Richard Wanamaker, 61, is determined to keep his mother Juanita, now 83 and a widow, in her home. No bones about it, she wants to stay in the Colerain ranch she’s called home since the 70s despite limited mobility, some falls and cognitive problems.

When his father, who died in October, began having problems that led to hospitalizations and dialysis in early 2009, it became clear they needed a plan. Richard took up the grocery shopping and driving, arranged for meal deliveries and spent nights with his mom when his father was hospitalized. But after his father’s death, his mother fell on one of the few nights Richard wasn’t there.

“I was at a loss,” he says, until a social worker at Deaconess hooked him up with the Council on Aging of Southwest Ohio, which did an evaluation, arranged for supportive equipment and helped Richard sort through information to make decisions.

He’s been able to keep his mother in her home with the help of a big-hearted neighbor, Wally Ornella, who spends nights, fixes meals and checks in on her. Between the two caregivers, his mother is alone only a few hours.

So far so good.

“She thinks she’ll live there forever,” he says, “and if that works, good. But I realize there may be a time when we have to make a move. But I want to keep her independent as long as I can.”

Independence — and planning — are what prompted Patricia and John Donaldson, both 82, to call a family conference in 2008 with their children to look at living options when their home in Milford became too much for them.

“They said, ‘don’t wait until you have to move. Move while you can enjoy the many things a good place has to offer,’ ” she says. After looking at several options, they chose an apartment and independent living at the Deupree House in Hyde Park, and are moving in spring 2009.

“At 82 we knew we could need more services down the road, but we feel we still have a lot of living to do. This just felt right the minute we walked in,” she says. “We’ve made very good friends quickly.”

Elephant in the room

Senior care. Nobody really wants to think about it, or talk about. It’s the elephant in the room, the subject we tiptoe around as children of aging parents and as aging seniors.

Mostly, we hope it will disappear. After all, what can we really do about? For the most part we can’t control medical problems, frailty or dementia.

It’s more fun to think about the good parts of the retirement years – travel, resting up from the exhausting 9-to-5 (or longer) years or venturing into new businesses.

But that’s exactly the time to start thinking about it, says Laurie Petrie, communications director for the Council on Aging of Southwestern Ohio, an unbiased agency that plans, coordinates and funds services to older adults in Butler, Clermont, Clinton, Hamilton and Warren counties.

“In their 50s, when people begin thinking about cruises and the fun parts of retirement, they should also think about the likelihood of long-term care at some point in their future.

“Unfortunately, very few do that,” she says, and the result is often a crisis crunch, usually involving a parent, “forcing you to make difficult and life-changing decisions in a stressful time. You are starting at square one and aren’t even familiar with the terms that hospital workers are throwing at you.”

But she puts a positive spin on planning ahead.

“Look at it as a gift to yourself and your loved ones. Everyone says they don’t want to be a burden to others. One way to do that is to plan financially, legally for the future, before you have to.”

Decisions to think about

There are many myths and much misinformation about caregiving, according to Petrie. The biggest is thinking ‘I’m not going to need care.’ “About 70 percent will need care at some point,” she says, but only about 40 percent of us think we will whether it is for ourselves, a spouse or parents.

“The first thing to do is realize you will need care – it could be short-time, it could be for years” – then consider the following:

Home care. Most people want to remain in their homes, Petrie says, and there are myriad ways to accomplish that, most carrying a price tag, whether it is modifications to a home like a chairlift or someone coming in to help.

Family. People should look at their family situation in considering options. Are there family members or children nearby who can be depended on for help? What will happen if driving is curtailed?

What kind of help can be realistically expected?

Legal and financial issues. Living wills, power of healthcare decisions, long-term health insurance, reverse mortgages.

“Medicare doesn’t pay for everything,” Petrie says. “You need advice from experts and we can guide people through this” so they can make informed decisions.

“People come up with all kinds of interesting, unique arrangements for caregiving,” Petrie says. “Because there is no one answer, it’s helpful for people to come to us because we are an area agency designated by the state and we’ve been helping people for 40 years. Our mission is to help people understand their needs and their choices in an unbiased, trustworthy manner.”

Seniors like the Donaldsons are in a great position to plan, says Laura Lamb, vice president for residential housing and health care of Episcopal Retirement Homes, providing living options that include independent living, assisted living, and nursing care at Deupree House, Marjorie P. Lee, St. Paul Village, Canterbury Court and Cambridge Heights.

In most cases, unless there is a life-changing event, it’s more of a planned event based on what they want their future to look like, she says.

And fortunately one of the biggest changes that’s taken place in the last five years is the “a-ha by providers that one size doesn’t fit all. Every senior is different,” Lamb says.

Seniors and their caregivers have more options than ever. Providers have listened to what they are saying. It might be a wish to customize an apartment, to get supplemental services, to not be billed for automatic services they don’t want or need.

“You have to sit across the table from them and enable them to share a life theyenjoy,” instead of fitting them into a pre-conceived plan, Lamb says.

Because planning when there isn’t a crisis is a plus, Lamb says, you have the luxury of a research stage. “Look at it like researching a car, a neighborhood or other major life decisions. ”

Kicking the tires might consist of visiting and spending time at several places, putting the counselors through their paces, asking questions, requesting need assessments and consulting their financial people.

“The more you know about what you’re getting into, the better the outcome,” Petrie says. “What we need to do more of is look at different living arrangements that are more flexible and give people more options in care-giving.”

Source: Council on Aging of Southwestern Ohio

Source: Council on Aging of Southwestern Ohio

Choosing a facility