The Vancouver Sun

November 3, 2007

Seniors just want to stay home

Question of how to care for elderly parents weighs heavy on the mind

by GILLIAN SHAW, The Vancouver Sun

Like many of B.C.'s frail elderly seniors, Douglas Craig just wants to stay home.

Not "a" home, but the home where he has lived for years, the home he shared with his wife Kathleen and where he is surrounded by the familiar rooms and furniture, the treasures and memories of a life well spent.

And thanks to virtually round-the-clock care by nurses, caregivers and family members, Craig, at 84, is able to have his wish, despite suffering from Alzheimer's and congenital heart failure, which have curtailed his long walks in the neighborhood.

"He sometimes asks me, 'How long can I stay here?' " said his son Alan Craig, who has moved into his parents' Burnaby townhouse to be with his father.

It's a question that weighs on the minds of many elderly people and their families as declining health can rob them of their ability to live independently.

The Craigs have already faced that dilemma with Kathleen, who is also 84. Her health started to fail before her husband's and Doug, as he is known, was her caregiver, a job he wanted to do. He rejected home help, but the burden took its toll. Eventually both ended up in hospital.

"He was exhausted," Alan said. "He did everything, he cleaned, made beds, he did the vacuuming."

Kathleen has diabetes, her blood sugar levels were way out of whack and her mobility was poor.

With her care needs escalating and Douglas no longer able to look after her, Kathleen moved to the Canada Way Care Centre, a residential care facility.

That still left Douglas, who could no longer manage on his own, so the family called in Nurse Next Door. Now, the Nurse Next Door's Loretta Lucero arrives every morning and spends six hours with Douglas while Alan is off running the painting business, Craig & Son, which he took over from his father, just as the elder Craig, the original son in Craig & Son, took over from his father.

Alan's father is on his own for only two or three hours before Alan arrives home, where he is spelled off some evenings and weekend time by other family members.

"It lights up his day when she is here," Alan said of Lucero. "As a family we are very appreciative of Loretta.

"I consider she has bonded with my Dad. He looks forward to her coming and she does a lot with him."

The pair goes on outings; Lucero can drive the elder Craig, who had to give up his licence two years ago. She's the one who takes him to medical appointments, acting as an advocate just as a family member would do. She also goes to see Kathleen, with another family member coming by to see that Doug isn't left on his own.

Lucero is a home-care worker, overseen by a nurse who drops by to check out Doug.

Ranging from $22 to $29 an hour, private care isn't a solution that comes cheaply, but it provides the opportunity to keep seniors in their own homes longer.

It's an option that Peter Silin, a social worker who started Diamond Geriatrics, a geriatric care management, counselling and consulting company, sees as the best one to serve our aging population.

"Sometimes it is a matter of getting people the help at the time they need it," he said.

Silin said people often come to him when they are in a crisis, or when they need an advocate or in the case of families, when they are out of town and unable to care for Mum or Dad.

"I do a lot of work with families struggling to make a decision," he said. "If you have three adult children, they have different needs, they all have different relationships with Mum or Dad. They have a different outlook on what should happen to Mum or Dad and how Mum or Dad's money should be spent."

Silin said he has seen a number of cases where the elderly person is moved into a care facility to save the family having to tap into the resource of the parent's home to pay for help.

"I think to myself, if you got a reverse mortgage or a line of credit, Mum or Dad could live in this house for another five years because they could hire someone to come in and look after them."

Silin said even when parents tell their grown children they can have the house, the children shouldn't take advantage of the offer.

"It really is financial abuse," he said.

For John DeHart, our aging population is creating growing demand for Nurse Next Door, the business he co-founded with Ken Sim.

"We are in the midst of expanding across Canada," said DeHart, adding that original plans to expand across the country gave way to franchising when they realized it would be better to have local business owners in each market, so they can build and train staff. The staff includes people with various levels of training, from registered nurses, to licensed practical nurses, to care aides and caregivers.

"If we can help keep a senior in the home longer, the costs to our health care system decrease dramatically," DeHart said, adding that 95 per cent of his business is care giving."We really only need those licensed professionals in highly complex situations, a lot in the final days of life. All the way up to that point, if it is carefully managed, you can have a caregiver managed by an RN."

DeHart said caring for the elderly at home comes at a much lower cost than institutional care and it gives the senior a degree of independence.

"We do have a fear of losing independence and moving into a nursing home," he said. "Now we are looking at a quality-of-life issue.

"If you look at the top three things Canadians fear about getting older, it is deteriorating physical health, losing their independence and needing long-term care or assisted living."

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