Making decisions for a family member with Dementia can be incredibly difficult. A variety of factors from identifying the stage of Dementia to logistics and affordability need to be taken into consideration. The most challenging aspect can be trying to balance your personal and professional responsibilities whilst supporting the ever-changing needs of your loved-one. This article shares information and case studies to help you navigate the specific decision to opt for Live-in or Hourly care.

According to the Alzheimer’s Association, 1 in 9 Americans over the age of 65 lives with Dementia. Every family of those 65 million people can attest to the painful and exacting decisions they have to make regarding the care of their loved ones. As Dementia progresses, the level of care and support required increases as well.

`        When deciding which model of care works best for your loved-one, it’s important to understand 3 key factors:

  1. The stage or rate of progression of Dementia
  2. Access to quality caregivers
  3. Hourly vs Live-in home care

At Care Mountain, our tenure in quality home care to patients living with Dementia provides the following guidance for required hours of daily care:

Care Mountain’ s team of knowledgeable caregivers go through a rigorous interview to ensure they have a wide breadth of experience and compassionate disposition. This reinforces the belief that the right caregiver can help slow down the progression of Dementia with timely and dedicated care. Inconsistent care can result in a painful, uncontrolled and accelerated progression of Dementia. In some instances, patients progress from mild to severe dementia in less than 3 years. A shocking contrast to those patients who receive round-the-clock care and live with an improved quality of life and limited deterioration for 10-12 years.

Care Mountain provides 2 main types of in-home care – Hourly or Live-in.

Hourly Model Live-in Care Model
  • Hourly care for approximately 6-12 hours (Details)
  • Common option for patients in mild to moderate stages of Dementia and Alzheimer’s
  • 24 hour care (Details)
  • Needed for moderate to severe cases of Dementia and Alzheimer’s
  • Ideal when loved one lives alone
  • Beneficial when loved one lives with a spouse who has their own health challenges, creating limited availability of support
  • Maintains privacy and independence in the home when the caregiver leaves and it’s family only at home
  •  Budget friendly during mild/moderate stages. Helps save funds for when disease progresses to a severe state and patient’s care needs are longer/ 24 hours a day
  • Less expensive as need for coverage increases
  • Care logistics with night time and weekend coverage are easier for families to schedule, and less expensive to arrange as part of a live-in care mode vs hourly model
  • Planning coverage for your loved one’s safety is challenging. It’s possible for gaps in care to occur and fall risk is high with Dementia and Alzheimer’s patients. Most falls typically happen when patients are alone
  • On a per hour basis, hourly care works out to be more expensive than live-in care
  • Your family’s privacy is limited
  •  Live-in caregivers require access to a private room, bed, closet, and bathroom
  • Live-in caregivers require 5-6 hours of daily rest. Additional caregivers or family members might be needed to be with your loved one at those times

The following case studies are a good way to understand the different scenarios in which hourly care vs live-in care is beneficial.

Case Study 1

Esther G. is an 80-year old widow who lives in Preston Hollow, TX. Esther was diagnosed with  Alzheimer’s dementia 5 years ago. Her husband had been her primary caretaker before he passed 2 years ago. Esther’s children reside out of state and both have asked Esther to live with them but she prefers the comfort and routine of her home. On occasion, when Esther visits them, she becomes more disoriented and forgetful. Studies show that consistent care in a familiar environment can help slow down the progression of Dementia. In this case, it is advisable for her children to seek live-in-care for Esther. Living with Alzheimers, alone and far from her family members, Esther’s health and safety are compromised by her inability to care for herself. A live-in caregiver provides her family with the knowledge that Esther is receiving quality, professional care from an experienced caregiver who can attend to all her needs from ensuring that she is taking her medications, getting outside for exercise, living in a clean environment with healthy meals, and interacting with another individual on a daily basis.

Case Study 2

Arthur C. lives in Southlake, TX and was recently diagnosed with Parkinsons. Prior to his diagnosis, he was incredibly independent and mobile, living on his own for many years after his wife passed away, and maintaining an active lifestyle. Arthur’s  only child is his daughter Eva who lives in Frisco. Eva also has a busy life as a lawyer, raising 3 children, and fulfilling extensive social and professional obligations. Eva recently noticed a decline in Arthur’s cognition and memory. Consequently, Arthur moved in with Eva so that she could help with his care. Even though they live together, Eva feels guilty that she is not able to care for her father full-time. Her family and professional life make it difficult for her to provide the time and attention Arthur requires during the day. In this scenario, in-home care provided by an hourly caregiver is ideal. Arthur can receive daily support from an informed professional who will ensure that he is receiving the best care for his condition. Eva also receives a lot of support by knowing that she is proactively helping him maintain his health with dignity and care. In the unfortunate event that Arthur’s condition deteriorates and he requires additional care, Care Mountain is able to seamlessly transition Arthur to live-in care with 24 hour coverage.

Case Study 3

Linda and Harold J. are both in their 80’s and live in Highland Park, TX. Their 2 sons live out of state and due to their hectic work schedules and young families, are unable to come visit often. Linda has been living with several medical ailments for the last 10 years – she has COPD, diabetes and rheumatoid arthritis. Harold has been her primary caregiver – driving her to doctors appointments, managing household duties, and ensuring that Linda takes her medications on time. In the last year, Harold was diagnosed with moderate Alzheimer’s dementia. Moving Harold and Linda closer to their children is complicated because uprooting them will add to Harold’s dementia-related agitation. Putting both parents in a home or care facility will prove to be very expensive and there is no guarantee that the couple can stay together if the health of one deteriorates faster. In this case, live-in care is the best answer for the family. Care Mountain is able to provide coverage for both Harold and Linda with an experienced caregiver who can oversee Harold’s dementia as well as Linda’s COPD and diabetes. Tandem care would ensure that there is consistent coverage and provide peace of mind to their sons.

While every scenario is different, the common thread is the pursuit of a well-informed decision that helps your loved one stay safe, comfortable, and healthy while helping to limit the progression of their condition.

2022-02-10 14:25:07

Dementia In-Home Care – Live-in vs Hourly Caregiver Models