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Most elders would prefer
to live their lives at home By Rita Baum
In The Wizard of Oz, the Good Witch tells Dorothy to click her heels three times and repeat over and over, "There's no place like home." Study after study has shown that most people over 60 believe there really is no place like home, either the home they have occupied for decades, or a smaller home purchased later in life.
Seventy percent of older Americans prefer to "age in place" with assistance from outside help, when needed, rather than move to a senior community or move in with their children. The truth is, most of us prefer to be remembered as the providers of care, not the recipients.
"Home," however, might not be the best or safest place if an elder has outlived family and friends and can no longer drive or use public transportation. The isolation and loneliness that comes with living alone can be unhealthy and depressing, regardless of how dear the home or how sweet its memories. Therefore, it's wise to explore all the alternatives before making the decision to remain in the old family home.
There are many resources available to those who need help with living arrangements in their later years: transportation, shopping assistance, nutrition services, health services, home care and a plethora of others.
A Reverse Annuity Mortgage (call HUD for information toll-free at 1-888-466-3487) and property tax postponement can help low- income elders continue living in their familiar homes. Consult the Senior Information and Referral Handbook--available at the Saratoga Senior Center or the library. It's also available by calling Information and Referral, 345-4532. This organization also provides free telephone counseling and referral to resources.
Additionally, many Internet sites are devoted to aging and geared toward older consumers and their families. Check the Internet "Resources on Aging, an Online Directory" through the Eldercare Locator, for services by ZIP code.
Personalized help is available through a case manager, either at no cost (Los Gatos and Saratoga: 378-1995) or through private case management.
Private case managers conduct an in-home client assessment, then prepare a personalized care plan that includes recommendations for in-home and/or other services. The case manager can also engage and monitor these services if requested. Generally, private case managers have a background and training in nursing or social services. Their fees run from $80 to $100 an hour. The process can take from one to three hours for the initial consultation.
Barring a disabling disease or condition, most older adults do continue to live at home and are not interested in exploring care facilities at any level. They are busy doing most of the same things younger adults are doing. Many are still employed at least part-time. But not all elders can remain in their homes and maintain independence or even the basic activities of daily living, without some help--especially in the eighth and ninth decades. With help, remaining at home is possible for persons at all levels of income and functioning.
For the disabled, home modifications can be made. An assistive design architect/consultant can be engaged to adapt and modify areas of the home while maintaining an attractive, non-institutional look. Free services are available to build and install ramps, handrails, grab bars, special faucet handles, and other assistive devices (locally, call 971-2560). In many instances, Medicare will pay for a hospital bed and wheelchair when ordered by a doctor.
Emergency home response systems can also be installed to ensure quick response to an emergency situation.
In-home care is available through a home care agency or for private hire through a home care registry or recruitment agency. Those on public assistance can get free help (928-3737). In-home care can include personal care, laundry, cleaning, shopping, meal preparation and help with medications (a pharmacy filled medi-set, which insures accurate dosage and timing of medications can be home-delivered). In-home services are available on a shift basis, hourly or live-in, with live-in providing the greatest continuity of care and the most economical for those needing a high level of care. Insist on a written plan of care that specifies desired services, and can be changed as needed.
The process of aging in place in familiar surroundings can be difficult in a house with stairs, narrow hallways or an inconveniently designed kitchen or bathroom. Many middle-aged and younger old people sell their big two-story houses and buy smaller, one-level residences. Sometimes, widowed siblings also sell and "buy down" to a smaller house they can share. The extra income gained from the move downward can be helpful in paying for necessary modifications, services and supports.
If planning a move, it is wise to look to the future and choose a location near transportation, medical and other desired services. The adjustment is better if a move is made prior to any loss of function.
Remaining in one's familiar home may not be the best choice if the older person is living alone. Studies have shown that socialization and a support group can contribute to better health and nutrition, a stronger immune system, greater life satisfaction and an extended life.
To avoid isolation and loneliness, the individual can choose one of several alternatives that can provide the means for privacy as well as community. The various options for community living should at least be explored and considered by the elder who is considering remaining alone in the home.
Thomas Jefferson called home the "anchor of our peace." By becoming informed and planning ahead for our later years, the home can be a true anchor of the things we know and love, a way to preserve the familiar memories that nurture and support us throughout our days.
Los Gatan Rita Baum has a master's degree in gerontology and has worked in the field.
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Saratoga, California Since 1975
