Frequently Asked Questions

My father loves to drive, but he’s 93 with significant short-term memory loss and dementia. He’s never had an accident but he’s gone through some red lights and we worry about him. My mother always goes along with him, to be safe.

HouseWorks knows that this can be a tough time for everyone and a difficult conversation (or series of conversations) to have. Driving is often the single-most important mark of one’s independence. The thought of having to take away that privilege, even if it is for our parents’ own safety, can be very troubling and anxiety provoking.

A few examples of things to look for that may indicate the time has come are minor accidents, difficulty finding familiar destinations, traffic tickets or warnings, dents on the car or around the house, and driving at inappropriate speeds – either much too fast or too slowly.

We often refer families to the DriveWise and DriveAdvise program run by the Beth Israel Medical Center in Boston or Newton-Wellesley Hospital’s Drive Safe program. Recognized as a national model, DriveWise offers an objective safe driving evaluation for people of all ages who have experienced neurological, psychological and/or physical impairments such as dementia and memory loss. 

If you want to urge your loved one to let you or someone else drive, there are many creative ways to start the conversation. For help brainstorming ideas or to learn more about incidental transportation, a service we provide that includes both medical transportation and non-emergency transportation to places like the grocery store or a hair appointment, call us today.

Falls prevention is an essential consideration for seniors and represents one of the most important steps we can take when helping elders ‘age in place.’ As we grow older our eyesight, balance, and reaction time may diminish gradually. Our bones become more brittle and injuries take longer to heal. Sometimes, just making a few simple changes around the home can help prevent a fall.

The bathroom is the most common place for falls to occur. For just a few dollars, placing an inexpensive rubber mat on the inside of a tub and a rug with a non-slip backing just outside of the tub can make a world of a difference. Grab bars help get into and out of the tub safely—we recommend 2 bars, one to hold as you step in and out, and one to hold while inside the tub. You should never expect a towel rack to support your weight. Instead, install an attractive grab bar and use it as a towel rack, too. A smaller hand-hold near the sink might also be helpful. Additionally, there are many types of raised toilet seats that can make the restroom easier and safer.

Surprisingly, many falls also occur in the bedroom. When waking in the morning or after a nap, people may be lightheaded at first. Take a moment to get your balance before you step away from the bed. A transfer handle bed rail may also be helpful.

Stairway safety is important, particularly for seniors. All staircases should have at least one sturdy railing running the full length on both sides—be sure the stairs themselves are in good repair. All entry doors and hallways should be well lit. HouseWorks suggests placing inexpensive automatic night lights throughout the home to improve visibility. It’s a good idea to place non-slip backings or double-sided tape on all entryway rugs, as this is a common source of slips and falls.

In the kitchen, reorganizing storage can make a world of difference. Possible measures include placing frequently used items in easily accessible cabinets and putting bulky or heavy items in the base cabinets or open shelves. HouseWorks recommends using the highest shelves for things that are used infrequently, like holiday items.

As we age, simply maneuvering around our home can become difficult. Try to move furniture and household items as needed to ensure there are clear, unobstructed walkways in each room. Make sure all power cords, cable TV and computer wires are neatly run along the walls—never put cables under carpet, as they can fray and cause a fire.

If you are concerned about an elder taking a shower safely, HouseWorks can provide a Caregiver trained to supervise showering while treating your loved one with respect and dignity. Simply call our main number, 617-928-1010 to speak with a Case Manager who can set things in motion. Our Home Modification Department is also a resource for families who want more information or would like to request an in-home evaluation.

A health care proxy is a type of advance directive, also known as a living will. It is a legal document prepared in advance to ensure that your caregivers understand your wishes about your care. A health care proxy names the person you have chosen to express your health care wishes and empowers that person with medical power of attorney. This person (or ‘proxy’) is recognized under Massachusetts law as the person who can speak for you concerning health care decisions if your doctor determines that you are no longer able to make or communicate health care decisions. This person is often a family member or close friend. Ideally, it is someone who knows your personal wishes, values and beliefs. It’s someone you can trust to make the same health care decisions you would make if you could.

Choosing this person before he or she is needed can help you feel confident that you will always be treated according to your own wishes. On your behalf, he or she can explain to your doctor why you may or may not want certain treatment. Your health care team will still determine what treatment options are medically appropriate in your case, but they will consult with your proxy—as they would with you—regarding your values and the goals of care.

Act now to preserve your voice

HouseWorks strongly supports your basic right as a patient to express your personal health care wishes and actively take part in decisions related to your health care. However, accidents or severe illnesses may occur that can prevent you from participating in decisions about your care or expressing your wishes. HouseWorks encourages people who are perfectly healthy as well as people who are sick to prepare a health care proxy. Many serious health problems arise unexpectedly, so it is advisable to have a health care proxy ready at all times.

The implementation of a health care proxy and the decisions made around such a document are quite complex and require much thought. It is important to note that the rules surrounding health care proxies can vary from state to state. As always, you will be well served by discussing the matter with your family doctor, your attorney, or both. 

For more information and to obtain a downloadable copy of a Massachusetts Health Care Proxy Form, Click here to visit the website of the Hospice and Palliative Care Federation of Massachusetts.

 

When all potential treatments have been exhausted and a person decides it is time to let nature take its course, hospice care provides pain management and emotional support. Hospice focuses on palliative care—care aimed specifically on making patients as comfortable as possible. Hospice care often provides patients with peace of mind, armed with the knowledge that their loved ones are not alone in the struggle to accept death and grieve the loss. That simple yet vital knowledge can make their last days much easier and offer immense emotional relief.

Choosing hospice is a very personal decision. Making the decision to call hospice care for your loved one can be heartbreaking. But in giving your loved one the best end-of-life care possible, hospice is a very good choice. Keep the lines of communication open with your loved one; when they mention hospice, it might be the right time to consider moving forward. Take them at their word and make the call, then trust the highly trained and compassionate hospice workers to help you with whatever comes next.

A patient is probably ready for hospice care when they have decided to forgo any medical treatment in search of a cure and opt instead for purely palliative care. It is important to contact a hospice agency before pain management becomes an issue. Each person's final months and days are unique to that individual. Therefore, setting a certain time frame on how long hospice care will be needed can be difficult. Most insurance companies pay for hospice care during the last six months of life. While some might find hospice useful for that entire period of time, others may prefer to wait until they are closer to the end of their life.

For more information about hospice care in Massachusetts, please click here for a link to the Hospice & Palliative Care Federation of Massachusetts.

 

Happily—as has been proven throughout our experience with clients—HouseWorks can attest that our aging-in-place focused home care services don’t result in a loss of independence. On the contrary, our home care assistance retains and reinforces genuine independence by allowing clients to feel safe, secure, well cared-for, and free from anxiety. Only then can they focus on the things that truly give them pleasure and provide their lives with a sense of fulfillment. Families can breathe more easily knowing their loved ones have home care assistance without sacrificing independence. 

Not convinced? Consider the following example:

A very elderly couple came to HouseWorks as clients. Dad’s dementia was gradually deepening and, since their adult children lived too far away to be a regular presence or act as a helping hand, Mom was left to cope alone. Between trying to stay on top of household matters and monitoring her husband to keep him safe, Mom was exhausted. But both were adamant—they wanted to stay in their own home where things were familiar, where they knew their neighbors, and where they had raised their family and felt most comfortable. Clearly, help was needed.

Following a home assessment with a HouseWorks Case Manager, the family engaged us to provide a Caregiver to spend a few hours with Dad every day. In good weather, they went for walks, and when he was well enough, they read books together and listened to music. This added assistance gave Mom the respite she needed from the “watch-dog” role with which she had been struggling. Home care services from HouseWorks gave her time to attend to her own needs without the feelings of guilt that she had been experiencing previously.

The presence of our Caregiver helped to keep Dad engaged and active both mentally and physically, while relieving Mom from the pressure of sole responsibility. For the first time in months, she was able to invite a couple of friends in for tea and benefit from renewed contact with old friends. The family enjoyed peace-of-mind knowing that our professional team would be keeping an eye on their parents and would let them know immediately if more help was needed. In turn, home care allowed Mom and Dad to continue living independently in their own home. 

Acknowledging that it may be time to get home care assistance can be daunting, yet this is one of the most important conversations you may have with a parent. Honestly assessing your own capacity as a caregiver takes courage, but is critical to everyone concerned. Regardless of how much you love your parents or how much energy you have, there may come a time when it gets to be too much. You may find you need support sooner rather than later, so HouseWorks recommends that clients begin the conversation before a crisis arises—while everyone involved can fully participate.  

An important step is to speak with your parent’s primary care doctor. Many people choose to meet privately without their parent being present; this allows you to have a frank conversation about your loved-ones’ medical status. To protect patient privacy, the physician is only able to share private healthcare information with you if your parent has given the doctor written permission to do so. Gaining permission can be taken care of right away, clearing the way for a discussion with your parent about what the future may bring and home care options.

We can answer all your questions

HouseWorks’ goal is to ease the challenges of aging so that our clients and their families can focus on those relationships, activities and interests that are most meaningful to them. If you think the time is approaching when you’ll need help – or if that day is already here – call us at 617-928-1010 or toll free at 800-928-3393. Our Case Managers are available round-the-clock to speak with you by phone. HouseWorks is also pleased to meet with you at home.

Our Case Managers will walk you through the variety of elder care services we provide and can answer any questions you may have, including those related to cost. Moreover, matching clients with the right Caregiver is a huge part of what we do at HouseWorks. Our Case Managers will work with you one-on-one to lessen your burdens, problem-solve, and create order out of chaos. HouseWorks is here to guide you through the toughest parts of helping your parent to age-in-place.

Even if you aren’t sure whether home care services are right for you, please call us. At HouseWorks, we understand how unsettling it can be to see your parent crossing that line, when frailty becomes obvious. Our goal is to help you think things through with absolutely no pressure. You don’t need to go through this alone. HouseWorks can help.

With an elderly parent it can be hard to know where to begin, especially when the stakes are high and time is short. That said, there are many sources of information and advice available for seniors and their families in Greater Boston.

Words to the Wise

Get help from the start – from family, friends, and professionals. Resist the impulse to do it all yourself.

Never rely on a single source of information or advice when making eldercare decisions.

Expect at least one false start. Don’t rush to fix the problem.

Listen to the experts, but trust your own judgment.

Take control by writing everything down, prioritizing, and delegating just as you would in your professional life.

Be present in the moment. Make time to “do nothing”.

We can answer all your questions

HouseWorks’ goal is to ease the challenges of aging so that our clients and their families can focus on those relationships, activities and interests that are most meaningful to them. If you think the time is approaching when you’ll need help – or if that day is already here – call us at 617-928-1010 or toll free at 800-928-3393. Our Case Managers are available round-the-clock to speak with you by phone. HouseWorks is also pleased to meet with you at home.

Our Case Managers will walk you through the variety of elder care services we provide and can answer any questions you may have, including those related to cost. Moreover, matching clients with the right Caregiver is a huge part of what we do at HouseWorks. Our Case Managers will work with you one-on-one to lessen your burdens, problem-solve, and create order out of chaos. HouseWorks is here to guide you through the toughest parts of helping your parent to age-in-place.