Dear Caregiver Support Line,
I have been providing care for my partner for many years. They are now requiring more and more physical care and I feel that they are at risk being at home alone. I am feeling more and more burnt out and exhausted – I just can’t do this anymore more. I know it’s time to look at finding a residential care home for them but then I feel so guilty even thinking that and feel that I am letting them down. Could you please advise me where to go to start this process? Where do I start? What do I do? Where can I get reliable information? Thank you for your assistance!
-Considering Long Term Care Options
Dear Considering Long Term Care Options,
For some families, there comes a time when a move to a care facility may be the best way to provide the most appropriate care needed and to relieve the overwhelming demands on the family. Making the decision to move someone we are caring for into facility placement is one of the most difficult decisions to make. This decision is often precipitated by a crisis or a change in health and becomes necessary either because the care recipient is no longer able to safely remain at home or because family members can no longer provide the level or type of care that is needed.
It’s completely natural (and expected) for family members to feel guilt, grief, or anxiety when having to make such a decision and it is also quite common to have differing perspectives from the various people concerned. The transition can bring with it new challenges and stresses for everyone involved. At this time building a circle of support around you is crucial. Choose a team of people who can support you emotionally and physically as well as through practical skills, such as having experience caring for someone in complex care, legal and financial expertise or research skills.
Cathy, a caregiver with a partner in care, gives this advice, “When the time comes to move into long term care, it’s helpful (but not always easy) to acknowledge the reality of the current situation, rather than holding on to the way things used to be. It is not a failure on your part as a family that you are no longer able to provide the level of care that is needed.” As the care recipient’s health declines the amount of care required can become overwhelming, especially for one person. In addition, the equipment needed to provide the necessary care may only be available in a facility.
Caregiving does not end when your family member moves into residential care. You may have more free time and will not shoulder the sole responsibility for the person you are caring for. Your role will look different but will be equally important. This can include providing emotional support, making legal and financial decisions, visiting your care recipient, and participating in care decisions. You will now have the opportunity to revisit and regain your previous relationship (i.e., as partner, son, or daughter) with your family member because you will not be focusing all your time and energy on primarily being in the role of their caregiver.
If you think that the time may be approaching for residential care to be considered, try to plan in advance and do your research. Family caregivers and the person they care for, are often, overwhelmed by the magnitude of the decision and the process. It’s not only the move itself; rather the preparation of the move and the adjustment post-move. Starting by knowing what your options are and the steps involved in the process can help lessen the stress and feelings of being overwhelmed. A good first step is to read the BC Government Websites that provide general information on Long Term Care Services and Eligibility Criteria, How to arrange for care and to prepare for an assessment and a booklet providing Help in Selecting a Long Term Care Home (Great checklist on p.7).
If you and your family are not yet connected to your local Health Authority, a key first step is to contact the Home and Community Care department of your local Health Authority with your request for assessment and long-term care placement. A case manager will contact you to arrange a visit in your home with the consent of your care partner. They will complete a detailed assessment to establish initial overall care needs of your care partner and the family’s ability to provide care. Generally, individuals with the highest care needs or living at highest levels of risks will receive priority access to relevant home and community care service.
If your care partner is not considered eligible for a placement, community-based support services such as Home Support Services, Adult Day programs, Respite, Bathing Services or Assisted Living may be recommended by the case manager as support. Cost for the services received is calculated at a percentage of after-tax income. For private pay residences, the Director of Care in the chosen residence can be contacted for information on their admission process.
For further information, questions or to talk to someone about your unique situation please call our BC Caregiver Support Line at 1-877-520-3267.
Caregiver Support Team
Debbie Norbury, HCC Case Manager, VIHA, Needs Based Access to Facility Care: A Review, https://www.familycaregiversbc.ca/wp-content/uploads/2021/04/Needs-Based-Access-to-Facility-Care_-A-Review.pdf
Government of BC, Ministry of Health, Long-Term Care Services Information, https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/long-term-care-services
Government of BC, Ministry of Health, Planning for Your Care Needs: Help in Selecting a Residential Care Facility, 2013, https://www.health.gov.bc.ca/library/publications/year/2013/planning-for-your-care-needs.pdf