Aging in Place: Pat Kelleher on Trends in Senior Care

We all prefer the idea of living at home as we age, and dread the thought of having to move to an institution if we become unable to care for ourselves. Fortunately, as baby boomers age and technology advances, more and more of us will be able to age in place, at home, rather than going to an assisted living facility, nursing home or similar residence.

Increased Use of Private Home care Services

According to Pat Kelleher, executive director of Home Care Alliance of Massachusetts, Inc. -- the Bay State's home care provider association -- private home care is the fastest area of growth within the senior care market. These private home care services, Kelleher says, are purchased either by the seniors themselves or by their adult children.

Remote Monitoring

Technological advances, says Kelleher, mean that many services that once needed to be provided by a doctor or nurse in a medical office can now be provided from home. For example, scales can now transmit a person's weight directly to the doctor when an elder whose weight needs to be monitored steps on the scale. Special monitors can be attached to refrigerators to show when a person has opened and closed it, allowing family members to track when elder is eating. Weight-driven monitors measure the weight of medication holders to detect whether or not an elder has taken her pills and, when necessary, send a beep to alert the senior to do so. Blood pressure measuring devices can be adapted to send the reading directly to a doctor.

These, and other technologies, make it easier for seniors who need daily monitoring to stay at home yet be overseen by their physician or someone trained to recognize a dangerous change in health status or behavior. And more seniors are using a combination of technology and other services to remain in their homes.

Preventing Falls: Senior Safety Issues

One relatively new service for elders provides an assessment of whether or not their home is fall proof. If the home is not safe, recommendations are given to help people decide what adaptations are needed to create a safer environment.

Since falls are a major danger, safety features and checks that prevent falls can make an enormous difference in how long seniors can successfully remain in their own homes. Home-care service providers now receive training to do these fall-proof assessments, which include evaluations of whether carpets are too thick, not securely anchored and can therefore bunch and cause a fall, whether there are grab bars in appropriate spots, such as in bathrooms, and other safety features.

Transportation

As elders age in place, one major issue for many is that they can no longer drive safely. Meals on wheels, available in many communities, can avoid the need for a frail senior to go shopping on her/his own, and the attendant problems of getting transportation to and from the store, remembering to bring a credit card or cash, and carrying and unpacking the groceries. Of course, another solution is for seniors to hire home care workers to shop for them or to drive them to a grocery store and then bring the food into the home and put it away, or to have family members or neighbors help. Some seniors live in neighborhoods that provide transportation to and from the grocery store for people in their age group.

Reimbursement Parity between Private Home Care and Institutional Care

More and more states are passing laws that enable elders to receive the same financial reimbursement if they stay in their home or go to a facility. Medicare, which is half paid by the state and half by the federal government, says Kelleher, is coming to this point of view though reimbursement parity is currently determined on the state level.

State Payment to Family Members Who Provide Elder Care Services

A new trend in senior care shows that many states are now paying family members other than spouses, who provide the care necessary to keep a senior at home. Although the pay often amounts to less than the caregiver would make at work, every little bit can make a difference, and it does help motivate family members to provide as much care as they can. This funding and the criteria for receiving this funding vary from state to state, area by area.

Individual Service Packages

In order to successfully remain in their homes, says Kelleher, elders and home-care service companies can develop individually tailored service packages that provide the different support systems needed to enable that person to age in place -- whether with remote monitoring, fall-proof assessments, help with shopping, meals on wheels, or a variety of other services.

Each elder has a different situation, and home-care services increasingly focus on finding the right balance of services for the individual senior, Kelleher says. Helping seniors stay in their own homes for as long as possible, she adds, is the wave of the future for senior care.

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Ronnie Friedland is an editor at Care.com. She has co-edited three books on parenting and interfaith family life.