“The laundry is in the basement and the stairs are so hard to climb.” “I’ve lived here for 30 years and this is my home.” “I don’t go out much because my eyesight isn’t what it used to be.” These are some of the common issues heard from older people as they age. The one thing they are all unified on is that they want to stay in their own homes as they age. But are they living their best lives when doing that? The good news is that it is possible, and with the right help, they have the opportunity to thrive and remain as social and engaged as they choose with their families, social networks, and communities. Remaining in your own home as you get older is called “aging in place”, and this article will share some suggestions to help you prepare and find the help you need to continue to live independently.
Planning Ahead for your Senior Life
It is always difficult to plan ahead because we just don’t always know, or want to know, what to expect. We rarely want to see ourselves as a senior or someone who is aging….”my parents were seniors, but I’m not”. A great way to start is to take inventory of your current health. Do you have any chronic illnesses, like diabetes or congestive heart failure, or COPD? If yes, talk with your clinician about how these conditions may make it more difficult to care for yourself in the future. If you have a spouse or family member that could become a caregiver for you, it will help to learn about the support and resources that may be available to them to help you remain in your home. You may also want to take a look at your living arrangement and think about what kind of help you may want in the future. Choosing to move to a more supportive environment, especially if you’re alone, could actually add to your ability to remain safe and independent in your own home.
Possible Options for Support and Care as you Age in Place
The Older Americans Act (OAA) was passed into law, in 1965, by President Lyndon Johnson, with the aim of ensuring that the welfare and dignity of older Americans be maintained through a network of community-based services designed to support and enable them to live independently. The Administration on Aging (AoA) is the main agency of the US Department of Health and Human Services (DHHS) charged with ensuring the Act’s provisions are met. Amongst other things, the AoA can help with funding for a variety of support needs, including transportation and support for carers. You can obtain more information regarding these provided services from your local Area Agency on Aging.
Separately, and usually for a cost, you can get almost any type of help you want delivered and/or provided right in your home.
- Personal Hygiene – bathing/showering, hair washing, dental care, and dressing could all begin to require assistance. A family member or friend could help, but you could also hire a trained aide for a few hours each day from a licensed Home Care company.
- Housekeeping – laundry, linen changes, pick-up, deep cleaning, yard work, shovelling, grocery shopping, home maintenance or modification are all considerations. Some Home Care companies will provide for some of these tasks and management needs, but there are also cleaning and yard services that can be hired and grocery and drug stores that deliver and dry cleaners that will pick-up and deliver your clothes.
- Nutrition and Meals – eating may not seem as enjoyable as it once was if it becomes an overwhelming task to cook or you get tired of eating alone. There is actual evidence to suggest that people who live alone are less likely to cook healthy and nutritious meals for themselves every night, so arranging to cook with friends could help, or going out to eat with them could be a more social and enjoyable experience. If you still enjoy cooking sometimes, you can make larger quantities and store them in your freezer for later use. It’s also possible to engage in meal delivery programs that focus on nutritional content, or even hire a Dietician or Nutritionist to help you come up with new creative ways to enjoy nutritious meals.
- Financial and Legal – paying bills, managing money accounts and retirement plans, mortgage/investment management, establishing healthcare advance directives and financial powers of attorney, and estate planning are all important aspects of life that can get more complicated and a bit confusing as you age and may require you to obtain some help. You can use a trusted relative or friend to assist you, or you can engage a Care Manager or fiduciary to give counsel or help oversee some of the processes.
- Health Management – if there are any ongoing or new medical needs, you may need to make accommodations. For instance, do you sometimes forget to take your medicine? If yes, you may need someone to help set up weekly pillboxes for you or utilize a wearable that can prompt you to take your medication through a scheduled reminder. You may also hire a Skilled Nursing company to manage your prescriptions and organize your pillboxes for you. You may also utilize a Care Manager to help stay on top of appointments and health maintenance needs.
- Mobility – you may worry about falling or already have challenges with walking or getting around. A walker may help, or possibly an electric chair or scooter. These are sometimes covered by Medicare through DME companies. You may also want to utilize a wearable with fall detection included, just in case there is a mishap, and you are alone.
- Home and Access Modification – as Activities of Daily Living (ADL) may begin to pose some risks, you may want to make some changes to your home that minimize those risks. For instance, shower bars, raised toilet seats, first floor bedrooms, non-skid floors, or stair lifts are all ways to help you take care of yourself with the least amount of risk. You may even be entitled to benefits or grants to help you pay for these modifications. Below are a few suggestions as to how you can modify your home to make it safer and more accessible. (The US DHHS also produces a useful guide, Aging at Home: A Guide for Home Improvements – PDF.)
- Fitting handrails on staircases and long hallways is a simple way to reduce the risk of falls.
- Grab-bars in bathrooms and showers can also make life easier and safer – particularly if you don’t have a walk-in shower or wet-room. You can also fit these next to toilets and steps.
- A raised seat can also make using the toilet easier and, if you have difficulty sitting down or standing up, a grab-bar nearby is also a great help.
- A walking frame with a tray enables you to move hot drinks and meals more safely around the home.
- Bathroom and kitchen flooring should have a non-slip surface to reduce the danger from spills or wet feet.
- If you often need to use the bathroom at night, you might want to consider having a commode in your bedroom to avoid any nighttime trips.
Common Concerns and Recommendations
If staying in your home is important to you, you may still need information regarding general safety, socializing, health maintenance, or other Activities of Daily Life (ADLs) not already mentioned.
- Transportation – if you are no longer able or willing to drive, you may need assistance with transportation to anything from appointments, errands, social engagements, or family visits. Volunteer escort services are sometimes available, or in some locations there could be access to free or low-cost public transportation. Taxis or hired car services are also an option. To learn about resources in your community, you can contact Eldercare Locator at 800-677-1116 or https://eldercare.acl.gov. You can also contact the National Aging and Disability Transportation Centre for further information.
- Socialization – staying engaged with friends and family and remaining social as you age is hugely important. Loneliness and social isolation can cause a decline in mental health as well as a reported decrease in life satisfaction. Community Centers and Senior Centers can be great resources for ways in which to get and stay involved, but you can also contact your local Area Agency on Aging to see what is all available near you.
- Crime – unfortunately, seniors have become the focus of scams and fraud in recent years. Never give your Social Security number, bank or credit card numbers, or other sensitive information to someone on the phone (unless you placed the call) or in response to an email. And always check bills for charges you do not recognize.
- Individual Safety – there are many ways to plan ahead and hope that you’re decreasing the risks of aging in place, but how do you get help when you need it while still maintaining an active and as-independent-as-possible life? There are many home and mobile systems that try to integrate modern technology to help you, which range in price and service from the most basic to the most discreet and mobile. Some include advanced systems for fall detection, medication reminders, GPS for directional assistance, and biosensors.
- Physical Exercise – many local community groups or sports facilities offer classes or activities specifically designed for seniors, such as yoga, Pilates, strength training, and Tai Chi. Low impact activities like walking and/or swimming are a great way to stay active with minimal risk, and they are even better if you can socialize with others while doing it, such as bird watching or water aerobics. Even if you have limited mobility or chronic health conditions, you may still be able to participate – although it is probably best to check with your doctor if these are suitable for you.
- Activities – arts and crafts, music, singing, dancing, cooking, knitting, playing card games, doing puzzles, reading, or nurturing other creative hobbies all help to keep you feeling vital and engaged in your own life.
Where to Find Help – Useful Resources and Suggestions to Help You Age in Place
- Personal Network – who do you know? Your family, friends, and neighbors can be a big source of help and they probably know the best way to get you what you need when you need it. Think about trading services with someone; for instance, one can mow your lawn and the other can cook dinner.
- Community and Government Resources – what are the available services in your community? The local Area Agency on Aging will be able to help, but don’t forget about your local churches or private businesses set up to help you in this process.
- Care Managers – professional care managers, typically also a nurse or social worker, can help you find trusted and vetted resources to make your life easier and work to create a long-term care plan specifically for you.
- US Department of Health and Human Services https://www.hhs.gov/aging/index.html
- Administration on Aging (AoA) (https://acl.gov/about-acl/administration-aging)
- Long-Term Care (LTC) (LongTermCare.gov) from the Administration for Community Living.
Cheri McEssy is a Nurse Executive and former owner of BrightStar Care of Chicago. She has extensive healthcare knowledge and experience, both clinically and in the senior care space.