In the Shoreline area, does the typical Adult Family Home offer end-of-life care like a hospice does?

Adult Family Homes are usually not equipped to handle the needs of residents who truly need the intensive care that a hospice offers, but most residents in an Adult Family Home do find everything they need. And one of the most important factors is, does the Adult Family Home you are considering have ‘wake staff’? In other words, if your aging loved one gets into difficulties at three o’clock in the morning, will help be there for them, a few feet away. Some Adult Family Homes have such wake staff; others do not. It should be one of the first questions you ask when you go to visit or talk with the staff of a home you are considering.

What kind of care does your loved one really need?

A hospice can be challenging to seniors in a different way to how an Adult Family Home is. An Adult Family Home tends to be more ‘up beat’ in that most of the time, at least, the residents are pretty mobile, healthy, and do not need any intense level of emergency care and attention every day. Having said that, a lot of the time, Adult Family Home employees – the care givers in this situation – are very often semi-retired registered nurses. This puts such Adult Family Home staff in the unique position to offer excellent quality care, especially in medical emergencies, to residents. When you are visiting an Adult Family Home in preparation for consideration, ask about the exact experience of the staff, and in particular, the wake staff.

Adult Family Homes are good because of the six resident limit

We’ve all watched those hospital medical series where the doctors and nurses rush to the patient with am emergency, only to stop in their tracks at the foot of the bed, scrambling to discover the background of the patient. They grab a clipboard, scratch their heads, then begin the guesswork. Sometimes, subtleties – or missing pieces of information – about that patient are omitted from consideration, and deadly decisions are made.

In an Adult Family Home, because the legal limit to the number of residents is six – it doesn’t take very long for any one staff member to know almost everything about each resident’s medical condition. Then, when that 3AM emergency call comes he or she (the care giver) doesn’t waste time trying to get up to speed on the resident’s history, but can make sound, timely decisions on behalf of that resident, even if they are, for example, passed out or unintelligible. Let’s face it, everyone’s medical history is unique, and is rarely fully transparent simply by looking at a clipboard, even if you had the luxurious time to do so before acting.

With six residents comes also a sense of security. Residents of an Adult Family Home also get to know their caregivers very well. They learn how to communicate their needs in a way that makes sense to the caregiver. Imagine living in a place where you did not know one caregiver from the next: You feel a pain in your chest, press the call button, and a stranger – whoever is on that shift – arrives to help you out. Are they a qualified nurse? A cook who happened to hear the bell ring? Will they understand you needs right at that moment, even if you are no fully coherent?

Residents get a far greater sense of security and personal safety with an Adult Family Home than they would get in a nursing home or a hospice. Still, if a hospice fits the bill for your loved one, that’s what you should consider. If they are already in an Adult Family Home, and are comfortable there, talk to them about what they options are. Don’t leave it up to chance, and don’t ignore it.

Talking before you need to talk

It’s a difficult subject, that “end of life” discussion. As they said in that movie, “in the long run, we’re all dead”, which means for each of us, our time will come. Still, it’s a subject we prefer not to let run through our heads. It’s much easier to get through today, and not worry about stuff that will happen – unpleasant stuff – in the future. It’s human nature to be like, and it’s why an amazing percentage of Americans (I’m sure it’s the same in every country) don’t have a will written, even if they have an estate.

While your parents are still relatively young and healthy – or if you are the person considering living in an Adult Family Home, you can bring up the subject – it’s never too early to understand what is ahead. If it’s a simple will you need, sometimes a simple scrap of paper expressing your wishes, witnessed and notarized by a notary public, will suffice as a will should you never get round to a more formal, full-blown will. But I digress... While your parent or loved one is living in your house with you, why not talk about what’s ahead, what options there are, and what they think they might like in the event of a necessary change in living circumstance.

There are also counselors out there who help specifically with this kind of issue. You can invite such a counselor into your home to make a plan for every person other than your kids – or maybe even for them, too – if for no other reason to get the conversation going. Even if you don’t have any specific agreements or paperwork signed early on, just bringing up the subject can be therapeutic and may set the stage for success later on.

I confess, I was in my forties before I knew what the work hospice meant. And that was only because someone I loved was losing his battle with cancer, and it became a discussion about “cancer management” now instead of beating it.

The answer would be – and this question should be asked of a medical professional which I am not – what the resident is comfortable with. There’s no one fixed answer for everyone. My own father spent the last twelve months in a nursing home, and he loved it. There were always dozens of people milling about, and he loved the sheer intensity of it, as far as I could see. He did need quite a bit of care and attention – by the time he moved to the home, far more care than my aging mother was able to provide to him – but he was able to move about and had all his bodily functions still working. He could easily have lived in an Adult Family Home, but as he said, there weren’t enough people to have a full game of bingo!

It’s a personal choice – Adult Family Home or Nursing Home.