Widow, age 85, living alone in her own one-story home and unable to drive. Her husband was a retired Army veteran.

• Has dietary needs related to her Type II diabetes.
• Tires easily and is often unable to prepare a hot meal for herself.
• Unable to keep up with housekeeping tasks such as vacuuming, window-washing, bathroom cleaning, kitchen floor, etc.
• Uses a cane but is often unsteady and has had a few falls but no serious injury yet.
• Has difficulty going up and down the several steps leading to her front door.
• Is a devout Catholic and would like to receive communion at home; misses going to church.
• Has limited funds and often finds her expenses exceed her income.

Action Plan

1. Diet: Consult with dietitian to determine an appropriate diet based on the elder’s food preferences. Arrange for elder to take a class in meal planning for diabetics.
2. Meal preparation options: Sign up for Meals on Wheels to deliver hot meals. Or, hire a caregiver to shop for groceries and prepare a hot meal at dinnertime.
3. Housekeeping: Hire a caregiver to provide light housekeeping service a few times per week.
4. Mobility: Consult with her doctor to determine if a walker should be prescribed. Arrange to have a walker delivered at home along with training in how to use it safely. Or, arrange for senior to visit a mobility equipment store and make a personal choice.
5. Home Safety: Hire a handyman to construct a wooden ramp to fit over the front steps. Alternatively, purchase a metal ramp and have it installed. Sign up mother for local medic alert service.
6. Transportation: Arrange for volunteer driver to take mother to and from doctor’s and dentist’s appointments and hair salon appointments. Apply to local paratransit service for transportation to shopping centers and other appointments and errands.
7. Spiritual Needs: Arrange for weekly visits from a lay minister from a local parish to bring communion to her at home. Arrange for volunteer driver to take mother to and from church services.
8. Financial Needs: Research ways to reduce expenses for such things as prescription drugs, phone and utilities. Consult HiCap and research government benefits available through MediCal or through TriCare for a veteran’s widow.

Profile II

• The wife finds caregiving is physically taxing and at times emotionally difficult.
• She feels socially isolated but also feels she needs to stay with her husband constantly.
• She is unable to keep up with housekeeping tasks such as vacuuming, window-washing, bathroom cleaning, kitchen floor, etc.
• She is unable to take care of simple home repairs that her husband used to do, such as fixing a leaky faucet, replacing expired smoke detectors or adjusting a door that sticks.
• The backyard is overgrown with weeds and is not safe for the husband to walk through.
• The carpeting in the house makes it difficult to push a wheelchair through.
• The husband is hard of hearing and doesn’t want a hearing aid at this time, causing others to raise their voices to be heard by him or, often, to avoid conversing with him.

Action Plan

Plan is made in cooperation with the parents and their concerned son living across the country.

1. Living options: Consider option of in-home caregivers, hired through reputable referral service or through an agency. Help with interviews and the paperwork involved in employing caregivers. Consider the option of moving to an assisted living facility where most of the identified needs of the couple can be met. Research available facilities and arrange for visits to determine which is best for them.

   If the couple decides to stay in their home:

2. Caregiving: Hire in-home caregivers to help with the husband’s needs for dressing and bathing.

   Arrange for visit by a physical therapist to determine if there are techniques and aids that will make it easier for the wife to handle transfers of her husband from bed to wheelchair, wheelchair to walker.

   Consult the husband’s doctor about what level of exercise is appropriate. Look into a local water exercise program that welcomes seniors, including the equipment to lower someone in a wheelchair into the pool.

3. Housekeeping: Hire a housekeeper once a week to take care of large jobs such as vacuuming and cleaning floors and bathrooms.
4. Support: Make information available to wife about caregiver support groups, some of which offer a social program for her husband while she attends the meetings.

   Suggest the wife try doing some grocery shopping online with home delivery, especially for staples and heavy items.

   Arrange for a hairdresser to visit at home so the wife can enjoy her routine haircare.

   Help husband and wife set up their computer so that they can communicate with other family members through email, picture-sharing and telephone/video if desired.

5. Safety in the Home: Consider such aids as a bath chair or grab bars in the shower. Replace thick carpeting in areas used by the husband with appropriate carpeting that allows easy wheelchair travel.

   Place a tap-bell within reach of the husband so that he can summon his wife if necessary when she needs to tend to meal preparation, housework, or relaxation elsewhere in the house.

6. Home repairs: Hire a handyman to make minor repairs as needed.
7. Yardwork: Hire a yardworker to clear backyard of weeds and maintain a safe pathway.
8. Hearing aid: Suggest the husband try using an inexpensive amplifier with headset so that he can hear conversations and TV better.
9. Companionship: Arrange for a compatible volunteer to stay with the husband for several hours once or twice a week so that the wife can get together with friends or run errands.

   Find programs at the local Senior Center that will be enjoyable to both husband and wife and that they can attend together or separately, depending on their interests.