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Open letter to Home Care Companies- Stop with the Guilt Trip Already

I'm especially tuned in to TV and radio commercials about senior care.  Whenever I hear Joan Lunden (A Place For Mom), John Walsh (Great Call) or Cindy Williams (Visiting Angels), my ears perk up to hear what they have to say about the companies they represent.  It's refreshing to see the commercials, I believe it continues to raise awareness among the general public about companies who serve seniors and it's a nice break from beer and beauty ads.  Usually, they pull on my heartstrings and make me want to cry.

Then I saw a senior care commercial that broke my heart.  It targets the guilt-ridden families and spouses who have ever considered or had to make the difficult decision to place a loved on in a senior care community.

The commercial starts out with the adult daughter talking about how mom had started to become more confused and that it was time to navigate the world of home care.  It goes on to laud the accreditations the home care company earns and the level of services that can be adjusted to keep up with mom's needs.

And then, the punch line is dropped to seal the deal.  “Because Dad made us promise we'd keep Mom at home.”

Really?  So instead of leaving it at “we are a great company, have lots of accolades and we hire excellent people” we are playing on the painful emotions that people have to grapple with because of a promise made when the loved one is not ill or cognitively impaired?  And keep mom at home from what?  Fantastic assisted living, adult care homes, or memory care communities that are really good at what they do?  I understand that people have this idea of what they think community-based senior care (assisted living, adult care homes, etc…) is really about, but they don't (especially if the last time they experienced it was in the 80's in grandma's nursing home).

I'm not upset at Bright Star specifically, they just happened to make the commercial.  Here are my concerns about home care companies making assisted living (substitute any level of senior care facility) the enemy.

Who would you rather be: Spouse or Caregiver/ Child or Caregiver?

home care companies

There are many cases where keeping mom (or dad) at home is simply no longer an option.  Sometimes keeping a loved one at home is risking the health and wellbeing of the family caregiver or spouse.  In my previous life helping families find care for a loved one, by the time those families found their way to me, it was clear that the mental and physical stress had taken it's irreversible toll on that caregiver (who was often a spouse in their 70's or 80's).

In addition, the resentment had built and the “promise to keep mom at home” had lost its luster and well-intentioned meaning.  If I had a dime for every time an adult child said “I just want to go back to being her daughter”…

Cost Comparison: Home Care vs Assisted Living

According to Genworth, the national median monthly cost of an in-home care aide is $3520 for 44 hours of care per week.  In comparison, an assisted living community runs $3600 per month.  At the same rate, full time in-home care would cost $13,440 per month.

So, if someone needs part-time care, financially, in-home care makes sense up to a certain point.  For most families and older adults, full time in-home care care is cost prohibitive.

True or False: In-Home Care can handle anything

The video asserts that as care needs change, so can the services provided by in-home care. The reality is that most aides are not certified nurses assistants (CNA's) although they may be overseen by an RN.  Some home care companies can't even provide medication management services unless they receive approval from state licensing agencies (state dependent). I have personally seen difficulties arise when in-home clients need more than stand-by assistance for transfers, have behavioral issues or are exit seeking because the caregivers are simply not equipped to handle these types of care needs.

Home Care Companies are NOT the only Solution

I'll finish my rant by repeating something I have said to families for years.

There are options, there is no silver bullet in the world of senior care and every situation is different.

If you have made the promise to “never put me in a home”- please don't beat yourself up.  If the time comes and it's your family's best option to find a quality senior care option, so be it.  If you never have to go through the process of finding a care setting for a loved one, I'm happy for you (and you're extremely fortunate).  In the meantime, I implore all companies that serve seniors to give these families a break-  Stay away from the guilt trips and stick to the heartstrings.

10 Comments

  1. My mom and I are trying to figure out what to do with my grandfather. He lives in a different state, so it is hard for her to visit on a regular basis, and in-home care is pretty expensive. It has been difficult because we want to do right by my grandpa, but his mind is not in the best place. Having home care companies try to guilt trip you in a commercial certainly doesn’t help… thanks for the post!

  2. I hope NO ONE is saying that Nursing Home or Board and Care Facility is an option! We need to find ways to keep our parents in their own home! Financial Elder Abuse is being committed by family members just to get money! What’s the difference of Live in Caregivers and putting them in a home? I am against Nursing Homes unless VERY CRITICAL!!

  3. Amie

    Great information for families in need of a care solution.
    Every situation is different and the better companies out there will
    discuss the options that may be available in your area that fit the current need.
    Thank you
    John Giordano
    Executive Director
    Bristal Assisted Living Communities

  4. Wow…you really hit home on this one. (no pun intended:). There is a place for everyone and as my mother’s guardian several years ago, the best choice for her was assisted living. She improved and even thrived! At home, we tried in home care on a part time basis however, she needed the socialization, the group encouragement and the place to serve others in her own way.

    Now, in case you think that I am opposed to in home care; I co-founded what I believe is one of the premier non-medical home care services called LEAVES Personal Care in Grandville, Michigan, and it is such a blessing to so many who desire to stay at home and are able to afford that option. Some families have grandma or mom move in with them, some go to homes for the aged, such as where I serve as a Memory Care Program Developer/Trainer and love it.

    It is about the fit, and I am a mentor and an encouragement to all providers of excellent care and services for personalized care. The mission at Rest Haven Homes in Grand Rapids, MI where I serve as a trainer/memory care consultant/social service coordinator is “by love serve one another” and they receive from us…we receive from them…Keep us thinking and improving! God bless you. Jan Dressander,

  5. I watched my 5 ft, fit mother wither away to under 90 lbs as she tried to care for my father with dementia because home was the best place for him. When he ended up in the hospital dehydrated from a GI bug the doctors took one look at her and said “we’re sorry but unless you can show us that he has 24 hour care at home to assist you, we cannot in good conscious allow him to return”. We moved him into a memory care community immediately (from the hospital- they held him an extra 2 days to make it happen). He immediately gained 11 pounds (he had lost 30 in the 2 months prior), and engaged in activities that were designed to capture his level of attention and ability. He slept well through the nights – because he was engaged during the day and had a set routine. My mom slowly regained a few pounds and discovered Yoga for her health, and remained very involved as his advocate and spouse until he died, 20 months later. It was a great relief to me, as the back up caregiver to know they were each where they belonged.

    1. Wow Jenn – Thank you for sharing that with us. While it seems like Home-Sweet-Home should (usually) be the best alternative… That’s not always the case. It’s clear from your story that the best decision for your dad’s care, AND your mom’s health was to move him into a memory care community. Very difficult decisions for most families to make. – Best! A

  6. I remember when my mom had to decide whether or not my grandma should stay and live with my aunt or go to a nursing home – at the time it was a traditional nursing home. My aunt was distraught, not managing her life or grandma well – there were even signs of potential neglect and abuse. We decided to place her in the lovely little nursing home in her small home town.

    Grandma, for the first time in her life learned to paint landscapes – though she could not see well, she did such a great job – we have matted, framed and hung her work in our homes. She hooked rugs, and wall hangings, she knitted and crocheted afghans, things she never had time to do or was encouraged to do before. All which are immeasurable treasures, giving her dignity and quality of life she would not have received otherwise.

    There is absolutely a time and place to keep someone in their own home. We kept Dad at home while suffering from Pancreatic cancer with support of in-home services and hospice, the only right thing to do in that situation.

    Amie, your comments are well written, thank you!

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