Episode 023: Day 14 – What Is Aging In Place For Mom & Dad?

Episode Description:

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult.  In Day 14, Zack talks about what it means when the term “aging in place” is used and how this may apply to you and your parents or an aging adult you know.

Show Notes:

Day 14:  What Is Aging In Place For Mom & Dad?

Did you know, according to AARP, that 90 percent of adults over the age of 65 want to age in place, or live in their home as long as they can.  In fact, 80% believe their current residence is where they will always live.  For some it can happen but for some others, they will be faced with challenges to remain home.   While many think it is the aging person that is the issue, reality is that it could be the home that has the challenges.   We’ll discuss this topic on Day 14 of the 30 Day Preparation Plan To Care For An Aging Parent.

Welcome to the Raising ‘Rents Podcast.  This show is sponsored by ComForCare, a national home care provider that will help you live your best life possible.  Day 14 of the 30 Day Preparation Plan is the next step in preparing a plan to become a caregiver. Keep in mind as we go throughout this process that our primary goal for family caregiving, regardless of circumstances, is to provide a loved one with a comfortable, caring environment in which to grow old.

The U.S. Centers for Disease Control and Prevention defines Aging In Place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.”  Mark Nager of Ageinplace.com adds that Aging in Place will mean that one has to be able to get all the assistance or services they need to maintain their safety and quality of life.

Why is this going to be so important in our near future?  Today 14% of the population is over the age of 65.  By 2050, it will be around 20%.  That’s millions of people that will need to age in place and to do that they will have a plan in place if they want to age in their own home.  It’s not as easy as it sounds.   With fewer caregivers per each person age 65+ a climbing trend, cost of resources rising, and government funding barely keeping up with its spending, it can be a problem…a real problem.  And with studies that have shown when someone has to move from their home to a care facility, there is a risk that there will be damaging effects on the emotional, mental and physical well-being of the individuals.  There are so many benefits to staying home.  A person is surrounded by their favorite possessions, memories, comfortable furniture, privacy, personal touch.  They may have their own garden and yard space.  It feels like home and that would be hard to replicate anywhere else.  What about the neighborhood, the surrounding shops and restaurants, park, favorite places to go to.  Neighbors, friends, their community.  Again, this is a familiar space to them that will hard to replicate elsewhere.  They have their routines, what they like to eat, and their favorite activities.  Leaving home makes them feel like they will lose much of this along with their independence.  It has been shown that aging adults not institutionalized exhibit less depression than young adults.

So let’s look at this from both sides of the equation—the person wanting to stay home and the home itself.  From the adult who wants to age at home, they will experience changes as they age.  Seniorresource.com lists (http://www.seniorresource.com/ageinpl.htm) many of these changes and keep in mind these are normal:  Hearing impairment,  Failing vision, Osteoporosis, Increased likelihood of arthritis, diabetes, heart disease, and hypertension, Mental process changes including long term memory decline.  In result, you get decreased mobility and dexterity, decreased strength and stamina and reduced sensory acuity such as vision, hearing, thermal sensitivity, touch, smell.  While these things are found to change, there are things that can remain the same–daily social and occupational functioning ability remains stable. Most language related skills also tend to remain stable with age. Most notably, creativity and wisdom continue at strong levels.  And of course, you will find other changes that may that are not physical or mental.  Social changes such as isolation from family and friends, loss of peer’s children living far away and a changing neighborhood could be disruptive.  The good news is that most seniors learn to adapt to their changing situations and lead happy and productive lives while remaining at home.

So, let’s look at it from the home side.  You can guess that the homes our parents age in may not necessarily be conducive to the physical challenges I mentioned before.  In response, a growing trend throughout the country is that many home builder and housing associations are organizing educational activities to highlight programs and support services, such as healthcare, chore services and transportation, which will enable elders to age comfortably in place.

One key piece of advice they give is that proactive steps to modify their homes should be taken while they are still financially and physically able. Modifications such as making sure you have one bedroom and bathroom on the first floor.  Many of the older homes I go into that we provide care for are very old and do not have bedrooms or even a bathroom on the first floor.  A full bath is important and something to consider.  There are usually stairs in the home, either in the front to get in or to go to a second floor.  Stair lifts are getting easier and more affordable to install, you can even rent them.  Other things to make it easier for people to age at home are lever handles that someone with arthritis can easily open, electrical switches positioned slightly lower, raised electrical outlets, thermostats with larger numbers, entranceways without steps, wider doors and hallways, “D” shaped pulls on kitchen cabinet doors, drawers instead of shelves, extra long hose for the faucet sprayer, and for the most important room, the bathroom, grab bars, a bath chair and a raised toilet seat can provide stability for the older person and prevent falls.   Ideally the bathroom should be enlarged to allow people with walkers and wheelchairs to maneuver.

Refer to the 30 Day Preparation Plan To Take Care Of An Aging Parent, Day 4, Episode 13 for more discussion on when visiting your parents’ home, what to look for and plan for.  http://raisingparentspodcast.com/episode-13-day-4-visiting-mom-and-dads-home-fall-prevention/

There may still be a need to secure other sources to help your parent age at home, especially if they are along.  Home care agencies that provide aides to assist with some of the activities of daily living or ADL’s and instrumental activities of living or IADL’s, may need to be hired.  We will talk about home agencies in a future episode.  For now, let’s make sure you have a good understanding about ADL’s because it has been shown the more capable one is in maintaining their ADL’s and IADL’s, the higher level of independence.

So the ADL’s are dressing, feeding, ambulating, toileting, and performing your own hygiene. And IADL’s are preparing meals, shopping, performing housekeeping, using the telephone, transporting themselves, medication management, and managing their own finances.

  • Knowing one’s capabilities and monitoring their levels of ADL’s and IADL’s will help you plan appropriately so that one can remain at home independently, or consider other options.

The loss of independence in the performance of an ADL may be a sign of a chronic illness such as dementiadepression or heart failure.

If caregiver supports are not adequate and the patient becomes a risk, a change in living situation (assisted living or nursing home) may be needed.” The loss of continence is a predictor for placement in long-term care facilities.  residential care, assisted living, continuing care retirement communities, and nursing homes.

While there is a lot to do to learn about options and plan for them, the payoffs are worth it in terms of boosting both independence and confidence in older adults.

  • Understand the costs of keeping your parent in his or her home. Most people want to grow older in their own home, surrounded by possessions and memories. How much will such “aging in place” cost, and can you find help?
  • Keep in mind, should a health issue arise, the cost of caring for a person in their home can get expensive very quickly. Friends and neighbors can move and favorite stores and restaurants can close. Independence can devolve into feelings of loneliness. And the fact is, even if you don’t want to take on the task of packing and moving, eventually, someone will have to pack up all that stuff.
  • For a comparison, you can refer to MetLife’s Aging in Place Workbook. https://www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-aging-place-workbook.pdf?SCOPE=Metlife   For a detailed look at in-home and institutional care costs, refer to Genworth’s site:  https://www.genworth.com/about-us/industry-expertise/cost-of-care.html

So that’s Day 14.  Join us for Day 15 as we talk about if you are going to have to pack up all that stuff, how you can help Mom & Dad Move.

Thank you for listening to the Raising ‘Rents podcast.  This was Episode 23.  If you have any questions or feedback, please go to our website www.raisingrents.com and click on the “Contact” tab.  You can also find the show notes and references to anything we talked about.  Until we talk again, remember that our parents raised us, the least we can do is help raise them. Talk to you later.

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