When my mother was 80, she suffered a life threatening mishap, a punctured lung, during surgery to insert a pacemaker. Her recover took eight months and left her very frail. In hindsight, I realized that my brother and I were completely unprepared to support our parents through their declining years. Fortunately, I discovered that there are predictable stages of decline that will help us plan for our parents,’ our spouse’s and our own increasing care needs, living arrangement changes and eldercare costs that will probably be necessary.
With advancing age, we step onto a ladder that only goes down, as physical and/or mental health decline. There are typically four stages of decline. Not everyone will go through all four stages, and the length of time spent at each stage will vary greatly. However, the need for increasing care in the final years of life can reasonably be expected.
With time, seniors’ joints become stiffer, they lose bone and muscle mass and stamina. Their reflexes, flexibility and balance aren’t as good either and their eyesight and hearing often diminish. Welcome to the supportive living stage, when seniors typically need a watchful eye from family members, neighbours and friends and ongoing help with chores. Living arrangement options are to stay at home with help, move in with family, or move into a retirement residence or seniors’ housing.
The risk of a medical emergency, such as a bad fall or a stroke, increases on this steadfast stepladder of decline. This may be a temporary setback, but most often it is the beginning of a more rapid decline in health. With increasing inactivity and frailty, and cognitive and/or multiple health problems, seniors decline to the assisted-living stage. They usually can no longer drive, cook, or take care of their home and may need help with a bath or getting dressed. Accommodations options are to stay at home with more help, move in with family, or into an assisted-living retirement residence.
When illnesses grow more disabling and complex, seniors become totally dependent on their family and health care professionals for their care and well-being. In this dependent-living stage, they will need 24-hour nursing care, an on-call physician, and assistance with most activities of daily life. The two most common living arrangement options are a nursing home or moving in with family, supported by health care professionals.
When a loved one becomes terminally ill, and close to the end of life, they have reached the palliative care stage. Medical supervision by an on-call physician for pain management, as well as 24-hour nursing and personal care are typically needed. Comfort care, and emotional and spiritual support help to provide a good death. The accommodations options are a nursing home, an acute or palliative care unit in a hospital, living with family supported by health care professionals and hospice, and a hospice residence.
By Shirley Roberts, Author of Doris Inc.: A Business Approach to Caring for Your Elderly Parents
 Roberts, Shirley. Doris Inc.: A Business Approach to Caring for your Elderly Parents. John Wiley & Sons Canada, Ltd. 2012. P.62. Print. Included with permission of the publisher.