It’s a life passage no child looks forward to: when you must help care for the parents who once took care of you. With the elderly population living longer than ever before-and the parallel trend toward delayed child rearing-many Baby Boomer women are finding themselves in the Sandwich Generation, when both children and parents need your help. Here, central Illinois experts weigh in on elder care options, deciding what’s right for your family, and ridding yourself of guilt.

Interim HealthCare

If given the choice, most people would want to remain in their own homes as long as possible, and with the services provided by Interim HealthCare, it’s often a real possibility for the elderly population. "We offer many types of services," said CJ LeMasters, director of operations. "Nurse, physical therapists, occupational therapists, and/or speech therapists are available to provide skilled, intermittent care. This means a nurse or a therapist goes into the home, performs a treatment for the client, and leaves. Visits are usually one hour or less."

Another alternative, she said, is skilled continuous care, which is when a nurse stays with a client for specific time periods. "We provide this type of care for patients who have medical problems that require a nurse or a specially trained caregiver to provide 24-hour-a-day awake care."

A certified nurse aide or homemaker staffs Interim HealthCare’s HomeStyles program. "Our goal with this program is to provide enough care to a client that we can delay or prevent the client from moving out of their home. We call it supportive care, and it can include housecleaning, meal preparation, companionship, errands, and supervision of a client if needed," LeMasters said.

LeMasters, who has oversight for Interim’s offices in Peoria, Springfield, and Bloomington, said their offices receive numerous calls every day requesting a wide variety of services and information. "Some clients we’re able to help and some we can’t, due to the lack of a payer source or simply the distance a client may be from us. For the clients/patients we can’t serve, we don’t just say ’sorry’ and hang up; we attempt to find services for the client through another source or agency in their area. Sometimes we just listen. Caregivers can become so overwhelmed caring for a loved one that they just need to talk. Sometimes they’re looking for services in the future and are inquiring about what’s available. We outline different options, explain the resources in the area, and provide phone numbers if we can’t care for them."

She said services such as the ones provided by Interim can be a great alternative to a nursing home. "Especially when a senior is in the early stages of forgetfulness or can’t care for the house, run errands, or even wash their feet or back. Many years ago, families would have cared for the seniors by dropping by every day or moving them into their home; now, families live out of the area or work, and we then become the solution."

There are many factors that go into determining when and if a senior should move into a long-term care facility, LeMasters said. "Interim HealthCare can always place a caregiver into a home for up to 24 hours a day. This service allows a senior to remain in his or her own home until death. However, this service requires private funds, as neither Medicare nor Medicaid will pay for what’s called ’custodial care.’ When a family can’t afford extended care hours, we would probably recommend facility placement if seniors are unable to manage their medications on a regular basis (taking more then prescribed, the wrong medications, requiring injections, etc.), their mental status makes them a risk to themselves (wanders out of the home, leaves the stove on, or forgets to eat), or they have frequent falls."

LeMasters said the response to Interim’s services from a senior’s family depends on many variables. "With our intermittent cases, everyone is grateful. We’re working on recovery to independence, and that’s always exciting. Our continuous care cases are very different. In this service, we deal with long-term illness or handicaps, and patients who can require awake care 24 hours a day. Families have nurses in their home 18 hours a day, listening and seeing everything they do. Families who feel guilty because they can’t care for a parent sometimes micro-manage from afar. A family can become upset over an employee’s laugh or the way the employee irons or makes a meatloaf. We realize this is how many families are dealing with the stress of caring for a family member who requires long-term support. They feel guilty for not being there all the time. We try to work with families on their expectations of a paid caregiver, and we create relationships with seniors and employees so the senior teaches the employees, the senior feels needed, and the employee enjoys the case."

Developing these relationships is why LeMasters wholeheartedly believes in home care. "Do I love home care? You bet I do. To help people come home or remain home with comfort, compassion, and quality of care is my mission."

Elder Care Management

Sandi Kistner, who runs Elder Care Management, has been in health care for nearly 30 years. She said while her company has been in the works for about five years, it’s only been in the last year that she’s gotten her vision off the ground.

She saw a substantial need for her services during her 20 years at Apostolic Christian Restmor in Morton. "Changing demographics were evident in my daily work. The number of children in a family were decreasing as longevity of parents was increasing. The parental support system was also impacted by a more mobile society. Health care, long-term care specifically, was and still is changing at a rapid-fire pace. Relationships were challenged as aging parents and their families struggled with numerous issues and decisions. I began to get calls from friends, friends of friends, and other professionals who needed direction in caring for an elder individual."

Then the challenge of others became her personal challenge, as her mother’s health began to change. "Locating services and putting systems into place to meet Mom’s ever-changing needs became an overwhelming and enormously frustrating task. This was complicated by my mom’s rather non-compliant, opinionated personality. Getting her proper medical care took at least a year. The demands of my mom, working full time, and raising four children would have put anyone over the edge. My saving grace was my years of working with the elderly and the knowledge of available services."

Kistner decided to go into private practice to give others the benefit of her years of experience. "My job consists of assisting the elder client and/or their family in the areas identified during assessment, providing consultation regarding what may be available to meet their needs, designing a plan for care that’s acceptable to the elder client, and linking to available services. One constant in my day is an attempt to stay current regarding products and services available to meet the assessed needs of elderly clients."

She said clients typically identify their own needs. "Sometimes the need is apparent. In other situations, the need becomes apparent through assessment. Elder Care Management Services attempts to locate the product, service, or individual to meet the identified need and then link the two. Services have varied from consulting with an elderly client about how to communicate with a physician, working with a client who needed respite from primary caregiver responsibilities, providing long-distance caregiving contact information, and encouraging a caregiver to inform an employer of parental care responsibilities."

Kistner receives requests for help from potential clients, their families, and even other service providers. "In all cases, the elder client must need and want the services. What others see as a need may not be a need to the individual. Self-determination is a factor that must be recognized and acknowledged. An unresolved concern or the development of a crisis is the typical reason I’m contacted."

Women, statistically speaking, are the primary caregivers of family members, Kistner said. So when daughters call and request her help with their parents, it’s not uncommon to witness guilt, anger, frustration, and fear about the situation at hand. "Approaches to addressing these emotions with caregivers vary. Some feel less guilty just having talked through the situation and identifying where to start, some need to identify what, specifically, they feel guilty about and address that issue, and some need information to know how to ask other family members for help. I’ve found that when caregivers are reminded of how the historical picture of the family has changed, there’s some sense of acceptance."

Providing answers to elderly clients and their families makes for very rewarding work, she said. "It’s been easy for me to remain passionate about advocating for this group. Listening to them in an effort to assess their needs and then putting a successful plan in place to meet those needs is very satisfying."

The work is not without frustration, however. "The challenge is recognizing how much needs to be done to help meet the needs of the elder client, the family of today, and the elder client of the future. For instance, how do we incorporate this challenge into our work lives? Caregivers need to ask for help, attend support groups, and benefit from shared information. The difficulty is that caregivers are so busy doing that they rarely take time to think about what services may help them. Our purpose is to help elders, as well as caregivers, identify what needs they may have and link them to, or work toward, the development of services that will meet their needs."

Sharon Health Care

Sharon Health Care System, one of the largest employers in Peoria, offers a variety of facilities and services to help seniors and their families make choices that are right for them. "Sharon Health Care Elms provides skilled medical and rehabilitation services, Sharon Health Care Pines provides individualized care and programming for persons with Alzheimer’s Disease and other forms of dementia, and Sharon Health Care Willows and Woods provide programming and treatment for individuals who are mentally challenged," said Dawn Lane-Wagner of Sharon admissions and marketing.

Lane-Wagner said nursing homes have changed dramatically over the years and aren’t simply institutions where elderly residents spend their last days. "An increasing number of individuals receive hospital-level therapy and rehabilitation services in nursing homes. Lengths of stays have decreased, leading some patients who normally would undergo therapy and rehab in a hospital setting to receive these services in a nursing home."

The needs and issues of caregivers have come to the fore in recent years, as well, she said. "Caregiving for a loved one can be physically and mentally overwhelming. Recognizing that you may need help in providing this high level of care is the first step in improving the quality of your life and that of your loved one. That’s why Respite Care has become so important. Regularly scheduled respite days allow the caregiver time for doctor visits, shopping, errands, and personal time."

Lane-Wagner said she loves that her job involves helping people on a daily basis, but in her line of work, educating the public is also a daily activity. "We try to rid people of the notion that all people do in a nursing home is grow old and play bingo. Our residents enjoy a multitude of opportunities in and out of our facilities. People sometimes find themselves more active than they’ve been in years. Programs include concerts, dining at favorite restaurants, pet or music socials, dances, obtaining a G.E.D. or taking a college course, shopping, access to computers, therapeutic work programs, and more. I know when someone comes here they’ll receive the highest level of quality care, along with a great quality of life." TPW