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Aging in Place Considerations

More and more people are wanting to remain in their homes as they grow older. The term “aging in place,” simply put is choosing to remain at home instead of moving to a senior living arrangement. More than three-quarters of adults age 50 and older want to stay in their homes as they age, according to a 2018 survey by AARP.

Aging in place typically means that older adults get to retain a level of autonomy and independence that they may not be able to get with other senior living options. In addition, it can allow them to continue to live in a familiar home, surrounded by treasured or important possessions while also allowing them to remain close to neighbors and shopkeepers, bankers, and grocery stores, whom they may have known for decades.

On the financial end, the cost of care at home is often lower than the cost of care in a senior living community or skilled nursing facility if you are generally medically sound and you are not experiencing chronic medical conditions or major neurocognitive disorders (such as advanced stages of dementia). While it’s typically less expensive to remain in your home than to pay for assisted living, that doesn’t mean it’s always more economical to stay put. You’ll still have a long to-do list. Renovations are one part of what you need to make aging in place work for you. Another consideration is to decide how you will manage maintenance and care for your home, and for yourself, as you age and face health challenges. In addition, building a support network of friends and neighbors is important. Furthermore, establishing strong ties in your community (such as volunteering to enjoying casual conversations at the local coffee shop) can play an important role in keeping older adults healthy and functioning. You won’t age in place well if you’re isolated and alone, a reality you don’t want to overlook as you consider your housing and financial options.

The likelihood of aging in place being successful is much greater if everyone involved does some conscious planning. While the needs of homeowners and their houses vary, some of the common features to accommodate aging in place include:

  • At least one no-step entrance to the house.

  • One-level living with a primary bedroom and bathroom on the same floor as the kitchen and laundry.

  • Accessible bathroom with a curbless shower with a seat and grab bars.

  • Wider halls and doorways for wheelchair accessibility.

  • An elevator or chair lift if a first-floor primary bedroom is not an option.

  • Lever handles and rocker switches for easier opening of doors and operating lights.

  • Non-slip floors and mats.

  • Enhanced illumination, including night lights, task lights and lighting along stairs and hallways.

  • Consistent flooring and extra lighting in areas that transition from one room to the next to avoid a tripping hazard.

On the flip side, you must also determine when aging in place will not make sense. In many cases, older adults can begin to fall in an awkward in-between stage in which they want to be independent, but physical, emotional or cognitive issues interfere with their ability to function. This can be further exacerbated when the wishes of the older adult do not mesh with the concerns of family members or recommendations given by their medical team. The following factors can decrease the chance of success:

  • You are a long-distance caregiver.

  • There are few friends and/or neighbors that you can draw upon for caregiving support when you are not around or available.

  • You are not comfortable building and coordinating a network of formal and informal caregivers.

  • You are in poor health yourself or do not have the emotional support to look after an older adult going through multiple medical issues.

  • You must continue to work full-time. (In some cases, managing home care is only possible if you, your spouse, or another caregiver leaves a job or works reduced hours.)

  • Your loved one’s home requires extensive adaptations for it to be accessible and safe and your family does not have the financial means to cover these adaptations or renovations.

  • Your family does not have the financial means to cover in-home services (such as overnight caregiver, around-the-clock caregiver, or part-time caregiver).

  • Your loved one is not comfortable having paid “stranger” caregivers in the home or if your loved one is exhibiting paranoia which can be exacerbated by having “strangers” in the home.

  • Your loved one is experiencing sundowning and is at a safety risk for wandering.

  • Your loved one feels lonely, isolated, or depressed.

  • Your loved one no longer drive and there are few alternate transportation options.

Over the next few years, as the population ages, the demand for new models and technologies to help people live in safety, comfort and dignity in their later years will continue to rise. Until then with proper planning, aging in place does offer many benefits but it also must be done so in a manner that allows the person to be safe and have a good quality of life. Lastly, neuropsychological testing is one way to identify the cognitive strengths and weaknesses of the individual which can help with making the determination about if they are cognitive capable of living alone independently or if they are experiencing major cognitive impairments that will negatively impact their ability to be at home alone. Dr. Burchette does include this kind of testing as part of his neuropsychological evaluations for older adults, particularly if there is a concern about dementia.

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