Please remember, this column is designed to help the consumer seeking behavioral-health information, and not intended to be any form of psychotherapy or a replacement for professional, individualized services. Opinions expressed in the column are those of the columnist and do not represent the position of other SelfhelpMagazine.com staff.

Question

What do you suggest for a couple where one needs institutional care and the other does not? The spouse who does not need daily assistance is unable to care for the other. They do not want to be separated? Are there any solutions you would recommend?

Answer

This is a sad and sometimes, too common, situation. A great deal depends on the care the incapacitated parents needs, the financial situation, and the resources in their area. At times there are no perfect solutions, only options from which to choose. The best option would be if home care or a live in can be arranged, but the cost of this can sometimes be prohibitive.

An assessment needs to be done to determine exactly the kind of care each parent needs. Can community services, adult day care, in home care, be put together to provide enough assistance? If this is not possible, then are there assisted care facilities that can accommodate both of them even if it may require that they live in separate wings? If that is not possible, then is there a facility near the well parent where the other spouse can live so that he/she can be visited on a regular basis?

Unfortunately, there are no easy Answers. May I suggest you contact your local social service agency for an assessment of the situation and assistance in exploring the community and residential options. Any geriatric social worker will first try to keep them together through community resources and then explore the other options. Someone needs to take a look at the total picture of needs, resources, and see if there are enough formal and informal support systems to keep them together. If they do need to live apart, try to find emotional support for them to help them through this sense of loss and adjustment.

You might want to contact: The National Association of Area Agencies on Aging. They have an Eldercare Locator which directs people to the local agencies on Aging. 800-667-1116, Children of Aging Parents 800-227-7294 can direct you to geriatric care managers.

The National Association of Professional Geriatric Care Managers 520-881-8008 also refers to geriatric care managers who are members of their organization.

3/12/98

Emily Carton MA, LISW, is a licensed social worker who works with Elder Options, a private care social service firm in the DC Metropolitan Area. She is also an is an intern in Bibliotherapy at St. Elizabeth's Hospital in Washington D.C.