Category Archives: Lifestyle

Many older adults will eventually need long-term care. On average, adults age 65 and older can expect to need at least 3 years of this type of care. 1 What level of care will depend on many factors, like ongoing health concerns, availability of family support and help, financial ability to pay for the cost of long-term care, and more.

The process of choosing the best long-term care option for yourself or a loved one can be daunting. There are multiple choices to pick from, each with its own pros and cons. To narrow down the right fit, it is helpful to understand the differences between these options and which ones might best meet your needs.

If you are considering enhanced assisted living as a long-term care solution, you will also want to weigh it against the other choices available before making a final decision. We’ll help by taking a closer look at enhanced assisted living, as well as other common long-term care options available to older adults.

What is enhanced assisted living?

To understand enhanced assisted living, we have to first understand the different levels of care. Older adults will have different care needs depending on their cognitive abilities, memory, and physical challenges. While some older adults can live independently, there is a 70% chance that someone age 65 or older will need long-term care services for a portion of their life. 2

When an older adult needs assistance with activities of daily living (ADLs), there are several care options available to meet those needs. Often, family is relied on for some help with these ADLs. But if the need for help is ongoing, with a person needing regular assistance with personal care needs and daily tasks, more intensive care is needed.

This is where options like assisted living facilities become a consideration. While these facilities can offer intensive help with ADLs, an enhanced assisted living facility adds another layer of care to the services available. This allows an older adult to remain in a private, independent living arrangement while receiving help with ADLs and medical care, without the higher level of care (and reduced independence) of a nursing home.

Nursing homes as an alternative to enhanced assisted living

To understand the difference between enhanced assisted living and a standard assisted living arrangement, let’s look at nursing homes as an alternative.

Also called skilled nursing facilities, nursing homes offer the highest level of long-term care services available. Older adults residing in skilled nursing facilities must qualify for this level of service. The requirements depend both on Medicare and Medicaid regulations and individual state rules.

Nursing homes offer care to residents that include management of cognitive and behavioral problems due to dementia, and treatment of medical conditions.

A person who is admitted to a nursing home for care can receive care for conditions such as:

• Medicines that can’t be given at home, especially intravenous (IV) medications
• Medical problems that are difficult to control
• Medical problems that have required long hospital stays in the past
• Complex wounds, including surgical wounds
• Rehab after joint replacement surgery
• Stroke
• Renal (kidney) disease (including patients new to hemodialysis)

This care can include nursing care, physical therapy (PT), occupational therapy (OT), and speech therapy.

Because of the level of skilled care offered in nursing homes, they are one of the more expensive options, with a national median monthly cost of nursing home care of $7,908 for a semi-private room and $9,034 for a private room. 3

Enhanced assisted living can offer some of these care services, like medication management, assistance with feeding, and wound care while allowing an older adult to stay in their own private apartment.

Assisted living as an alternative to enhanced assisted living

If you require assistance with ADLs but don’t have an ongoing need for a higher level of medical care, simple assisted living may be the right fit. In assisted living facilities, residents enjoy the privacy and independence of their own living unit but receive daily help with care needs such as:

• Personal care, like bathing and dressing
• Housekeeping and laundry
• Social and recreational activities
• Transportation to activities like shopping and doctor’s appointments
• Meals

This type of long-term care is not covered by Medicare, but portions of it may qualify for Medicaid reimbursement. The median monthly cost for assisted living facilities is $4,000. 4

CCRCs as an alternative to enhanced assisted living facilities

Continuing care retirement communities, or CCRCs, are another option for long-term care that can meet the changing needs of an older adult. A CCRC offers a spectrum of long-term care, starting with independent living and moving through 24/7 care.

By offering all of these services in one community, older adults who want to maintain familiarity throughout each transition in their lives can access the same services whether they are in assisted living or skilled nursing care, for example.

Some long-term care options offered in a CCRC include:

•     Private apartments or homes
•     Assisted living
•     Nursing home/skilled nursing care
•     Home care services for those living independently
•     Healthcare services

CCRCs often require an entry fee, with the average fee at $402,000, and monthly costs thereafter of $3555 (not including annual increases). 5

Home care as an alternative to enhanced assisted living

Home care is increasingly preferred by older adults as an option for long-term care. As many as 90% of adults age 65 and older prefer to age in place. 6 For these older adults, bringing long-term care services to their homes allows them to meet care needs and the desire to stay in their home environment.

Non-medical, professional in-home care services include:

• Bathing & dressing
• Light housekeeping
• Bathroom assistance
• Transportation
• Meal prep
• Companionship
• Help with safe ambulation (walking)

In-home care can be used occasionally as respite support for family caregivers, or this service can offer part-time, 24/7, or even live-in caregiver assistance depending on your needs.

If medical care is needed, additional services must be brought into the home to provide this care.

Like assisted living, in-home care is not covered by Medicare. The national median monthly cost for in-home care is $5,148. 7 Some programs do exist to help offset some of these otherwise out-of-pocket expenses: HCBS and PACE.

HCBS

Medicaid offers waivers for in-home care called Home and Community-Based Services (HCBS). These can help to cover some of the long-term care costs associated with home-based care. Eligibility rules vary from state to state, and there are also caps on enrollment.

PACE

Medicaid and Medicare offer a program called the Program of All-Inclusive Care for the Elderly (PACE). This program is not offered in all states. Designed specifically to help you avoid leaving your home to receive long-term care, you must meet these criteria to be eligible: 8

• Be 55 or older
• Live in an area serviced by a PACE organization
• Need a nursing home-level of care (as certified by your state)
• Be able to live safely in the community with PACE assistance

Other long-term care options as alternatives to enhanced assisted living:

If assisted living, in-home care, skilled nursing, or CCRCs aren’t quite the right fit for your needs, there are also some other options for long-term care:

• Adult day care centers- these can be used by older adults who have family caregivers the majority of the time, but sometimes need to stay in a safe and supervised environment during the day while their family caregivers work or tend to other responsibilities. In these centers, an older adult can receive help with ADLs and access to social activities during daytime hours and then return home with family.
• Board and care homes- also called group homes, these facilities offer non-medical care in a small facility that is usually in a large home, with residents sharing bedrooms. This can be a lower-cost alternative to assisted living facilities.

Long-term care can help you live your best life

No matter which long-term care option you choose, these services all offer support to help you improve your quality of life. By considering the level of care you need and comparing it to the available choices, you can make the best decision.

Another resource that can help you finalize your care decision is the National Council on Aging (NCOA) or your local council on aging. Along with offering resources and assistance in figuring out eligibility for care services and Medicare coverage, they can help you find services in your area. The NCOA’s AgeWell Planner is one example of the tools available.

If you’ve decided that in-home care is the best option for your needs, Caresify can help you coordinate these services in your home. You can read more here, or call 888-799-5007.

References

1. https://acl.gov/ltc/basic-needs/how-much-care-will-you-need
2. https://acl.gov/ltc/basic-needs/how-much-care-will-you-need
3. https://www.genworth.com/aging-and-you/finances/cost-of-care.html
4. https://www.ahcancal.org/Assisted-Living/Facts-and-Figures/Pages/default.aspx
5. https://www.aarp.org/caregiving/basics/info-2017/continuing-care-retirement-communities.html
6. https://gero.usc.edu/students/current-students/careers-in-aging/the-value-of-aging-in-place/
7. https://www.genworth.com/aging-and-you/finances/cost-of-care.html
8. https://www.medicare.gov/sign-up-change-plans/different-types-of-medicare-health-plans/pace

Questions and decisions about long-term care options are common later in life. As we age, activities of daily living (ADLs) can begin to become too challenging to manage alone. Older adults experiencing changes in mobility, vision, and even cognition have several long-term care choices to pick from. But which one is best?

A personal care home may be one of the choices you are considering as a long-term care option. Understanding what they offer, and what alternatives there are to personal care homes, can help you make the best decision for yourself or your loved one.

What is a personal care home?

Personal care homes, in general, are facilities where an older adult can live long-term and receive help with ADLs. Often, they are smaller in size and situated in a residential home rather than a facility. They may serve a small number of older adults, with care provided by the facility owners who live on-site.

Each state has different rules about what kind of facility can call itself a personal care home, but in most cases, you can expect that a personal care home does not offer medical care or skilled nursing-level services.

Personal care homes are similar to assisted living facilities, and in some states, they are essentially considered to be small assisted living facilities. In other states, such as Pennsylvania, assisted living facilities are licensed differently and offer a higher level of services. 1 An older adult living in a personal care home can expect assistance with care needs such as:

• Personal hygiene, like bathing
• Dressing
• Toileting
• Eating
• Laundry/light housekeeping
• Help with ambulating (walking) safely
• Transportation to and from activities, such as doctor’s appointments

If your care needs involve ADLs and regular caregiver supervision, a personal care home may be a good fit. Let’s take a look at the other options available as well.

Nursing homes as an alternative to personal care homes

Also known as skilled nursing facilities, nursing homes offer a higher level of care for their residents. Older adults who have medical care needs can receive help with both ADLs and healthcare while living in a nursing home. This can include skilled nursing care, physical therapy (PT), and occupational therapy (OT), for example.

Nursing home care is generally one of the more expensive options for care, with the national median monthly cost of nursing home care at $7,908 for a semi-private room and $9,034 for a private room. 2

People who are eligible for a nursing home level of care may be able to cover a portion of their care costs with Medicaid, Medicare, or both. Some rules and restrictions define who is eligible for this type of care, and what part of the costs are covered. These vary from state to state.

To determine who qualifies, these four areas of need are often part of the process:

• Physical functional ability- what level of help a person needs with ADLs

• Cognitive impairment- the impact of Alzheimer’s, other dementias, or conditions like Parkinson’s on a person’s ability to live independently

• Behavioral problems- the presence of dementia-related behaviors like aggression and wandering

• Health issues/medical needs- whether help is needed with medical services like injections or catheter care

A person who is admitted to a nursing home for care can receive care for conditions such as:

• Medicines that can’t be given at home, especially intravenous (IV) medications
• Medical problems that are difficult to control
• Medical problems that have required long hospital stays in the past
• Complex wounds, including surgical wounds
• Rehab after joint replacement surgery
• Stroke
• Renal (kidney) disease (including patients new to hemodialysis)

Continuing care retirement communities (CCRCs)

Maybe right now you don’t need nursing home care, and a personal care home offers the right kind of support for your needs. But what if those needs change in the future? A continuing care retirement community (CCRC) might be the solution you’re looking for.

CCRCs offer multiple long-term care options all housed in one community. They are designed to allow older adults to start at one level of care, and easily transition to a higher level of care without losing the familiarity and resources of their community.

In a CCRC, you can find choices from independent living to 24/7 supervised care. Services provided to residents may include:

• Private apartments or homes
• Assisted living
• Nursing home/skilled nursing care
• Home care services for those living independently
• Healthcare services

This combination of choices means as your needs change, so can your care. It comes with a price, though- an average entry fee of $402,000 to buy into the community, in addition to the average standard monthly charges of $3,555. 3

Home care as an alternative to personal care homes

There is another option available to you if you don’t need nursing home care for ongoing medical needs. In-home care brings caregivers to you in the comfort of your own home. A home care aide can assist you with the same ADLs as a personal care home.

They do not, however, offer skilled nursing care. Depending on your needs, these services can sometimes be brought to you through a home healthcare agency, with your daily personal care needs met by your in-home caregivers.

In-home care can be part-time, 24/7, or even just for occasional respite help. Some older adults even choose to have a live-in caregiver help with ADLs so they can stay in their homes longer. Most older adults– as many as 90%– prefer to stay in their homes as long as possible, called aging in place. 4

The national median monthly cost for in-home care is $5,148. 5 Medicare does not cover this type of care, but there are some options that can help with the cost:

• HCBS- Medicaid’s Home and Community-Based Services waivers cover part of the cost of home-based care. Eligibility rules differ between states.
• PACE- the Program of All-Inclusive Care for the Elderly, or PACE, is offered by Medicaid and Medicare in some states to offset some in-home care expenses if you are eligible for a nursing-home level of care.

Other options as an alternative to personal care homes

Along with the long-term care choices discussed above, there are some other options to consider:

• Adult day care centers- these programs are available to supplement family caregiving tasks. They provide a safe and supervised environment for an older adult to stay in during the day while a family caregiver works or tends to other responsibilities.

• Large assisted living facilities- depending on your state regulations, these facilities may be able to offer a larger spectrum of care services, including access to some skilled healthcare services as needs change. They can also provide activities and amenities that may not be available at a smaller personal care home. Your state’s Aging Services Division can help direct you to specifics in your area.

Some final thoughts on alternatives to personal care homes

No matter which long-term care option you choose, care needs can change. It’s important to be flexible and keep the resources discussed here in mind. Each one has its own pros and cons. You may find later that changing long-term care plans from whatever option you pick now to a different one offers better resources for you or your loved one.

If you’ve considered these choices and would like to use home care as a long-term care option, Caresify offers professional caregiving services to meet any personal care and companionship needs you or your loved one may have at home. You can read more here, or call 888-799-5007.

References

1. https://www.phca.org/for-consumers/all-about-long-term-care/choosing-assisted-living-personal-care
2. https://www.genworth.com/aging-and-you/finances/cost-of-care.html
3. https://www.aarp.org/caregiving/basics/info-2017/continuing-care-retirement-communities.html
4. https://gero.usc.edu/students/current-students/careers-in-aging/the-value-of-aging-in-place/
5. https://www.genworth.com/aging-and-you/finances/cost-of-care.html

Many older adults can benefit from the help a caregiver provides. As changes in mobility, cognition, vision, and hearing begin to cause difficulty in everyday activities, having an extra pair of hands to help with personal care, daily tasks, transportation, and more can mean the difference between staying in your own home and moving into a long-term care facility.

At first, an in-home caregiver may only be needed occasionally, or for part of the day for specific activities. As time passes, however, incorporating a live-in caregiver may become helpful. How and when should you make the decision to have a live-in caregiver, and what are the benefits of this arrangement?

Why would someone need a live-in caregiver?

It can be helpful to clarify that a live-in caregiver does not provide 24-hour care. They are close by for any unexpected emergencies that could happen, but they also may take days off of work and have hours set aside for sleeping.

However, a live-in caregiver is otherwise regularly dedicated to meeting the needs of an older adult who requires extra daily assistance.

Part-time caregivers vs. live-in caregivers

Many older adults live alone- in the US, it’s as many as 27% of adults age 60 and older, with another 46% living with only one other adult. 1

An older adult who needs caregiver help might at first be able to have visits from family members, friends, and professional caregivers to help with light housekeeping, cooking meals, or personal hygiene.

But this part-time caregiver help may not be a good long-term solution. Someone who has trouble getting around the house safely without falls, for example, might need regular help walking to the bathroom. An older adult with dementia who is prone to wandering could get confused and leave the house, or put themselves at risk for hazards like a home fire.

In these situations, having occasional help or a caregiver for only a few hours out of the day may not be enough. A live-in caregiver is available throughout the day to help with mobility and other activities of daily living, increasing safety for the older adult in their care.

What are some benefits of a live-in caregiver?

Along with the safety benefits discussed above, what are some of the other benefits of a live-in caregiver?

Companionship

Older adults, especially those with mobility and health concerns, are at risk of social isolation. This is true even when they live with a family member, with 43% of older adults reporting loneliness in one survey, even though only 18% of them lived alone.2 A live-in caregiver means a familiar face is always around to help. Live-in caregivers can build a solid relationship with the people in their care and offer consistent companionship.

Help in emergencies

Injuries and medical emergencies can happen, even with caregiver help. Older adults with chronic medical problems can be at risk for unexpected complications, recurring problems, or new infections and illnesses. A live-in caregiver may notice these problems early and get medical care before they become serious. And in emergencies, having someone close by to help, even if it’s calling 911 quickly, can make the difference in a situation where every second counts.

Support for families

For families who are providing care to a loved one, a live-in caregiver can offer support and peace of mind for family caregivers. Adult children often still juggle other responsibilities like jobs, childcare, and more. Coordinating schedules with paid caregivers from outside the home can become complicated and may not be flexible enough. A live-in caregiver can offer more flexibility, readily available as schedules change.

Consistency

As mentioned earlier, a live-in caregiver is a source of consistent companionship. Instead of a rotating schedule of different paid caregivers, you or your loved one can count on the same friendly face every day. A live-in caregiver gets to know the routines you prefer, your favorite activities, and your dislikes as well as your likes. This can be especially helpful for people with dementia, who can benefit from predictability.

Reduced risk of infections

Along with the consistency provided by a live-in caregiver, having one automatically limits the number of people coming and going from your home. During the era of COVID-19, this has obvious benefits, lowering the risk of infection.

Even more importantly, receiving care at home vs. a long-term care facility also reduces your exposure to community spread of illnesses. It’s estimated that healthcare-associated infections are responsible for 380,000 deaths each year. 3 By staying in your own home with a live-in caregiver, you reduce exposure to illnesses like the flu, pneumonia, RSV, and others.

Assistance for aging in place

Most older adults prefer to stay in their own homes for as long as possible–also known as aging in place. It can be difficult to do this as the need for care increases. Assisted living facilities and other long-term care solutions can provide regular care, but so can a live-in caregiver, without a person needing to leave behind their familiar home environment and community.

What kinds of care do live-in caregivers provide?

A live-in caregiver can provide personal care (but not medical care). What this means is that they can offer all the same care as any other in-home care, including:

• Bathing & dressing
• Light housekeeping
• Bathroom assistance
• Transportation
• Meal prep
• Companionship
• Help with safe ambulation (walking)

They cannot provide medical care in the home, such as:

• Medication administration (including IV medications)
• Nursing care
• Wound care
• Rehabilitation services (such as physical therapy)
• Any other services that treat a health condition

Making the transition to a live-in caregiver

Deciding to use a live-in caregiver is a big step. They’ll need to have access to their own private space in your home, and you’ll need to feel comfortable with this person being a regular presence in your life.

Some questions you might ask when trying to choose a professional live-in caregiver include:

• How many years of experience do they have?
• Do they have any experience with your specific medical problem(s)?
• What certifications do they have? Are they CPR trained?

To help make the transition to a live-in caregiver go more smoothly, you might consider starting out on a trial basis with regularly scheduled care so that everyone can get to know each other and see if things feel like a good fit. You may even find that you are already using a caregiver regularly who might be interested in a role as a live-in caregiver instead.

If you are exploring in-home care options and would like experienced support to find out more about live-in caregiver services and how they can help you or a loved one, Caresify has expert caregivers available to help meet your care needs. You can learn more here, or call 888-799-5007.

References

1. https://www.pewresearch.org/fact-tank/2020/03/10/older-people-are-more-likely-to-live-alone-in-the-u-s-than-elsewhere-in-the-world/
2. https://www.ucsf.edu/news/2012/06/98644/loneliness-linked-serious-health-problems-and-death-among-elderly
3. https://www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/guides/infection-prevent.html

For many older adults, there comes a time when considering long-term care options becomes necessary. Changes in the ability to perform daily activities independently, along with chronic health conditions and limited mobility, often mean extra help is needed.

A common choice for long-term care is an assisted living facility. In the US today, over 800,000 older adults live in assisted care facilities, for a median stay of 22 months. 1

How do you know if an assisted living facility is right for you, and what are the alternatives? In this article, we’ll help you evaluate and understand each choice, so you can make the right long-term care choice for you or your loved one.

What is an assisted living facility?

Older adults who require assistance with activities of daily living (ADLs) like meals, light housekeeping, and personal care, may choose to live in an assisted living facility. This allows access to caregiving services and common areas and activities. It also provides residents with their own living quarters.

Residents of assisted living facilities may receive help with medication management and special services like dementia care (sometimes called memory care), but do not need the level of medical care provided by a nursing home.

The national monthly median cost of an assisted living facility is $4,500.2 The cost of this type of long-term care is not covered by Medicare. Medicaid may cover a limited portion of care in an assisted living facility (not including room and board costs). 3 The remainder must be either paid out of pocket, through long-term care insurance, or a combination of strategies.

When is a nursing home the right choice?

As mentioned above, a nursing home (also called a skilled nursing facility) offers a certain level of medical care. Residents of a nursing home may need temporary nursing care and services like physical therapy (PT) and occupational therapy (OT) to recover from a long hospital stay, for example. Or ongoing skilled nursing care may be required for certain chronic medical conditions.

Conditions treated include:

• Complex wounds, including surgical wounds
• Rehab after joint replacement surgery
• Stroke
• Renal disease (including patients new to hemodialysis)
• Medicines that can’t be given at home, especially intravenous (IV) medications
• Poorly controlled medical problems, or problems that have required long hospital stays

Each state has its own rules about who qualifies for the nursing home level of care. These four areas are often part of determining who qualifies for this level of care: 4

• Physical functional ability- what level of help a person needs with ADLs

• Health issues/medical needs- whether assistance is needed with tasks like injections or catheter care

• Cognitive impairment- the impact of Alzheimer’s, other dementias, or conditions like Parkinson’s on a person’s ability to live independently

• Behavioral problems- the presence of dementia-related behaviors like aggression and wandering

The national median monthly cost of nursing home care is $7,908 for a semi-private room and $9,034 for a private room. 5

If Medicaid (based on your state’s criteria) certifies that you are eligible for a nursing home level of care, it covers the cost of nursing home care. Eligibility is re-evaluated at least annually.6

Medicare also partially covers the cost of nursing home care, depending on what program you are enrolled in and other factors. This includes very limited coverage for certain medical needs, as well as prescription drug coverage, and coverage for short-term stays. 7

Continuing care retirement communities (CCRCs)

These retirement communities offer multiple living options for older adults who have a range of needs, from independent living to 24/7 supervised care.

Because different levels of care are all available within the same community, a CCRC may offer an easier transition from one type of service to another, without losing familiar surroundings, resources, and activities.

An example could be starting out in assisted living, and then transitioning to more medically advanced care in a nursing home setting.

Some long-term care options offered in a CCRC include:

• Private apartments or homes
• Assisted living
• Nursing home/skilled nursing care
• Home care services for those living independently
• Healthcare services

The average monthly charge for this type of care is $3,555, with annual increases of around 2% and a hefty initial entry fee averaging $402,000 in some cases. 8

Home care

If you’re faced with health and mobility challenges but not ready to make the move to assisted living or a nursing home, you’re not alone. Most older adults would prefer to stay in their own homes for as long as possible.

Fortunately, there are options to help you receive the same kind of help you can expect from an assisted living facility, but in the comfort of your own home.

Professional home care services can provide daily assistance with care needs, including:

• Bathing & dressing
• Light housekeeping
• Bathroom assistance
• Transportation
• Meal prep
• Companionship
• Help with safe ambulation (walking)

This non-medical care can be part-time, 24/7, or even occasional respite help. Advantages can include staying in a familiar environment and community, the potential for continuing to live with family caregivers (if applicable), and less exposure to contagious illnesses.

In-home care usually requires some assistance from family for a portion of caregiving needs.

The national median monthly cost for in-home care is $5,148. 9 Like assisted living, it is not covered by Medicare. Along with self-pay options, some other resources can also help cover the cost of this care.

HCBS

Medicaid’s Home and Community-Based Services (HCBS) waivers can help to cover some of the long-term care costs associated with home-based care. Eligibility rules vary from state to state. There are caps on enrollment as well.

PACE

A Medicaid and Medicare program called the Program of All-Inclusive Care for the Elderly, or PACE, can also offset in-home care expenses to help you avoid leaving your home to receive long-term care. It is not offered in all states. To qualify, you must: 10

• Be 55 or older
• Live in an area serviced by a PACE organization
• Need a nursing home-level of care (as certified by your state)
• Be able to live safely in the community with PACE assistance

Other long-term care options

Along with the above options for long-term care, some other choices can meet care needs as well. These can also offer alternatives to assisted living facilities:

• Adult day care centers- available to supplement family caregiving tasks, by allowing an older adult to stay in a safe and supervised environment while a family caregiver works or tends to other responsibilities.

• Board and care homes- also called group homes, these facilities may offer a lower-cost alternative to assisted living facilities, depending on your area. Typically a small private facility housed in a large home, a board and care home offers non-medical care under one roof. Residents may share bedrooms.

Long-term care should enhance your life

No matter which option you choose, long-term care should offer you improved safety and quality of life. With high-quality caregiving services, you can even stay healthier longer, by avoiding common problems like falling and skin breakdown.

If you’ve decided to use home care as a long-term care option, Caresify offers professional caregiving services to meet any personal care and companionship needs you may have at home. You can read more here, or call 888-799-5007.

References

1. https://www.ahcancal.org/Assisted-Living/Facts-and-Figures/Pages/default.aspx
2. https://www.genworth.com/aging-and-you/finances/cost-of-care.html
3. https://www.medicaidplanningassistance.org/assisted-living/
4. https://www.medicaidplanningassistance.org/nursing-home-level-of-care/
5. https://www.genworth.com/aging-and-you/finances/cost-of-care.html
6. https://www.medicaidplanningassistance.org/nursing-home-level-of-care/
7. https://www.medicare.gov/what-medicare-covers/what-part-a-covers/health-care-prescriptions-in-a-nursing-home
8. https://www.aarp.org/caregiving/basics/info-2017/continuing-care-retirement-communities.html
9. https://www.genworth.com/aging-and-you/finances/cost-of-care.html
10. https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/pace

Stress is a common experience for most of us. It is a part of everyday life and can be a minor and passing experience or become a more chronic problem. When dealing with personal health concerns, worries like the COVID-19 pandemic, or the challenges involved in being a caretaker for a family member, stress can be a major factor in your life.

Knowing how to spot the warning signs and symptoms of stress becoming an unhealthy problem is important. So is learning how to manage or prevent the issues caused by stress. Read on to learn more about the impacts of stress and how to help conquer it.

What is stress, exactly?

Stress is more than just a feeling. Our bodies are programmed to physically react to challenges and threats. When we experience an external event such as increased household responsibilities or navigating a new health diagnosis and multiple medical bills, we have a mental and physical response. This response, sometimes called “fight, flight, or freeze,” happens automatically to help us get through a difficult situation.

When stress becomes chronic, however, the body’s physical responses triggered by fight or flight can be damaging. The American Psychological Association (APA) notes that stress affects every system of the body including the respiratory, cardiovascular, gastrointestinal, musculoskeletal, nervous, endocrine, and reproductive systems. 1

Some symptoms caused by the body’s stress response include:

• Increased heart rate and blood pressure
• Muscle tension
• Dizziness or shaking
• Trouble sleeping
• Headaches
• Upset stomach or other digestive problems
• General aches and pains
• Change in appetite
• Decreased sex drive

Health problems that can happen as a result of chronic stress

Symptoms of the body’s response to chronic, uncontrolled stress are a warning sign that health problems may be developing. The Centers for Disease Control estimates that 75% of all visits to the doctor are related to stress. 2 These are some problems caused by chronic stress:

• A weakened immune system
• Anxiety
• Depression
• Heart problems like coronary heart disease
• Worsening asthma or chronic obstructive pulmonary disease (COPD)
• Endocrine system-related problems like diabetes and obesity
• Digestive system problems including worsening of existing inflammatory bowel issues

Stress and mental health

While all of these health problems are a serious concern, the impact of stress on mental health has led to the APA calling stress in America “A National Mental Health Crisis.” 3 Along with potentially worsening pre-existing mental health conditions such as bipolar disease and schizophrenia, stress can trigger anxiety and depression. It’s important to know what to watch for and to seek help if you’re concerned about your mental health or the mental health of a loved one.

For someone who is experiencing serious distress or having thoughts of hurting themselves, the National Suicide Prevention Lifeline is available 24/7 via call or text at 988.

Symptoms of depression

These are common symptoms of depression, according to the APA: 4

• Lack of interest or pleasure in daily activities
• Insomnia or excessive sleep
• Being unable to concentrate
• Weight loss or weight gain
• Feelings of guilt or worthlessness
• Lack of energy
• Thoughts of death or suicide

Symptoms of anxiety

Many of the symptoms of stress are the same as those seen with anxiety. In addition to these symptoms, you may feel a constant sense of unease, worry, or impending doom. Anxiety can cause: 5

• Always feeling restless or on edge
• Trouble concentrating
• Fatigue
• Irritability
• Sleeping too much or too little
• Headaches, muscle aches, or unexplained aches and pains
• Upset stomach
• Inability to stop worrying

How to Conquer Stress

Ultimately, learning tools for managing stress is key to reducing the health problems that can happen with chronic stress. There are several things you can do if you notice signs and symptoms of stress becoming a constant problem:

• Get enough sleep- try to sleep at least 8 hours every night. Adults who sleep less than 8 hours per night report higher levels of stress than those that sleep longer. 6

• Practice mindfulness- exercises like deep breathing and meditation reduce stress. You can even try downloading apps designed for this and make a daily routine of setting aside some time for this activity.

• Take time for self-care- it’s important to take a break and choose self-care activities that contribute to staying healthy and removing yourself from stress. Read a book, spend time on a hobby, or listen to music- whatever helps you unwind the most.

• Exercise and eat healthy- staying active and fueling your body with healthy nutrition is important to help combat the physical effects of stress.

• Avoid excess caffeine- caffeine increases the body’s stress response.7 Sometimes stress and lack of sleep can create a vicious cycle of adding fuel to the fire by drinking caffeine.

• Consider therapy- regular visits with a therapy provider can help you with processing stress and developing healthy thinking patterns to minimize the impacts of stress.

• Practice positivity- during times of stress, negative thoughts can begin to crowd out the positive ones. Some people find setting aside time to reflect on positive thoughts, such as a daily gratitude journal, can help shift thoughts away from negativity.

• Try yoga- a great combination of mindfulness and physical exercise, yoga reduced stress for 85% of people in a national survey. 8

• Lean on friends- involve friends in your life who are positive and supportive, and are willing to be a listening ear or a companion for a fun activity.

• Just say no- sometimes when you are at your limit and can’t take on any more commitments, it’s healthy and necessary to say “I’m sorry, I can’t” to any requests.

Sources of stress for seniors and caregivers

Another way to reduce stress is to take steps to improve the situations that are contributing to it or causing it, if possible. For seniors and caregivers, there are some common sources of stress. Seniors who are experiencing stress are not alone, either– one survey found that 44% of seniors feel stressed. 9 And for caregivers, stress can lead to burnout.

So what are these common sources of stress, and how can they be reduced?

For seniors:

• Caring for a sick spouse
• Financial concerns
• Fear of losing independence
• Chronic illness
• Loss of physical abilities
• Death of close friends, relatives, or spouse

While not all of these can be avoided, there are some ways the effects can be reduced. Prioritizing companionship, taking steps to improve home safety, and involving in-home caregivers to help with a sick spouse or with any personal needs, can all improve stress levels for seniors.

For caregivers:

• Physical demands of caregiving
• Challenges with dementia-related behaviors
• Conflicting demands of caregiving and other responsibilities
• The need for 24/7 care in some cases
• Not being able to take a break
• Managing complex health conditions of a loved one

In many cases, for a caregiver, solutions to stress such as self-care, sleep, exercise, and being able to say no to excess demands, do not feel like an option. Easing this level of responsibility by involving other family members and even a professional caregiver can allow a caregiver to have more freedom to take actions that will improve their stress levels. These services can be arranged as regular visits, or as respite care.

The strategies discussed in this article are vital to helping reduce the fallout from chronic stress. Although they require a commitment to put in place, the effort is worth the improvement in quality of life.

Even starting small- just one or two strategies- can make a big improvement. It may help to choose one that you feel may be easiest first. For example, set an alarm to remind you to take a 2-minute mindfulness break and practice deep breathing every few hours. Once you see the positive effects, it may be easier to add more stress-relieving strategies.

If in-home caregiver services would be a big help and reduce stress for you, Caresify’s home care providers are available for many caregiving tasks. You can read more here, or call 888-799-5007.

References

1. https://www.apa.org/topics/stress/body
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341916/#b7-mjms-15-4-009
3. https://www.apa.org/news/press/releases/stress/2020/report-october
4. https://www.apa.org/topics/depression
5. https://www.nimh.nih.gov/health/topics/anxiety-disorders
6. https://www.apa.org/news/press/releases/stress/2013/sleep
7. https://corporate.dukehealth.org/news/caffeines-effects-are-long-lasting-and-compound-stress
8. https://www.psychologytoday.com/us/blog/urban-survival/201512/yoga-stress-relief
9. https://www.stress.org/seniors