This is the second story in a two-part series relating to the trials and tribulations of those in the sandwich generation. 

For previous story, CLICK HERE

By Nate Jones

Staff Writer 

Whether a FEMA agent traveling across the globe, a single mother working full-time or one of many siblings in a large extended family, taking care of parents is not something many people have time for. As more active, middle-aged people are finding themselves faced with making decisions about care for their elderly family members, the market has produced a variety of care options for seniors and their families. 

Anne O’Sullivan, a family care specialist at the Southern Maine Agency on Aging (SMAA), said there are a number of possibilities for those finding themselves part of the “sandwich generation” who do their homework, including in-home care, assisted and independent living facilities and nursing homes.

William Hobbs, a 53-year-old FEMA agent from Scarborough has placed his 81-year-old father under the care of Comfort Keepers, just one of 20 in-home and respite care providers in Maine. Hobbs said he made the decision so he could meet work obligations, traveling over the globe to disaster sites.

“I’ve had to make myself unavailable, taking care of him has been a 24-7 job,” he said. “We didn’t think he’d need that kind of thing at first, then it came to the point where he looks forward to having it.”

His father recently had several major surgeries, during which Hobbs has put off various work related responsibilities. 

“I only have one Dad, but there will be many disasters,” he said.

Hobbs said his father will return home where trained care providers will assist him after his recovery in the hospital.

“People want to live and age in their homes, [their] emotions are directly linked to their health,” Peter Violet,  Scarborough Comfort Keepers owner and a licensed clinical social worker said. 

Violet said his company is not a medical service, however, and is limited in its ability to remind patients to take medications they have already been prescribed by a doctor.

Family members should make sure any in-home service carefully screens their employees before enrolling a senior in any program that cares for people, O’Sullivan said. Liability should also be researched to avoid any legal repercussions in the event of an accident, she said. Adequate staffing is also a must.

“You hope that with an agency, they would have a backup in case a provider cannot make time,” O’Sullivan said. 

According to a national study by the Family Caregivers Alliance, the average cost for personal or in-home care in Maine is $19 a day, which is slightly above the national $18 average, with aides receiving an hourly wage of $8.86. Medically qualified home health care visits are somewhat more expensive at $20 an hour.

Hobbs said his father does not receive any state assistance to finance his care, as it is paid for through his father’s retirement pension.

“It’s all basically out-of pocket,” he said. 

O’Sullivan said there is also a little-known program available from the state which makes it possible for qualified family members who are not the senior’s spouse to receive an hourly wage for taking care of a senior.

“It appears to be a fairly straightforward application process,” she said.

For seniors who need more than in-home care, there are assisted and independent living options.

Assistant Administrator and Admissions Director for 75 State Street Lori Maxwell, said there’s a delicate balance between appeasing residents and their family members. 75 State Street, a non-profit organization in Portland aimed at providing services and housing for 150 seniors,  is allowed to provide medical care for their assisted living residents but not for those enrolled in the independent living programs, she said.

Local radio advertisement representative Gracie Johnston of South Portland moved Edward, her 75-year-old father, into 75 State Street’s independent living facility in 2006. Johnston, who is also a mother of three, said her family made the decision to move her father from his Florida home when they began to notice changes in his lifestyle during his visits.

“We all knew there would be a time,” she said. 

Johnston said her 3-, 8- and 9-year-old daughters enjoy accompanying her on visits to see her father, which she does several times a week in addition to organizing his finances, medications and doctor’s appointments. The tasks are time consuming, which doesn’t always coincide with work schedules, she said.

“In sales, if you want to make it you have to be out there. Luckily my employer’s very family friendly,” Johnston said.

Cape Elizabeth resident Ruth Conly’s 86-year-old mother has been living at Scarborough Terrace, an assisted living facility for nearly a year. Conly, a 60-year-old mother of two who works fulltime as an administrative assistant at the University of Southern Maine’s Muskie School of Public Service, made the decision to place her mother in an assisted living program once it became apparent she was experiencing the affects of Alzheimer’s disease.

“I’m in a better place now,” Ruth Conly said. “I was in overdrive for a month, it took the whole family to take care of her.”

O’Sullivan said while assisted and independent living options allow seniors to be monitored on a 24-hour basis, the decision to move into a dormitory type setting is difficult for families to make. 

“People need to think about what’s going on,” she said. “You may not be able to choose how often you want to move.”

Not all facilities such as 75 State Street or Scarborough Terrace accept MaineCare’s housing funding assistance program, O’Sullivan said. Maxwell said nearly half of the residents at 75 State Street were on MaineCare, which provides $22 dollars less than it costs the facility to house the seniors.

“We’re operating at a loss 50 percent of the time,” Maxwell said. “Which is why so many other organizations don’t accept MaineCare.”

The Conly family sold the house where their mother had lived for 40 years to afford the cost of her assisted living care, while Johnston said her family was lucky enough to receive a pension from her father’s days as a clergyman in Massachusetts.

“There’s no way I could afford to pay for it, I don’t have that kind of money,” Gracie Johnston said.

According to the Family Caregiver Alliance study, the average yearly cost for an assisted living facility in Maine is $51,444, significantly higher than the national average of $35,628.

O’Sullivan said nursing homes are also an option for seniors who need intense levels of medical and behavioral care, but are generally frowned upon by elders who may have preconceptions about nursing home facilities.

“Our parents’ generation has the worst image of what a nursing home can be,” she said. “The sandwich generation needs to see them as a viable option.”

O’Sullivan said it is important for sandwich generation members to explore other care options before looking at nursing homes, which are often only an appropriate choice for select seniors. 

“In Maine you can’t get into a nursing facility unless you show you really need the care,” she said.

Maria Wood of Scarborough not only lives with her own 63-year-old mother but made the decision to place her 86-year old mother-in-law in the South Portland Nursing Home.

She said her mother-in-law suffers from various forms of dementia, while her own mother is still plays a large role in running the family household.

Wood said she would encourage other sandwich generation members to lean on as many state resources as possible when it comes to funding nursing home care, which according to the Family Caregiver Alliance costs $259 a day in Maine.

Her mother-in-law receives MaineCare,  Medicaid and a pension to provide for her housing at South Portland Nursing Home.

Wood, a 43-year-old single mother of two adolescents said she didn’t view her family’s weekly visits to the nursing home as a chore but rather a commitment.

“I grew up in a big Italian family, we were taught to take care of your own. These are the matriarchs of our families,” she said.