By Gregory Solometo
Since founding a concierge home care agency (Alliance Homecare) ten years ago after caring for my grandmother with Alzheimer’s, I’ve learned a lot about people, family dynamics, elderly needs, and, of course, home care. During that period, in which I navigated her care, I realized firsthand the challenges of caring for an elder and the low bar set for options, services, and choices in the home.
The bond I had with my grandmother was beyond words, and care for her was a labor of love. My goal during that time was to find the best care that our budget allowed. For three years, we paid for caregivers to come to her home six days a week, and I covered the seventh day. Eventually, it came time to find her a living facility that could handle advancing cognitive decline.
I worked closely with our elder care attorney and assessed state-funded programs, but, ultimately, couldn’t justify “cheaping out” on my grandmother by placing her in a facility that smelled like urine just to save some inheritance. I reverse-mortgaged her home and spent all of her assets to provide the best care our finances would allow. If she had lived longer, I would have been paying personally and would likely have faced further hard decisions. She passed away in 2008 with her dignity and my peace of mind both fully intact.
Out of these life lessons formed my passion, and our company mission, which was to establish a best-in-class service that met and exceeded the needs of my grandmother. Our philosophy is called “The Grandma Rule®” and it is something we live and breathe by. The question remains, “What does good look like when it comes to home care?” I can attempt to tell you what it is but I can more easily tell you what it isn’t.
Home care that meets the Grandma Rule® is a comprehensive ecosystem of experts, specialists, and service providers that will improve someone’s quality of life. It looks like a philharmonic but instead of strings and brass sections, you have elder care attorneys and neurologists.
Every scenario, family dynamic, and support network is unique and needs to be assessed individually. One size does not fit all in the last two to five years of life. Most of our rapidly aging population need more than just caring home attendants to help them get bathed, dressed, prepare meals, and cue meds. It’s a great start and a challenge of its own to recruit and vet these individuals, but it’s only half of the full equation.
Today’s elderly need an intelligent and experienced care coordinator creating, cultivating, and overseeing any care plan. Solely hiring caregivers and leaving them alone to manage care is like the symphony playing without its conductor. Nobody is keeping time and everyone is playing off-key. People with privately hired or unmanaged help and family not actively visiting are often doing their family members a disservice. In the best of circumstances, they have inexperienced staff holding up the fort without any knowledge, training, or guidance and are vulnerable to caregiver burn out. These situations aren’t created out of malice; they emerge from people doing their best without instructions or leadership.
Most families going through this don’t have the luxury of prior experience. They make decisions like I did 10 years ago, with very little guidance.
Having any kind of live-in help means that the caregiver needs to sleep a reasonable amount through the night to survive each day. If mom or dad is going to the bathroom four to six times each evening (typical with Alzheimer’s and Dementia), how is the caregiver going to sleep? How many months can they do this until they burn out? Eventually, either the caregiver collapses or the client has one or multiple falls from stumbling to the bathroom unattended, and ends up in the hospital and/or rehab with a broken hip. Once admitted to the healthcare system, they are susceptible to pneumonia and other types of diseases commonly spread across the continuum.
In the worst of circumstances, unmanaged caregivers expose vulnerable adults to neglect and sometimes severe abuse—whether that be physical, financial, or mental. Caregivers alone are not equipped to manage and problem solve the needs of elders in their final years of life. To us, the most critical solution involves a dedicated home care manager to oversee the entire program.
What can be done to achieve this? Stay tuned for our next segment on the key members of the band.
Gregory Solometo started Alliance Homecare after caring for his ailing grandmother for five years. He created The Grandma Rule® hiring philosophy to provide all clients with an elite and highly qualified team of healthcare professionals. Prior to Alliance Homecare, Gregory worked primarily in the financial services industry. He graduated from Emory University in 1995.