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How to approach a loved one about in-home care

What to say—what not to say—and what to expect

As you can imagine, approaching a loved one about in-home care is a topic that needs to be broached delicately.

The staff at Right at Home Georgian Triangle have a helpful resource called the  RightConversations guide. It shares pointers and tips about how to talk to your parents about this very issue.

“Frequently the inquirers’ parents think they don’t need any help,” says Nancy L. Esson, Community Relations and Office Owner of Right at Home Georgian Triangle, “so you have to approach it very carefully.”

When someone calls to ask about care for their parents, one of the first questions the staff ask is are their parents aware that they are making an inquiry to arrange some care for them. They also ask if the parents know who’s paying for it. Often, it’s the children of the people receiving care who will pay, and in some cases this can be a sensitive issue. Caregivers are instructed not to discuss it with their clients; instead, their focus should be on what they can do to help improve their quality of life.

“The care that you may receive from government-paid care is very task-oriented, so it’s much more obvious that the person is coming in to provide assistance for specific things like bathing, showering and basic rise-and-retire functions,” says Esson. “Whereas if it’s family-paid care, such as what we provide, it’s much more customized and a much gentler approach. The caregivers go in and they’re not in a hurry. They’re not performing any specific tasks, so they become a part of a person’s daily life.”

Typically it’s the adult children who start the conversation. Often, they live somewhere else and their parents sound fine on the phone and tell them that everything’s going well, though in reality, it isn’t. The children may visit and find food on the counter or see that their parent hasn’t been bathing enough, for example.

“There’s always a trigger when people call us. Either their parents are just not managing their personal care or they’re not eating properly,” says Esson, who explains that Right at Home’s programs are focused on wellness. “We try to get them to eat properly, drink enough fluid, make sure their home is safe, that they get a little bit of physical activity (if that’s possible), and give them a little bit of mental and social stimulation.”

One of the best ways to approach this conversation is from a fitness and wellness standpoint. “If they think they’re improving their health or continuing to stay healthy, they might be more likely to accept having assistance,” she says.

It’s best not to force the issue, she advises. The generation (who typically needs assistance) is not as used to having extra people around the house as the baby boomers are. They’re very independent and reluctant to give that independence up. Approach the subject gently, by simply introducing the idea. 

Often the solution lies in easing into the care itself. A caregiver is brought in a couple of times for a short period and they don’t do much at first—just talk to the parent, play cards, maybe prepare meals or help them do things around the house. This helps them get used to being comfortable with having an extra person in their home. 

It’s not uncommon for parents to say that it’s too expensive—even if they’re not the ones paying. They often think it’s extravagant to have a helper around the house. “It’s interesting because when you think about the cost of lawn care, pool care or even car maintenance, it’s way more expensive than taking care of yourself, which is the most important thing we should all do,” says Esson.

Right at Home Georgian Triangle has a care planner who meets with the family (and sometimes the parent) in order to properly match the caregiver with the client. They try to get a sense of what the parent’s personality is like so they can find someone compatible to work alongside them. 

You may start out using the services of a companion or personal support worker, and over time, as things evolve, move to nursing or, sadly, palliative care. “You can build up to a full continuum of care. The times, intensity and the types of skills that are provided change according to the changing health conditions of the client,” Esson explains. “Whatever people want, we can do. We work for the family, so it’s guided by them.”

If your parents are still hesitant, listen to their concerns. It can help to redirect their attention towards the things they don’t want to do themselves. When family, friends and neighbours come to visit, they don’t want to be bogged down with the activities of daily living; they look forward to fun, social outings together. Explain that if someone was helping them with tasks around the house, they’d have more time to relax and enjoy their social visits. “You don’t want to burden your friends, neighbours and family members with the kinds of tasks that are happening as peoples’ health declines,” she says.

There are lots of great resources in the community that can help. Right at Home Georgian Triangle has a pretty robust blog on their website, along with many related articles. All of the direct disease societies have good resources on their websites—the Alzheimer Society of Canada, Parkinson Canada and Canadian Cancer Society are excellent, for example. VON Canada Adult Day Programs are good, says Esson, and 211 Ontario gives you access to even more information.

“One thing that’s often a pain point is the cost of potential home care,” says Esson. “Currently, for every dollar the government spends on direct-to-seniors care, 87 cents are going to bricks and mortar and the overhead to run nursing homes and long-term care facilities(1). But these services are for a very small percentage of seniors—only 80,000 people benefit. Thirteen cents of every dollar spent on home care is crazy when during the pandemic (and every other time) people have indicated that they don’t want to go anywhere, they’d prefer to age in place if they can.”

Everyone should support Home Care Ontario, she urges. While family-paid care is not an option for everybody, the government is grossly underfunding home care. Says Esson, “We need to make sure that there are resources available for people in our community to be able to get access to home care if that’s what they choose.” 

For more information on in-home care and assisted living services, visit Right at Home Georgian Triangle or call 705-293-5500.

(1) Source: CBC Radio