If you're one of the many Americans in your thirties or forties caught between caring for young kids and caring for aging parents (the "sandwich generation"), you may find this dual caregiving role to be exhausting. At some point, you may need to consider your own mental health (along with the state of your marriage) and determine that it's time to give one of these jobs up for good. However, you're likely reluctant to turn over care of your parents to a facility or in-home provider without doing your due diligence; especially when internal guilt and external pressures can cause you to doubt the need for outside assistance. Read on to learn more about some of the factors that can indicate it's time for professional nursing care as well as how you can find an appropriate care facility or service for your parents. 

How do you know when it's time for outside assistance for an elderly parent?

In many cases, the changes associated with aging come on so gradually it's difficult to notice them on a day-today basis. You could find yourself brushing off caregiving duties you never would have dreamed of undertaking a few years ago. However, regardless of the level of care you're comfortable providing, it's generally best to bring in outside resources when you're faced with tasks that could physically injure you. This can mean that once your parent is no longer mobile and needs assistance to use the restroom, shower, or get into or out of bed, he or she could likely benefit from a skilled nursing facility (SNF). Attempting to lift your parent out of bed or even support the majority of their weight on a daily basis could lead to joint problems or even fractures -- meanwhile, SNFs or in-home nursing agencies have a rotating staff of young, fit individuals whose bodies won't suffer as much wear and tear as yours.

You'll also want to enlist outside assistance if your parent's mental state has deteriorated to the point you're no longer comfortable leaving him or her alone for long periods of time. Many seniors dealing with dementia or Alzheimer's disease deal with a process known as "sundowning" and can become confused, agitated, or even physically aggressive during late afternoon and early evening. Having assistance during these times can help you physically and emotionally deal with the painful process of watching a loved one's mental abilities decline. 

What types of nursing care are available?

There are several tiers of nursing care that may be available for your parents, depending upon the level of care they need to function. 

For situations in which your parents need occasional assistance with medical tasks -- like giving insulin injections or testing blood sugar, changing an ostomy bag, or bandaging wounds -- an in-home nursing agency may be able to dispatch nurses once or more per day to help provide medical care. For non-medical assistance with personal care tasks, companionship agencies can also provide an individual to sit with your parent and help them to and from the bathroom, fix meals, and do light house cleaning. 

If you find that your parent needs care more frequently than can be accommodated by an in-home caregiving agency, you may want to investigate an assisted living facility or SNF. Assisted living homes such as Hilltop House are often set up like townhouses or condominiums and allow your parents to live a relatively independent lifestyle while still being close to medical and other assistance when needed. 

SNFs provide your parent with daily hands-on nursing care in an inpatient environment. While your parents may have a private room at an SNF, there will be more oversight and monitoring than they would experience at an assisted living facility. In some cases, you may be able to have your parents placed in an assisted living community that will allow them to transition over to the SNF side when the need arises.