Once it has become clear that elders can no longer be safe living completely independently, families most often look to one of three solutions: provision of in-home assistance; moving the elder in with a family member, or moving the elder into a care facility in the community. Each solution has advantages and disadvantages that can be considered before arriving at a final decision.
- In-Home Care. Providing an elder with in-home care assistance allows that elder to remain in their own comfortable and familiar home environment. This is often a preferable situation for all involved parties. However, in-home services can become costly and will require someone (usually a family member) to function as a coordinator, researching and hiring outside caregivers. In-home care is also only a viable option for minimally to moderately impaired elders. Very severely impaired elders will likely require a more constant level care than any in-home provider can offer.
- Living with a Family Member. There are multiple benefits associated with moving an elder in with a family member (usually an adult child) as a care solution. The care-providing family member is able to spend time with their elder, is able to more directly coordinate his or her care, and in general, is less likely to worry about the quality of care the elder might receive at the hands of a third party. Children in the family member's household are given the opportunity to get to know their elder and to develop stronger family relationships. Depending on health and functional limitations, the elder may also be able to help out around the house to some extent. A final benefit is that this solution is often the least expensive care giving option.
There are also significant disadvantages to having an elder come to live in the home, however. Both family members and the elder will experience a loss of privacy. Having been used to living in his or her own home, the elder may suddenly feel as though he or she has no personal space anymore. He or she may need to place possessions in storage or sell them, either of which may lead to additional feelings of loss. While family members may feel good about providing care for their elder, they may also feel some resentment or obligation when the responsibility of providing care decreases their own options or otherwise ends up interfering with family routines and schedules.
- Living in an Eldercare Facility. Elders who move into a community-based eldercare facility experience a mixture of benefits and losses. On the benefits side, they are in a position to receive the care they require, and, frequently, are able to receive that care where they are (rather than having to drive to get care). There are also significant new socialization benefits, as the elder is now living near other elders in similar situations. Care facilities are likely to offer organized activities and scheduled social times to encourage residents to interact. This opportunity can come as a welcome and energizing change for elders who were formerly confined to their homes due to poor health.
As always, disadvantages are also present. Elders moving into to a community facility experience the loss of their home and possessions which can produce intense feelings of grief. There is also a corresponding loss of autonomy, as the elder's former schedule and routines need to be adapted to the routines of the facility. If it was not the elder's explicit choice to move to a facility, he or she may develop feelings of abandonment and resentment towards family members.
There is no 'best' answer to the problem of selecting a method for providing elder care. Though elders' varying needs must determine the types of care they require, real-world care solutions must fit within the financial, time and emotional resources that family and the elder can contribute, and the family's existing commitments and attitudes towards providing care.