Warning signs like piles of unpaid bills, neglected personal hygiene or scorched pots and pans may be an indication an older relative is in need of additional care.
Locally, there are a number of businesses and agencies that offer such services, but in many cases they supplement the care provided by the individual's own family.
Family caregivers "arrange their schedules around work, around their own families," said Cathy Ash, Caregiver Advocacy Program manager for the Area Agency on Aging 8. "They're really the backbone of providing care for people staying in their homes."
EVAN BEVINS The Marietta Times
Interim Healthcare home health aide Susan Brunoni, left, plays a game of Scrabble with client Sharon Shreve Tuesday at Shreve’s Marietta apartment. Home health aides assist clients with a variety of daily activities as well as providing social activities.
According to statistics provided by the agency, 65 percent of older people with long-term care needs rely exclusively on family and friends for their assistance. Another 30 percent supplement such assistance with paid providers.
"We can do everything from just a few hours to 24 hours," said Dorthy Kratche, account executive with Interim Healthcare in Marietta.
10 warning signs senior loved ones need help
Poor eating habits resulting in weight loss, no appetite or missed meals.
Neglected hygiene - wearing dirty clothes, body odor, neglected nails and teeth.
Neglected home - it's not as clean or sanitary as you remember growing up.
Inappropriate behavior - acting loud, quiet, paranoid or making phone calls at all hours.
Changed relationship patterns that friends or neighbors have noticed.
Burns or injuries resulting from weakness, forgetfulness or misuse of alcohol or medications.
Decreased participation in activities such as attending the senior center, book club or church.
Scorched pots and pans showing forgetfulness for dinner cooking on the stove.
Unopened mail, newspaper piles, missed appointments.
Mishandled finances such as losing money, paying bills twice or hiding money.
Source: Senior Helpers.
Family meeting guide
The person leading the meeting can be the elderly relative who anticipates needing care in the future. If that person already needs care, an adult child, friend or relative can lead.
Encourage discussion and get input from everyone. Make sure everyone makes their feelings known.
Discuss money. Who will pay? How? If the money is coming from the elderly relative's estate, who will be the executor?
At the end of the meeting, everyone present must commit to support the plan.
Write it down. Good intentions are often forgotten over time and family members must have their responsibilities right in front of them.
Source: Senior Helpers.
Holiday gatherings may provide an opportunity for families to assess the needs of older relatives and determine whether they need some help in their day-to-day lives. Senior Helpers, an in-home care company that serves this area with offices in Vienna, W.Va., said in a recent release that adult children who come home for Thanksgiving and Christmas may be surprised to see their parents aren't doing as well as before. The company offered a list of 10 signals that a loved one needs help, including not only evidence one sees around the home - like unopened mail, inappropriate behavior or injuries - but also changes in participation in church or social activities.
"What's been changing? What's not been done that would normally be done?" said Kelly Fabbri, owner of Senior Helpers in Vienna.
These can be tip-offs to people who see their relatives more regularly as well, she said.
Sometimes, though, that familiarity could be a hindrance, Kratche said.
"When you are close, when you're working with your family member, you're seeing them every day, sometimes you miss some red flags," she said.
Interim and Senior Helpers both offer free assessments from a third party that can look at the situation more objectively.
Making the case
Sometimes that third party can also broach the subject of getting assistance more easily, said Pat Drake, Interim office manager.
"A lot of times family is afraid to approach," she said. "I always tell people not only is it easier for someone to assess them, it's easier for someone else to tell them what to do."
Issues of pride and financial concerns can sometimes make the family member wary.
Marietta resident Larry Proctor, 65, ran into that when he hired an agency to provide a few hours of help a week to his father, Pete. The elder Proctor seemed to appreciate the service - until he got the bill.
"He's a Depression-era man; he doesn't spend a dime on (anything)," Proctor said. "When they sent him the bill and it was for $60, he just about had a heart attack."
Lisa Turner, adult day center program manager with the O'Neill Center in Marietta, said if families are struggling with whether an elderly relative needs assistance, it's best to get the input of a doctor.
"A lot of times if it comes from the doctor, they're going to be more willing to listen than if it comes from a family member," she said.
Assistance can also be difficult to accept because it seems to represent a loss of independence. Drake suggested having the family member talk with a peer who receives assistance to get a better idea of how the process works. She and Fabbri also said it helps to stress the benefits to them, including staying in their home.
"It's to make your life easier, not to take your independence," Fabbri said. "It's helping you stay independent."
That's how Marietta resident Sharon Shreve sees the assistance she receives from Interim and a Columbus-based provider for six hours a day on weekdays and four hours a day on weekends.
"It's better this way than going to an assisted (living) program," said Shreve, 65, who was diagnosed with multiple sclerosis in 2001. "This way, I am independent. If they're not here and I need something done, I'll do it myself."
And Shreve doesn't just sit around and expect her caregiver to do everything for the time she's there.
"There's a lot of things I cannot do, like run a vacuum cleaner," she said. "(But) sometimes I say, 'Oh, let me help you make the bed.'"
That's fine with Susan Brunoni, a home health aide with interim.
"We don't want to take away from them doing things," she said.
In addition to cleaning, helping out around the house and taking Shreve to doctor's appointments, Brunoni provides companionship for her client, like playing games or just lending a friendly ear.
"They're my family," Shreve said of her caregivers.
Some family members opt to be the primary caregiver for a loved one.
Warren Township resident Susan Wunderlich, 60, took on that responsibility for her mother-in-law, Ethel, about three years ago.
"If I had been working a full-time job, I couldn't have done this," she said. "But we wanted to care for her as long as we could."
Her mother-in-law is in pretty good physical health but suffers from dementia.While Wunderlich is glad to be able to care for her, it can be taxing at times.
Her brother-in-law comes over twice a week so Wunderlich can go to church and run errands. A few months ago, she was also accepted into the Area Agency on Aging's Caregiver Advocacy Program, which provides 10 hours of respite care a week.
"It's a lifesaver," Wunderlich said. "It just feels in a way like it's an answer to a prayer."
Ash, the program's manager, said federal funds allow the agency to contract with caregiving entities to provide that respite care. Funding for the caregiver program is limited; only 33 people in the eight counties the agency serves participate, and Wunderlich was on a waiting list for more than two years.
The agency also administers the PASSPORT program locally, which provides in-home care to nearly 900 residents who meet income requirements, are at least 60 years old and need assistance with daily living.
Ash said these programs are valuable. Not every person needs round-the-clock assistance, and it's a cheaper option than using public funds to keep an individual in a nursing facility.
"It's less costly for the taxpayers," she said.
Proctor's father has significant hearing loss, interfering with his ability to go to church, play cards or participate in other social activities. In addition, he has dementia issues that resulted in him getting lost just four blocks from home in Marietta, the city he's lived in all his life.
Proctor now lives next door to his father and serves as his primary caregiver.
"It becomes very emotionally draining," he said.
Proctor's respite comes from the O'Neill Center's adult day center, where he takes his father five days a week. It gives him time to do things like shopping and other daily activities without worrying about his dad's well-being.
"I can go to breakfast, I can go to the grocery store, I can run errands," he said. "It's a great break in the action, let me tell you. I don't know what I'd do without them."
Proctor said he feels what he pays the center is worth every penny. Turner noted that while it's open to anyone, financial assistance, through the Washington County senior levy and grants, is available to county residents age 60 and older.
"It just provides them a safe place to go during the day," she said. "And it provides them with that socialization so many older adults need."
Making the decision
Whether to utilize a professional service, family care or some combination thereof is a decision that must be made by each family for each individual.
"Every individual is different. And everybody has to have an individualized care plan," Drake said.
If family members do need outside help, Ash recommended against simply advertising for someone to come and help out around the house or stay with them for a while. Agencies "have trained their staff. They have a certain level of supervision," plus insurance, she said.
Interim and Senior Helpers officials both said they can provide whatever level of care a senior citizen needs, whether it's regular hours or occasional assistance needed to supplement a family's.
"We don't put any minimums or maximums on our services because we try to stay as flexible as possible," Fabbri said.