Jacqueline Ulissey, LMSW
Introduction
This article includes several ways older adults can age at home while maintaining some level of independence. You will learn what resources and support systems are available, and options to pay for nonmedical home care and/or home healthcare.
What it Means to Age in Place
A person who ages in place is able to continue living safely, comfortably, and independently at home and within his or her community as he or she grows older. Sometimes accommodations are made to make it easier for an older person to age at home. They might downsize from a family style home to a one-bedroom apartment on the first floor. They could move the upstairs master bedroom downstairs. They could remodel your living space to prevent falls. This could include adding grab bars, getting rid of the bathtub, adding a shower bench/chair, and installing brighter lighting both inside and outside the home.
Someone who wants to remain in their home throughout old age should consider their overall health including physical, mental, and cognitive, their ability to complete simple and complex tasks of daily living, surrounding networks of support, and budget after retirement.
Activities of Daily Living
First, let’s review the necessary skills people need to thrive as they age in place. These examples showcase an older person who is self-reliant.
Older adults need to be able to shower/bathe, dress, and use the restroom without falling and hurting themselves.
Older adults need to manage money effectively. It is important they pay bills on time, avoid overspending, and not give away personal finance information to scammers.
Older adults need to manage their medications. This means keeping track of what medications to take and when.
Older adults need access to transportation. This could be driving, walking, biking, or using public transportation.
Older adults need to maintain the household. This includes making sure the house is reasonably clean, appliances are working, and yard is being taken care of.
Older adults need to be safe when cooking. If they can follow sequence of steps when preparing meals and remember to turn off oven or stove top, that means they are still independent enough to cook for themselves.
If any of these things start to become challenging for the older adult, it is a good idea to seek outside support. When cooking becomes an issue, meal or grocery delivery services can help. A family member or friend could come over and cook a meal while the older person helps set the table.
An older adult who cannot drive and lives in a town where driving is essential, will need someone who can drive him or her. Sometimes neighbors, friends, or family can help. Other times it is necessary to hire someone from a home care agency.
If the older person used to clean the house and mow the yard themselves, but now feels overwhelmed, they will need to seek assistance from someone they trust. This can be a friend who helps as a favor, someone they hire from a cleaning business, or a paid homemaker. Who they decide to receive help from will depend on their specific needs and budget.
As an older person's health declines the more medications they are likely to be prescribed. An older adult who is having difficulty managing their medications could benefit from having a reminder system in place and using a pill organizer box. Also, it is a good idea for their doctor and a trusted family member or friend to know if medication management has become a problem.
If an older adult is unable to manage his or her finances and has been the victim of a financial scam, then it is time to get curious about why that is. Sometimes it is effective to learn about financial literacy and when to suspect a scammer might be interacting with you. Many older adults are still capable of learning new skills and acquiring the tools they need to remain safely independent. However, older adults experiencing cognitive impairments or who are uninterested in learning new things will likely need frequent support.
The same is true for an older adult who lacks the necessary physical mobility and/or balance. He or she might need to move in with a family member or have hired staff help prevent falls or be there to call 911 if necessary. If falls become too frequent, then the older adult will likely need round the clock support.
When informal support networks like family, friends, and neighbors are unable to assist with the older adults needs to age in place, then non-medical home care and home health are two helpful resources.
Non-Medical Home Care
Included in this level of care are caregivers and homemakers who aid older adults in the following ways:
Assists with personal hygiene tasks like bathing, dressing, and toileting.
Helps transfer older adult from one location to the other. This could be transferring them from bed to chair or supporting them as they walk to another room.
Provides light housekeeping (dusting, doing laundry, washing dishes, making the bed).
Cooking, meal prep, grocery shopping.
Drives clients to appointments or spending an afternoon out of the house together.
Provides companionship and emotional support.
People working for a non-medical home care agency are not equipped to assist with medication management, wound care, or other medical needs. While uncommon among most non-medical home care agencies, sometimes a social worker can support older clients and their families by helping them access additional resources not provided by hired caregivers and/or offering short-term counseling, education about the aging process, and support groups.
People utilize private pay, long-term care insurance, and sometimes veteran assistance benefits to pay for home care needs. Some Medicare Advantage plans help pay for non-medical home care. It is important to speak with someone licensed and qualified to explain Medicare, so you choose the best plan to meet your needs. The cost to pay for such care varies depending on individual’s needs, location, and rules set by the home care agency. Sometimes clients are required to utilize services a minimum number of hours a week, while others are not. Many agencies charge hourly and, in some cases, have a per visit rate when hours are minimal. It is best to set up a free consultation with a home care agency who provides services in your area.
Home Health Care
People who work for home health care can provide mostly the same services as non-medical home care as well as additional support for medical needs. Exact services will depend on the agency and what medicare reimburses. There are caregivers, nurses, physical therapists, occupational therapists, speech therapists, and medical social workers who provide care to older adults in their homes. It is common for people being discharged from the hospital to be placed under the care of home health. Medicare will pay for these services if a doctor’s order has been placed and it is proven to be medically necessary. Those with mobility challenges are good candidates to qualify for home health care. One caveat is such care needs can only be reimbursed by Medicare when the care is intermittent and/or temporary. Someone needing round the clock home care will need to contact a non-medical home care provider.
Conclusion
There are several options for seniors to safely age in place. There are companies that will help seniors downsize and declutter their space. There are nonprofits that will assist with home modifications. There are many options for stove safeguards or timers that will turn off oven after so many hours. Amazon has plenty of pill boxes to help organize medications. Some seniors have helpful family and friends who live nearby while others have the hired support of home care and/or home health.
Comments