Paul Kusuda’s column
LONG-TERM CARE
LONG-TERM CARE
Conclusion
By Paul H. Kusuda
In January, I wrote that as we get older, we should make contingency plans about where we
should live when the time comes to decide to leave our home or apartment because it’s
increasingly difficult to live without a lot of personal help. We might need help with basics
such as cooking or getting meals, bathing, toileting, moving from room to room, going up and
down stairs, just getting out of bed, etc. Daily living independently may no longer be an
option. We might too often forget where we put things; we might forget to take pans off the
stove after cooking or heating food. (We’re lucky when we use a microwave!) We might have
a tendency to lose our balance or even fall occasionally.
By Paul H. Kusuda
In January, I wrote that as we get older, we should make contingency plans about where we
should live when the time comes to decide to leave our home or apartment because it’s
increasingly difficult to live without a lot of personal help. We might need help with basics
such as cooking or getting meals, bathing, toileting, moving from room to room, going up and
down stairs, just getting out of bed, etc. Daily living independently may no longer be an
option. We might too often forget where we put things; we might forget to take pans off the
stove after cooking or heating food. (We’re lucky when we use a microwave!) We might have
a tendency to lose our balance or even fall occasionally.
Eventually, we may have to accept the fact that even though we don’t want to move from familiar surroundings, we
must. The point becomes clear that most need considerable help to decide when it’s time to move to an unknown, or
little known, place and probably with few friends—relatives, maybe, but not many friends.
Because social agencies are doing such an excellent job of responding to the wishes of the elderly who want to
avoid moving to a nursing home (the primary alternative a couple of decades ago), the dreaded decision-making need
has been postponed by many, possibly too many. My concern as an advocate for the elderly is that insufficient attention
has been paid to the difficult task involved in helping an elderly person face the reality situation before the time comes
when moving from home or apartment to some strange place becomes a must rather than a maybe later. Case
managers are an excellent resource for their clients, but do they have enough staff time to do as much as they believe
necessary? What about those who are not receiving social agency services?
Social agencies provide many services to enable elderly persons to remain in their own homes or apartments. They
include volunteers to deliver meals; volunteer drivers to take elderly or those with physical disabilities to medical, dental,
or other appointments; telephone assurance calls; friendly visits; low-cost congregate meals with emphasis on
socialization; caring for care-givers; adult day-care facilities; falls prevention and gentle exercise programs; card parties
and bingo games for socialization and interaction opportunities; hospice programs; indoor and outdoor chore services
by volunteers; community center activities; information about community resources; home health services; loan
programs for canes, wheel chairs, and other medical-related equipment; etc.
Many social, medical, and health-related organizations are available in or near local communities. Many are public,
others are private, and still others though private have access to public or foundation funds that enable reduced costs to
elderly who meet financial qualifications. Wisconsin has three Area Agencies on Aging (that cover the entire state), local
community centers, senior centers, public and private non-profit organizations, all with knowledgeable staffs who can
provide services or make referrals to appropriate resources.
For years, older people had few alternatives available when they faced the reality that they had too many obstacles to
overcome to remain in their own homes or apartments. Social agencies recognized that nursing homes or hospitals
must not be the only alternatives for the elderly. Thus, in-home services were developed. Public money (federal, state,
county, city, and other local), foundation grants, community funds (for example, United Way and Community Shares) and
personal contributions are used to provide the variety of services now available to help the elderly remain in their own
homes or apartments as long as possible.
Housing alternatives to nursing homes are available, at a cost, of course, to meet the physical, emotional, spiritual,
and other needs of the elderly. Housing villages now provide facilities for independent living, assisted living, and long-
term care. Nursing home needs will doubtlessly increase as our population ages; therefore, they need to be upgraded
in some cases. Patient care staffs need to be trained and certified in greater numbers so that facilities may be
adequately staffed. Their pay should better reflect the value of the work they perform.
Unfortunately, an unanticipated result of the emphasis on staying put is that the elderly person’s need to come to
grips with the inevitable decision to leave familiar surroundings is indefinitely postponed. Now, increased attention (and
concomitant funding) must be given to helping the elderly make plans specifically for that move. Adequate funds should
must. The point becomes clear that most need considerable help to decide when it’s time to move to an unknown, or
little known, place and probably with few friends—relatives, maybe, but not many friends.
Because social agencies are doing such an excellent job of responding to the wishes of the elderly who want to
avoid moving to a nursing home (the primary alternative a couple of decades ago), the dreaded decision-making need
has been postponed by many, possibly too many. My concern as an advocate for the elderly is that insufficient attention
has been paid to the difficult task involved in helping an elderly person face the reality situation before the time comes
when moving from home or apartment to some strange place becomes a must rather than a maybe later. Case
managers are an excellent resource for their clients, but do they have enough staff time to do as much as they believe
necessary? What about those who are not receiving social agency services?
Social agencies provide many services to enable elderly persons to remain in their own homes or apartments. They
include volunteers to deliver meals; volunteer drivers to take elderly or those with physical disabilities to medical, dental,
or other appointments; telephone assurance calls; friendly visits; low-cost congregate meals with emphasis on
socialization; caring for care-givers; adult day-care facilities; falls prevention and gentle exercise programs; card parties
and bingo games for socialization and interaction opportunities; hospice programs; indoor and outdoor chore services
by volunteers; community center activities; information about community resources; home health services; loan
programs for canes, wheel chairs, and other medical-related equipment; etc.
Many social, medical, and health-related organizations are available in or near local communities. Many are public,
others are private, and still others though private have access to public or foundation funds that enable reduced costs to
elderly who meet financial qualifications. Wisconsin has three Area Agencies on Aging (that cover the entire state), local
community centers, senior centers, public and private non-profit organizations, all with knowledgeable staffs who can
provide services or make referrals to appropriate resources.
For years, older people had few alternatives available when they faced the reality that they had too many obstacles to
overcome to remain in their own homes or apartments. Social agencies recognized that nursing homes or hospitals
must not be the only alternatives for the elderly. Thus, in-home services were developed. Public money (federal, state,
county, city, and other local), foundation grants, community funds (for example, United Way and Community Shares) and
personal contributions are used to provide the variety of services now available to help the elderly remain in their own
homes or apartments as long as possible.
Housing alternatives to nursing homes are available, at a cost, of course, to meet the physical, emotional, spiritual,
and other needs of the elderly. Housing villages now provide facilities for independent living, assisted living, and long-
term care. Nursing home needs will doubtlessly increase as our population ages; therefore, they need to be upgraded
in some cases. Patient care staffs need to be trained and certified in greater numbers so that facilities may be
adequately staffed. Their pay should better reflect the value of the work they perform.
Unfortunately, an unanticipated result of the emphasis on staying put is that the elderly person’s need to come to
grips with the inevitable decision to leave familiar surroundings is indefinitely postponed. Now, increased attention (and
concomitant funding) must be given to helping the elderly make plans specifically for that move. Adequate funds should
be provided, even in these lean times, to
social agencies to enable them to help
elderly persons make the inevitable decision
to move. Resistance to such planning is
understandable. Therefore, efforts to help the
elderly plan for the relatively-near future is
critical. The terrible fact, however, is that
public and private funds have dwindled and
will continue to dwindle.
social agencies to enable them to help
elderly persons make the inevitable decision
to move. Resistance to such planning is
understandable. Therefore, efforts to help the
elderly plan for the relatively-near future is
critical. The terrible fact, however, is that
public and private funds have dwindled and
will continue to dwindle.
