There’s no question that as loved ones get older, and start requiring more care, there are a series of complex decisions that must be made. Perhaps the most important for family members is, what type of care is best? Is an assisted living facility appropriate, or can home health care provide what is needed? 

MyGeneration spoke to two families about their recent decision, and why it worked for them. For most, it comes down to the level of care that is required. 

Dennis Wight, whose father recently entered Avita of Stroudwater, a state-of-the-art memory care facility in Westbrook, says his family avoided assisted living for as long as they could, but that it ultimately came down to a doctor saying it was necessary. 

Wight’s father, who is 79, received a diagnosis of dementia, but is also diabetic. At Avita, he can receive around-the-clock care, as well as his specific diet needs that couldn’t be met at home. 

Three years prior, Wight’s mother died, but, Wight said, his parents needed assistance even before that. Wight, who has five brothers, slowly became the constant in-home caregiver. He said he helped his parents through issues with hygiene, medication, diet and transportation. 

But, he said, making decisions about the future of his father’s care was difficult, clouded by a large family with varying opinions and some “denial.” Also, his parents had always expressed a wish that they stay at home as long as possible. 

“We were trying to honor that wish as long as we could, as long as they were safe,” he said. “But, in the time after my mom passed, there just weren’t enough hours in the day to give my father the type of home care that he needed.” 

Wight said there wasn’t a home-health option that could meet his father’s needs, which he described as 24/7. With that, he said, costs become substantially higher. 

Lea Rust, the director of marketing at Avita of Stroudwater, said last week that she has seen the toll that home caregiving can sometimes take on families. She said families pitch in to check in, take time off from work, and change hours to fit caregiving needs. 

When she begins work with a family, there is often a recent diagnosis of forms of dementia or Alzheimer’s. 

“I see families make the decision when all other resources at home have been exhausted,” she said.

“It becomes unmanageable and a full-time job where family members can’t make that kind of commitment due to own personal needs,” she said, mentioning careers and children.

“It gets to a critical point where a decision has to be made,” Wight added. 

He said since his father has entered Avita, he has commented on how much he enjoys the food and other amenities. 

“I feel good knowing his meals are great,” he said, mentioning his father’s specific diet needs. Wight added that his father also engages in activities and is no longer isolated. 

Rust said she’s a “big supporter” of home health, and like many, hopes that her parents can remain in their homes for life. But for loved ones with certain needs, such as Wight, home health can become more expensive than rent at the average  assisted living facility. 

According to statistics from the Met Life Mature Market Institute, home health is cost effective, but it greatly depends on the amount of care that is needed. In 2010, the average annual cost of a private room in an assisted living facility with one to two hours per day of personal care, was roughly $60,000, compared to staying in your own home with three hours of care for $25,000. In a nursing home facility, the costs were even greater – more than $100,000 for the same level of personal care. 

But, for individuals who only need a few hours of care per day, like Paul Wilner, home health is the natural choice. Wilner, 60, said this week that he has gradually lost mobility in his legs, and can no longer shower or reach certain things without assistance. His said his wife, Elaine, still works full time and the couple made the decision to use LifeStages caregiving, a divison of VNA Home Health. 

Wilner said that while he wasn’t working, it was necessary that his wife remain working, which left them with a decision. 

“We decided to gradually get help,” he said, adding that they have slowly increased care as he has needed it. VNA’s LifeStages program provides personal care, companionship and transportation. For many situations, home health can provide the most economical choice. 

Wilner said he generally receives help twice a day – once in the morning and once in the afternoon. He said the program is flexible, and “there when you need it.” 

When asked if he is happy with the care that he receives, Wilner have a resounding “absolutely.”

“I strongly recommend LifeStages,” he said. 

Wilner agrees that caregiving situations simply depend on the needs of the person. He said that he’s also beginning to lose mobility in his arms, and that even in a wheelchair, it means he’ll be asking for more help. 

“Having everything ready and prepared is such a help,” he said. 

At Avita, the residents are in vastly different situations from Wilner, who’s dealing with a decline is his physical abilities only. Rust said that assisted living can provide that extra level of care when it’s needed. 

“At some point, aging adults need more,” she said, adding that assisted living facilities also provide socialization, where you are surrounded by peers. “Quality of life can be maintained in the home, but at some point people may need more. And assisted living is there to provide that for those who seek it, or the very least, learn about it.”