More than 90 percent of people over the age of 65 would want to remain at home as they get older, according to AARP. This popular trend is called "aging in place" or "aging in community". Yet many people fail to consider the many factors that help determine whether they can remain at home.
"I tell our clients that what's most important is to keep an open mind, be flexible about what will maximize independence, safety and well-being," cautions Jody Gastfriend, Vice President of Senior Care Services at Care.com. "That's really a very individual decision with several factors to consider." Try not to have preconceived notions about what may be optimal.
Gastfriend's own mother, Adele, had been living in her aging, two-story family home after her husband had moved to a nursing home seven years before. While Adele loved the house, it became apparent that Gastfriend's childhood home was not safe for her mom and they needed to find another option.
"She was walking down the stairs near her office with only one working light bulb, lost her footing in the dimly lit hall, and fell and broke her femur," Gastfriend recalls. "Between that and the demands of maintaining an old home, it was time to look for alternatives."
Fortunately, the family found a single-family home in a nearby senior community, with ready access to a full range senior care services, and all the comfort and convenience of being in familiar surroundings. The house itself was designed with seniors in mind, with features such as an easy access floor plan, bathrooms with safety features and emergency response systems.
Before committing to aging in place, you need to evaluate a loved one's individual needs with an eye toward the future and take into account a number of things. Here's a simple checklist of items to evaluate to help determine if your home -- or your parent's home -- can handle aging in place:
Examine Personal Considerations
Proximity/relationship to family and friends. Do friends and family live nearby? Are they available to help your loved one? Have candid conversations before they become necessary. Read our article on talking to your senior and Bringing the Senior Back into Senior Care ?
"Isolation is always a concern with the elderly, so you want to be sure they have a support network nearby," Gastfriend recommends. "It's a real plus for my mother to live in a senior community. Now she has a community of people she can connect with."
Gastfriend explains that isolation can lead to many problems -- from depression to malnutrition, as elderly people are more prone to neglect shopping and eating regularly. This tendency to isolate can also be affected by personality.
Help your parent avoid this by encouraging them to form new friendships or rekindle old ones. Check out this article on Seniors and Social Life ?
Temperament. Are your parents self-sufficient and do they enjoy living alone? Are they active and social, willing and able to extend themselves to connect with others, or are they introverted and prone to isolation?
Gastfriend recalls a Care.com client who couldn't tolerate strangers in her own home, even though she really needed hands-on help. She found it less intrusive to move to an assisted living facility, where she had private quarters and access to care but was able to live very independently.
Evaluate the Physical Home
The safety and practical comfort of a home for an aging loved one is a major concern. Home adaption or universal design companies can adapt a home for seniors after conducting a home evaluation. Here's what to look for:
- Stairs/levels. This is one of the more obvious perils for seniors, and falls are the number one cause of preventable hospitalizations. Read this article on Preventing Senior Falls ?
- Lighting. Easily overlooked, adequate lighting is a very important factor.
- Doors and doorways. Thresholds that aren't flush to the floor, glass sliding doors that may be overlooked, and doorways too narrow to navigate in a wheelchair can all be hazards.
- Hallways. Are hallways wide enough for a wheelchair?
- Flooring. Slippery floors or area rugs can be tripping hazards.
- Bathrooms. Shower and tubs that require the senior lift their leg to enter or exit are common dangers in most homes. Glass shower doors, counter and toilet heights and slippery flooring are also concerns.
- Access. A long walk, hills or steps to enter the home can quickly become a problem as a person ages.
- Kitchen. Examine counter heights, drawers and cabinets for accessibility from a wheelchair or walker.
- Clutter and other hazards. Excessive clutter, which can pile up quickly over a lifetime, can be a safety, fire and hygiene hazard. Also look for things like loose wires, an abundance of breakable knick-knacks and closely spaced furniture can all become problems for a senior navigating their home.
- Maintenance. Older homes often require a lot of maintenance and "are not always built with seniors in mind," says Gastfriend. They can either keep an energetic and skilled senior happily busy or become a tremendous burden. Envision things like cleaning out gutters and dusting crown molding. Is it feasible or will you need to hire a housekeeper or other outside help?
Assess the Community
Next to personal considerations and the home itself, the actual community is almost equally as important to the aging in place process. For instance, a sleepy suburb that was fine for working empty nesters might present real challenges for a senior. Here are a few items to take into account:
Access to resources. As much as possible, you want to live in a place where the essentials, for both today and tomorrow, are readily accessible. Does your parent have to drive to everything? Yes, your mom can handle a car now, but is she likely to be a safe driver in five years? In ten? See if these options are available nearby:
- Senior agency
- Senior center
- Health care, hospital, rehabs
- Safety of surroundings. Sadly, some communities may change greatly over a lifetime, and mom and dad's neighborhood may not be safe for vulnerable seniors. Local police and neighbors may be able to offer realistic advice about crime rates.
- Climate/geography. While many of us can't easily relocate to sunny destinations, moving to a milder climate may be worth considering if you need to move from your home anyway. If friends or family live in warmers areas, consider a visit to explore options.
For many seniors, aging in place, or in community, is a realistic option, as long as you plan thoughtfully well ahead of time. Part of the process of identifying options for care -- whether it's home care, assisted living, senior housing, etc. -- is also to understand the cost and how to pay for it. Medicare and other payers typically do not pay for long term care, so you need to explore other options. Learn more about Senior Care Costs and Rates ?
"From my experience, what's important is keeping the individual in mind, planning ahead, considering costs and being flexible as needs change," concludes Gastfriend. "Be open-minded about options."
Longtime caregiver to her elderly mom, Isabella Yosuico has two young boys of her own, including one with Down syndrome. Formerly in communications management with a Fortune 1000 company, Isabella is now a freelance writer, specializing in health and wellness, and is completing her master's degree in PR. She resides in an arts colony in Berkeley Springs, West Virginia.