St. Andrew's Senior Solutions

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Frequently Asked Questions from Caregivers

Question: I think my parents need to make a move into a senior care facility, but I’m not sure what is the difference between all the various types?

Answer: This is very confusing and most individuals are not aware of all the little nuances that make up the different between an independent living environment, an assisted living community or a skilled nursing facility.

  • Independent Living Units (ILU): A housing facility type integrating shelter and services for an older adult who is willing and able to remain living independently, but who requires assistance in coordinating the support and services they need. ILU facilities coordinate environment, services, and community support in order to increase independence and offset social isolation. Services generally include housekeeping, maintenance, activities, personal care, nutrition, and transportation.

  • Assisted Living (ALU): A residential community with services that include meals, laundry, housekeeping, medication reminders, and assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The exact definition will vary from state to state, and a few states do not license assisted living facilities.

  • Skilled Nursing Facilities (SNF): A nursing facility providing medical and rehabilitation services to patients. Services are of lower acuity than those provided by a hospital. SNF beds provide patients with a high level of nursing, supervision, and health care.

Question: What is the difference between Medicare and Medicaid?

Answer: Medicare is a federal insurance program that primarily serves people over 65, whatever their income.  In addition, it serves younger disabled people and dialysis patients.  Patients pay part of costs through deductibles for hospital and other costs.  Small monthly premiums are required for non-hospital coverage.  Medicare is basically the same everywhere in the United States and is run by the Centers for Medicare and Medicaid Services, an agency of the Federal Government.

Medicaid is an assistance program that is run by state and local governments within federal guidelines and varies from state to state.  It primarily serves low-income people of every age.  Patients usually pay no part of costs for covered medical expenses although a small co-pay is sometimes required.

Question: The doctor told me my dad has dementia. What exactly is dementia and is it the same thing as Alzheimer’s?

Answer: Dementia is a "cluster" of symptoms, characterized by loss of cognitive skills (impaired memory, confusion and difficulty reasoning) that interferes with daily functioning. It is NOT a disease and is NOT normal, but rather accompanies certain diseases.  The most common disease that produces dementia is Alzheimer's disease and other diseases include multi-infarct dementia and Parkinson's disease.  The cause and severity of dementia will vary depending on the disease.  It is VERY important that the person who is experiencing signs of dementia undergoes a thorough diagnostic assessment to accurately diagnose the cause in order to provide optimal treatment.

Question: My dad drove me to the store the other day and his driving really scared me. What can I do?

Answer: Driving is one of the most significant areas of independence and the threat of losing this independence is very SCARY to the individual and makes this subject difficult to address for the caregiver.  If you feel that your older loved one's driving skills have declined, the best thing to do is to get a driving assessment for your loved one from a professional.
If found that it is unsafe for your older loved one to drive, some ways to help persuade him or her to stop or reduce his or her driving are: 

  • Enlist the help of an authority figure such as healthcare professionals, law enforcement officials, and Departments of Motor Vehicles. 

  • Offer a range of transportation options to the older adult while showing the costs and benefits of each. Researching various transportation options, exploring them, and slowly replacing them for private driving may be more helpful than just suggesting that the person should no longer drive. 

  • Encourage the older driver to voluntarily take a refresher course offered by AARP, 55 Alive or their insurance company, which may help improve current driving skills. 

A Care Manager can assist you by researching alternative transportation in your older loved one's community and/or get you connected to driving assessment programs.  If you are interested in getting more information on older adult drivers please feel free to contact Senior Solutions at (314) 726-5766.

Question: My mom has been asking me for more and more help and I am getting concerned about her ability to take care of herself. What do I need to do?

Answer: This is a very important question because an older person may be slowly declining secondary to medical reasons, cognitive changes and emotional issues.  A person may not want to tell you he/she is no longer able to do many of these daily tasks anymore because he/she is fearful of the outcome.  As a caregiver, you need to determine how much help she needs taking care of herself on a daily basis and how safe she is in the home.
Things to look for include:

  • Is she able to get dressed, bathe and cook for herself?

  • Can she do laundry and/or clean the house?

  • How much help does she need to manage her finances?

  • Does she have a history of falls?

  • Does she know what to do in an emergency situation?

  • Is her judgment good regarding potentially unsafe situations?

  • How much assistance does she require for her health care needs (medication, insulin injections, and dressing changes)?

After you answer these questions, you may want to contact your Care Manager to help determine the level of care needed for your mom.

Question: I have the durable power of attorney for healthcare for my mom.  Does she still need a living will or an advance directive?

Answer: YES.  The following answer is from the Probate Law Resource Guide from the Missouri Bar.  "You accomplish a few things by giving advance directives, regardless of whether they direct all possible treatment, no treatment or only some treatment.  First, you ensure that the treatment you receive is the treatment you desire, no more and no less.  Second, you take the burden off of your family and friends to make those decisions for you at a time when they will most likely be emotionally upset by your critical condition.  Finally, you may be avoiding litigation to determine what treatment you really desired or intended.  In any event, it is time well spent."

Question: Can I use the services of Senior Solutions if my father lives in Florida?

Answer: Most definitely!  We are able to assess your needs and address your concerns with a relative who lives in a different city.  Additionally, we can assist you with your needs if the caregiver lives out of town.  Long distance services such as education and support are available through your Care Manager via the phone and mail while technology allows us to access many community resources and housing options nationally.

Question: Mom is alone and depressed. Who can help?

Answer: The first step to determine who can help is for an Eldercare Specialist to complete a comprehensive assessment for your mom.  This will clarify what is going on with your mom, what interventions would be beneficial, and what community resources are needed to help mom feel better.  There are times when different medications interact and cause depression.  Living alone can contribute to a depressed state.  Solutions are sometimes as simple as providing a companion during the day to interact with mom or maybe referral to a geriatrician is the most appropriate solution. Whatever choice is made, having the initial assessment will determine the best and most appropriate course of action.

Question: Dad is still living alone, and forgetting to take his medication. What can I do?

Answer: This is a common problem and one that often leads to preventable hospitalizations. Working with dad to monitor his medications can be undertaken by a friend, neighbor, or family members as long as it is spelled out exactly what they are to monitor and they can do it consistently.  Without this, it is best to have a professional provide medication management—an investment in this can keep one healthier, safer, and give the family comfort in knowing everything is as it should be.

 Question: What do I do if my aging loved one resists outside help?

Answer: Some older adults are accepting of receiving help with activities such as housekeeping, meal preparation, running errands, etc.  However, others may initially resist the idea of getting help from someone else, particularly a non-family member. This assistance is usually necessary to maintain the safety and independence or the older adult while reducing the stress and worry of the family.
Some suggestions about addressing your aging loved one’s resistance to non-family member assistance are as follows:

  • If you are overwhelmed with your care giving duties, sometimes simply ask your loved one to help make your life easier by doing you a favor and trying out having another caregiver come in to help with some of these activities.

  • Sometimes it just takes a different person asking.  Ask a trusted third party suggest to your loved one that he or she hire a professional caregiver. This could be his/her doctor, geriatric Care Manager, religious leader, etc. 

  • Involve your loved one in the planning for their care. Older adults are usually more open to the idea when they can participate in the decision making process.

  • Talk with your loved one the benefits of having a non-family member provide these services such as remain independent, safe, and in their home. Most of these professional care giving services provide free consultation to assess your aging loved one’s specific situation and make recommendations.

Additionally, a Care Manager can assist you discussing this matter with your aging loved one.  Please feel free to contact Senior Solutions at (314) 726-5766.