Navigating Long-Term Care Challenges for Seniors with Complex Needs

Long-term care

The elderly person has a severe disability certificate, but it does not include the ten major categories.
For the first four months, the family provided care on their own, and later applied for foreign caregivers.
However, the caregiver is experienced and speaks Chinese.
When the caregiver needs to leave after a year, we have to return to the rehabilitation department for the doctor’s assistance.
This year, the elderly person only needs someone to watch over her while walking (care must be taken as she tends to walk faster and has difficulty turning to avoid obstacles...
there are still many issues).
However, during the follow-up visit at the rehabilitation department, the doctor observed that she only needs to hold hands while walking and stated that since she can walk on her own, further assistance is not necessary.
Yet, she has ongoing issues related to her brain affecting her left limbs (having a caregiver who can communicate with her is beneficial for her learning other functions, which is better than having someone who cannot communicate and does everything for her, as that could accelerate cognitive decline).
Memory is also a concern.
May I ask if we can proactively apply for cognitive or dementia-related assessments? This was the first suggestion given to us by the clerk at the health bureau.
(Having a severe disability certificate but not falling under the ten major categories seems contradictory.) Or could it be that we are consulting the wrong department? My husband and I are wondering if we are not following conventional methods.
Is that really the case? What should we do? There are only the two of us and the elderly person at home (if there is no caregiver).
Is it safe to leave her at home like this?

Hong, 30~39 year old female. Ask Date: 2012/05/28

Dr. Gao Qingyun reply Family Medicine

Dear Hong,
Hello.
Your letter indeed indicates that caring for the elderly in your family has brought you considerable distress.
Since I have not personally examined the elderly individual in your home, I may not be able to provide suitable judgments or recommendations.
The issues you mentioned regarding exercise and dementia fall within the realm of neurology.
I suggest that you take your elderly family member to a neurologist (either at our hospital or a medical center) for a relevant evaluation.
Thank you! Wishing you peace and health.
Sincerely,
Dr.
Gao Qingyun
Attending Physician, Family Medicine Department
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2012/05/28

More Info

Navigating the complexities of long-term care for seniors, especially those with significant health challenges, can be a daunting task for families. In your situation, it seems that your elderly family member has a severe disability but does not meet the criteria for certain types of support, which can indeed feel contradictory and frustrating. Here are some insights and recommendations based on your concerns.

Firstly, it’s essential to understand the importance of a comprehensive assessment of your elderly family member's health and cognitive status. Given the history of neurological issues and the challenges with mobility and memory, it would be prudent to seek a thorough evaluation from a neurologist or geriatric specialist. They can provide a detailed assessment of her cognitive function, including memory and potential dementia-related issues. If you are considering cognitive testing, you can indeed request this proactively. Many healthcare providers offer cognitive assessments that can help determine if there are underlying issues that need to be addressed.

Regarding the care situation, it’s clear that having a caregiver who speaks the same language can significantly enhance communication and the quality of care. This is particularly important for someone with cognitive impairments, as understanding and being understood can help maintain their cognitive functions and prevent further decline. If the current caregiver is not meeting these needs, it may be worth discussing with the agency or considering a different caregiver who can provide both the necessary physical assistance and effective communication.

You mentioned that the rehabilitation department indicated that your family member could walk with assistance but did not qualify for further therapy. This can be frustrating, especially if you feel that her condition warrants more support. It may be beneficial to seek a second opinion or consult with a different rehabilitation specialist who can assess her needs more comprehensively. Sometimes, the criteria for therapy can be strict, and a fresh perspective might yield a different outcome.

Safety at home is another critical concern. If you and your spouse are the primary caregivers, it’s vital to ensure that the living environment is safe and accommodating for her needs. Consider implementing safety measures such as removing obstacles, using mobility aids, and possibly installing grab bars in key areas like the bathroom. If you feel overwhelmed, it might be worth exploring additional support options, such as respite care, which can provide temporary relief for family caregivers.

In terms of long-term planning, it’s essential to consider the future needs of your elderly family member. Engaging with social services or local aging agencies can provide resources and support for families navigating these challenges. They can assist in understanding the available options for long-term care, including potential eligibility for various programs that might not have been initially considered.

Lastly, it’s crucial to take care of your own well-being as caregivers. The stress of managing complex care needs can take a toll on your mental and physical health. Seeking support from local caregiver support groups or counseling services can provide you with the necessary tools to cope with the challenges you face.

In summary, navigating long-term care for seniors with complex needs requires a multifaceted approach that includes medical assessment, effective communication, safety measures, and caregiver support. By taking proactive steps and seeking the right resources, you can create a more manageable and supportive environment for your elderly family member.

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