by Patricia Hunter, MSW
Programs and Policy Director, Western and Central Washington Alzheimer's Association
Companionship and supervision needs start early. In the earlier stages of Alzheimer’s, care needs are usually minimal, focusing more on homemaker type services. During the middle stages, behavior challenges and safety concerns will require full-time supervision and prolonged vigilance. Personal care needs, which are activities of daily living such as eating, dressing and toileting, will increase too. In the later stages of the disease, the physical, mental and emotional aspect of caregiving is considerable.
The costs of care
The availability of services and their costs will vary in each community. Typical costs will range from a low of $15 per hour and up depending on the type of service. But don’t assume costs are beyond your budget. Your loved one may qualify for assistance through government programs like Medicaid or other family caregiver programs. Some communities have temporary emergency care available for caregivers who are in “crisis.” Most adult day centers (see article on page 5) offer some type of fee scale based upon income. Adult day centers offer the family caregiver a break from caregiving and the person with memory loss benefits from the center services too. If your loved one served in the military, it may be worth it to contact the Veteran’s Administration and ask about eligibility for benefits like respite care. If your employer offers an Employer Assistance Program, check with them too as they provide employees help with a variety of needs including elder care services.
Types of care for hire in the home
Homemaker Services offer typical housekeeping type services which includes cleaning, laundry, bed-making, meal preparation, shopping and sometimes transportation services. For the elder family caregiver who may be frail, homemaker services can take care of the more physically challenging tasks, such as mopping floors, vacuuming and clearing clutter.
Companion Care Services offer one-to-one visitation in the home, focusing on the person. The paid companion gives lots of personal interaction. These types of services are a nice gradual way of introducing help because interactions are focused on pleasant activities, discussion and are non-threatening for most. Senior centers, community centers, faith-based groups and corporations sometimes have a special companion care volunteer program that offer this type of care.
Personal Care Services involve helping the person with dressing, toileting, bathing, walking or transferring. Care may be supervision with reminders and guidance with these activities. It can also mean total help with these activities including helping a person who may have significant cognitive loss, confusion and little functional ability.
Skilled Care Services provide help with certain medical needs by a licensed health care professional such as a registered nurse or physical therapist. An example of skilled care may be hiring a nurse for IV drug therapy or wound care. Hospice care may also fall into this category. Skilled services are sometimes paid for by Medicare but usually very limited.
For help with your research contact the Alzheimer’s Association or call your local Senior Information and Assistance program. The Washington State DSHS website at http://www.aasa.dshs.wa.gov/ offers information on services as well as how to apply for MEDICAID. Another resource to try, if available, is your Employee Assistance Program.