Choosing Between Home Care and a Facility for the Elderly –Aspects you Need to Consider


At some point in time, an adult child will be confronted with the dilemma of how best to see to the daily needs of a parent who is no longer in peak physical and/or mental condition. The parent may be insistent that he or she wants to live out his or her remaining days in the comfort and familiarity of home. However, the adult child is aware that the parent cannot cope alone. 

Remaining at Home can be a Viable Option

With some adjustments, many elderly couples or surviving spouses make it work. Don’t discount the idea out of hand as impractical. There are also plenty of benefits, such as getting to keep beloved pets, not having to reduce belongings to fit into a smaller area, being close to family and social circles, and having full control of one’s schedule.

The Activities of Daily Living (ADL)

The Activities of Daily Living (ADL) and the Instrumental Activities of Daily Living (IADL) are systems for rating the level of independence a person has and evaluating the essential tasks that they can no longer perform without assistance. The ADL items are being able to bathe oneself, walking unaided, transferring from one position to another (e.g., from bed to chair), getting dressed without assistance, feeding oneself, and managing using the toilet alone.

The Instrumental Activities of Daily Living (IADL)

There are also six Instrumental Activities of Daily Living (IADL). These are remaining capable of handling one’s budget, taking script meds correctly, the ability to make and receive calls, the capacity to do one’s shopping, being able to manage light household tasks, and being able to make meals for oneself. If a senior cannot perform these tasks, they need supportive care while they can retain some autonomy. 

Why Move to Facilitated Care?

When elderly persons are unable to perform even one of the tasks of the ADL, they cannot look after themselves. Full-time skilled nursing care is needed. Facilitated care in a center is one option. Another choice is to hire round-the-clock home-based care. This can be very costly and will require qualified staff to work in shifts. A third possibility is moving the parent to an adult child’s home and caring for them. This option is difficult if one has small children and impossible if one is working.

Facilitated care facilities provide graduated levels of care to match the senior’s remaining independence. For example, the Parc Provence memory care facility is based in the St. Louis region. It provides four different levels of care. These are memory care, assisted living, rehabilitation, and skilled nursing. Assisted living is needed for the person who can manage the ADL items but cannot perform all the IADL ones.

A person who cannot independently complete the six ADL tasks requires skilled nursing. Rehabilitation is temporary care for someone who had a stroke, surgery, or an accident and needs help to recover and regain independence. This resident of a care center may have to wear diapers while a hip replacement, for example, heals. Thereafter, rehabilitated patients go home, while some may be transferred to a skilled nursing facility as they did not respond sufficiently to rehabilitative measures.

Memory care provides a secure, structured environment for residents suffering from memory loss due to dementia. The premises are controlled to prevent a resident with dementia from getting lost, which happens in more than half of these cases. Special activities are designed to enhance memory recall and keep the patient engaged and functioning at their best. Constant supervision ensures that these residents get to meals, attend appointments, get the correct medications, bathe daily, etc.

The solution is highly dependent on the level of independence a senior has, the budget for home care, and family support.

About Author

LaDonna Dennis

LaDonna Dennis is the founder and creator of Mom Blog Society. She wears many hats. She is a Homemaker*Blogger*Crafter*Reader*Pinner*Friend*Animal Lover* Former writer of Frost Illustrated and, Cancer...SURVIVOR! LaDonna is happily married to the love of her life, the mother of 3 grown children and "Grams" to 3 grandchildren. She adores animals and has four furbabies: Makia ( a German Shepherd, whose mission in life is to be her attached to her hip) and Hachie, (an OCD Alaskan Malamute, and Akia (An Alaskan Malamute) who is just sweet as can be. And Sassy, a four-month-old German Shepherd who has quickly stolen her heart and become the most precious fur baby of all times. Aside from the humans in her life, LaDonna's fur babies are her world.

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