ask all kinds of questions about qualifications, background checks, etc.
The questions that really matter when it comes to predicting whether this will work are different.
How do they handle a bad day? Because there will be bad days. Days when your parent doesn’t want help, days when they don’t remember why someone is there to help them, days when they are just having a tough day. Some people know how to navigate this. Some don’t. And those who don’t just make it worse.
What do they do when the designated caregiver is not there? This is how many care arrangements crumble. Mom gets used to Susan. She trusts Susan. She goes along with what Susan does. Then Susan is sick and suddenly someone else has to help Mom with her morning routine, medication, and activities of daily living. For many parents with anxiety or memory issues this can set off an entire week of meltdown.
Many families find that services like Senior Care Lancaster provide this kind of familiarity and hold the line no matter what happens with schedules because backup caregivers already know the lay of the land.
What medical knowledge does the caregiver have? This varies! Some home health aides can check blood pressure, recognize when someone is retaining fluid and needs medical attention. Others are glorified companions who can do daily activities with someone but wouldn’t know another issue if it bit them (and they might not).
For some parents who need help it’s probably all they need. For others who need more medical attention it’s not. Both parties need to know which this is.
The Trade-Offs Nobody Talks About
Every option involves trade-offs.
Facilities may offer built-in socialization but no privacy and no routine. Care at home keeps everything familiar but requires coordination of services, changing schedules and inconsistencies in services rendered if a caregiver is unavailable.
What no one asks about is which trade-offs your specific parent can tolerate. Someone who was always social may thrive in a group environment. Someone who craves their own routine above all else may do much better at home with help.
Most people don’t ask this until after the fact when they realize it’s not working. Dad seemed fine with assisted living until he got there and realized he hated eating at someone else’s schedule. Mom said she’d be fine with someone coming in to help but she’s too embarrassed to show up for her shower routine with someone else watching.
These are questions that can’t be perfectly asked but matter being discussed honestly up front before anyone commits to anything.
When Needs Change (And They Will)
What surprises families the most is that the level of care required this month is not the same level of care that will be needed in a year.
Sometimes needs change for the better when someone recuperates from an illness or injury but most of the time conditions change after a fall or some other medical emergency requiring more help.
The current arrangement needs to be able to adapt to changing needs whether gradual or sudden. Some facilities make it easy to just add on care as needed while others require moving older people to different units or buildings which can be utterly disruptive for someone with cognitive challenges.
Home care can also change as needs change, but both parties need to know if this service can ramp up the level of care without having to start all over again with new people.
The Parts People Overlook
Something that matters more than anything else is this: how does Mom or Dad feel about what’s going on? Not just about their direct caregivers but about everyone involved in their care.
Some facilities treat older adults like children who need to be managed instead of like human beings who have lived long lives and made choices and mistakes and who should therefore be considered in planning their future. This matters when it comes to their schedules and levels of care.
Difficult parents will not take medications, will avoid going out and will find a way to assert their independence even if it means doing something unsafe. People who feel they are respected and have agency in their lives will work with their caregivers instead of against them.
What Actually Represents Quality
After talking to hundreds of families about their arrangements and sharing what has worked (or not), it comes down to the following attributes that have nothing to do with marketing materials:
The caregiver or facility communicates proactively. They don’t wait for the family to call and ask how things are going. They reach out upon seeing a possible change or issue.
They also respect the connection between the parent and child when planning and during activities related to designating levels of care.
They are honest about what they can provide and will let a family know if they think Mom or Dad needs more than they can offer.
What Nobody Gets Right Off the Bat
No one gets it right on the first try so we leave you with this: what matters is paying attention to what’s really going on after someone comes in to help or goes somewhere for help.
Be willing to change things up when something is no longer working. This may mean going back on what you said you needed in the first place. It’s okay to admit that you need more help than you initially thought.
The families who navigate this best keep everyone honest, stay communicative, understand that finding good help for your parents is a process, not a decision, and pay attention to what actually works over time.
Keep communication open with caregivers as well as with your parents, and don’t forget your own needs too. Your needs will change as your parents’ needs so the arrangement needs to change too.
