Congregate Care

Care Don and Mary were happily married for 50 years and had two successful children and five grandchildren. Don and Mary met while serving in the U.S. Army during the Korean Conflict. After their military service ended, they married and embarked on their careers. Don and Mary were healthcare professionals; Don was a professor at the local medical school, and Mary was a hospice nurse. Don and Mary were always active in their church and volunteere3d their time in the community. Both retired at age 65 to [pursue their dreams of international travel and spending their children's inheritance. During the early years of their retired life, the couple continued to work part time, travel extensively, and spend time with their grandkids. Their retirement plans seemed to be going swimmingly until Don noticed that his wife was having memory problems at the age of 78. Mary always kept up on the latest topics and was always th first to complete the crossword puzzles and other logic games in the newspaper. However, Mary seemed to become increasingly forgetful; she would run errands to purchase specific items and return home empty-handed. The couple decided to seek help from a gerontologist. An extensive battery of cognitive and neuropsychological test determined that Mary's language skills and mental abilities had markedly diminished. Mary was diagnosed with Alzheimer's disease, an incurable terminal brain disease. After the initial shock of the diagnosis, the couple developed a plan to cope with the disease - Don was going to be Mary's caregiver. The p progression of the disease was tough for Don and the family o watch. At first Mary became confused, then she became progressively irritable and aggressive. Five years after the diagnosis, Mary became almost totally withdrawn. Her appetite was nonexistent, and she became incontinent. Additionally, Mary suffered from "sundowners syndrome" - a phenomenon whereby the individual experiences confusion and exasperation during the late afternoon or early evening hours. Don struggled to care for her and keep an upbeat attitude; however, he too was experiencing the deterioration of aging. After years of being a competitive runner, his knees and other joints prevented him from fully assisting Mary. Don hired a home health aide to visit daily to assist Mary and also do some light household chores. As Mary's condition grew more serious, he had to make a decision. He was no longer able to care for her, and his own ailments were starting to severely impact his ability to take care of himself. Additionally, their retirement savings had dwindled to the point that they needed financial assistance from family members to get by. The case of Mary and Don is not uncommon, as many seniors experience the inevitable choice of long-term care. 

Case Study Questions 

1. What long-term care options should Don consider for Mary and himself? 

2. What are the requirements necessary to access the care you have chosen in Question 1? 

3. What funding mechanisms are available to Don and Mary, and how does this affect the choice of their care options? 

4. What could Don and Mary have done to plan their care during their later years? What is your plan to prepare for the possibility of your need for long-term care?