The nature of multi-level homes creates a great deal of challenge for older adults. Care Pros can redefine daily routines to decrease the number of trips undertaken between levels of the home. We can do this by grouping tasks, and ensuring needed items are brought together.
Designing easy routines is important for all adults, but it is much harder for older adults who live in multi-level homes. Laundry is probably done on a different floor from where most of the tasks of the day, or the night before, are done. It's bedroom is most likely the floor even further away. Our goal is not to always just move individuals out of the homes they are accustomed to. Rather, we should evaluate the ways that the day-to-day tasks can be made easier instead of jumping to a solution of relocation.
Which Daily Routines Can Be Moved to One Floor or Grouped Together?
I start with the tasks that require multiple trips.
There are some trips that just cannot be avoided based on holding tasks together to their greatest extent. Others, however, can be avoided by the design of the home. Take the bedroom and kitchen for example. It may be helpful to consider placing some of the most used items, like reading materials or a phone charger, near the bedroom before the individual has to go back downstairs to the kitchen.
Laundry is another example. If the washer and dryer are on different levels of the house, transporting clothes to/from those levels means additional trips for an older adult. The Care Plan may include some household tasks that the Care Pro would be able to assist with thus, reducing the number of trips the older adult has to make between the floors each day.
For our other home care services, our goal is to mimic the older adult’s normal routine as closely as possible instead of reorganizing the household into a completely new routine.
A quick way to review the day is to ask,
- What are the first tasks an older adult needs in the morning?
- What tasks/items are used most throughout the day?
- What are tasks and/or items that currently require multiple trips?
- Can household chores be done in a more efficient manner by doing related tasks together?
- Is the older adult able to do certain tasks/chores independently?
This does not mean moving everything to one level. It means making decisions that will enhance the older adult’s independence without changing the major parts of their routine.
What does a Care Pro do to Assist with Pacing?
A Care Pro is skilled in planning the day to include more deliberate task prioritization.
If going downstairs to make breakfast and then coming back upstairs needed to be done more than once due to forgetting something in the kitchen or going back downstairs to complete another task, it may not be the task that is the problem. It may be the repeated trips that makes the task difficult to complete.
I would look for ways to combine tasks.
For example, imagine all or most of the tasks for the morning can be completed before moving to another floor: having the morning meal, looking over the day’s schedule, collecting what is needed for later, and completing a small task around the house. That is likely easier than doing all of those tasks separately.
A Care Pro may also help by:
- Collecting needed items on a regular basis prior to starting the morning tasks L
- Keeping a visible daily schedule so routine tasks are easier to anticipate
- Assisting with occasional household chores that help avoid multiple trips
- Reminding the older adult of tasks they have already chosen to complete
- Helping support breaks in the activity to rest
- Helping prepare the next part of the day before moving to another floor
Current family caregivers may also be able to use some scheduled support while they take a break from their daily responsibilities. Respite care in Druid Hills offers that service.
When considering what's best for families who carry the greater share of the day-to-day responsibilities themselves, respite care in Druid Hills is another option for families to use while the family caregiver takes some time for themselves.
What Non-Medical Home Care Can't Account For In A Multi-Level Home
Home safety evaluations, physical and occupational therapy, along with the proper contracted work to modify a home fall outside the realm of non-medical home care.
That boundary becomes critical in the presence of stairs.
A Care Pro can assist with the routine and help decrease unnecessary travel, but home care cannot replace an evaluation to make sure an individual can use the stairs safely. When there is concern for balance, strength, mobility, rehabilitation, or the safest means of traveling throughout the home, these concerns should be directed to the appropriate healthcare professional.
The same holds true for the changes made to the house.
If the concern is regarding the application or change of railings, stairs, the installation of equipment, the modification of a bathroom, or other construction as it pertains to the home, this work should be assessed and executed by the appropriate qualified professional.
Sometimes home care and home modifications may address different segments of the same home-based problem. A therapist, for example, may evaluate mobility and perform a manual system in conjunction with the home care worker.
I would not expect one type of support to do all three jobs.
Questions to Review if The Home Layout Continues To Present Challenges
If the challenges continue to affect the day, think critically about where the challenges exist to determine what changes should be made.
These questions can help:
Which floor gets the most use?
If the majority of the day happens on one floor, identify what pulls the person away from said floor. Is it the laundry room? Closets? Bathrooms? Where do routines take the person?
Which trips are compulsory and which can be avoided?
Going upstairs to sleep may be part of a person's chosen routine. Going upstairs three more times because commonly used items are stored there may be the easiest to address.
Is the problem the stairs or everything around the stairs?
It may not be as easy to move from floor to floor. It may be easy to move, but carry lots of individually used items and return numerous times because the routines of the household are not organized.
Have there been recent changes?
If someone who was previously able to manage a multi-level home is now struggling with the same activities, the family should consider involving a healthcare professional. While home care may help with the routines, they cannot give the reason for the new change.
What does the older adult want to continue doing?
These do not replace the need for the other questions, and may remain the most important, but these ask, “What does the older adult want to continue to do?” Here, a person may want help with the laundry, but wants to continue cooking breakfast on their own. They may want help with bringing the needed items into the house, but want to organize their bedroom by themselves. These should inform an ideal Care Plan.
Questions for families to consider when assessing daily challenges resulting from their home's layout when choosing required assistance from our Atlanta area Home Instead office.
Commonly Asked Questions About Home Care in Druid Hills
Will home care assist my parent who lives in a two-story house?
Yes, home care can easily adjust to the routines involved for a two-story or multi-level home. With a given Care Plan, this may involve completing some household chores, organization, reminders of routines, and/or assistance with meal-related and other activities so the person does not need to make multiple trips.
Will a Care Pro carry things between the floors?
For the Care Plan, it depends on the specific task and what a Care Pro can safely assist with. Discuss what items are creating a challenge and why. It may even be possible to reorganize supplies and/or change the layout to minimize the number of trips required.
Does a Care Pro decide on the safety of the stairs for my parent?
No. Non-medical home care does not do Safety or Mobility evaluations. A Care Pro can assist with routine duties in the home but all questions pertaining to the balance, rehabilitation, ability, and use of stairs should be directed to the appropriate healthcare professional.
Do we need to prepare the bedroom downstairs for home care?
We don't need to move bedrooms to begin home care. Home care doesn't moving someone's bedroom as a prerequisite to care. When we say home care starts, we mean we begin caring for the person, using the routine the person has right now. We identify the problem areas of the routine and compare the pros and cons of reorganizing the rooms. Relocation of rooms, cabins, closets needs to be decided by the older adult and after consultation with the relevant service professionals.
What if home care needs to help with the laundry?
That may be the issue. If laundry needs to be moved from an upper floor, carrying laundry may be more difficult than the other things you do around the house. We can make a helpful care plan that focuses on the tasks that need to be done.
Can home care services and therapy coexist?
Both services can help at the same time, but they work in different ways. Therapy addresses clinical or rehabilitative issues that fall under the scope of the therapist, and non-medical home care assists the client with the day to day activities and the domestic duties of the house. The families of the clients should ensure that both services have clear understanding of their responsibilities to avoid overlapping.
How can we tell if the home is becoming too difficult for the person?
Take note of what upsets the person's daily routine. We can look at things that are done repeatedly but left unfinished. Avoidance of some areas of the home can signal the current home does not work for the person. There may be a need for home care, assessment, and other modifications for the home.
If the multi-level house in Druid Hills is making your day-to-day duties feel like a burden, reach out to the Home Instead team assisting Druid Hills. We can address those segments of the day and help you make sense of where non-medical in home care may be appropriate and where known duties may in fact be best fulfilled by other qualified professionals.
About the Author
Matt Cohn has spent more than 25 years helping older adults and their families find support that helps them remain safe and comfortable at home. He works closely with families, caregivers, and care professionals through the decisions that come with aging and in-home care.
