AgeWise Colorado’s Guide to Aging in Place

 

​”According to an AARP study, 90 percent of people age 65 and over would prefer to stay in their own homes as they get older — and not go to a nursing home or assisted living facility.”

Source: https://www.aarp.org/

What is Aging in Place?
Aging in place allows older adults to maintain their independence and live in a home that is familiar. It also lets them stay in communities that they have often been a part of for years. In addition, the cost of staying in one’s home is often (but not always) less costly than living in a senior living community or skilled nursing facility.

Aging in place, as defined by the CDC, is the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.
Website: https://www.cdc.gov/healthyplaces/terminology.htm

Aging in place allows older adults to maintain their independence and live in a home that is familiar. It also lets them stay in communities that they have often been a part of for years. In addition, the cost of staying in one’s home is often (but not always) less costly than living in a senior living community or skilled nursing facility.

Deciding on what works for you, or a loved one’s living situation can be challenging and there is no one size fits all solution. Therefore, you’ll need to balance out considerations like personal preference, physical and mental capabilities, community resources, the condition of the home and more – in order to decide what is the best environment for that individual.

There are several issues to think about in when determining the best place for an older adult to live, but essentially, they all boil down to three factors, which are:

  1. Person
  2. Place
  3. Social support network

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Content Index

  • When is aging in place the right choice?
  • When Aging in Place Might Not be the Best Choice
  • Steps to take to successfully age in place
  • Steps to take to help in the decision-making process
  • Financial Health Assessment and Alternatives
  • Deciding Whether to Make Home Modifications or Downsize is a Big Decision
  • How Smart Technology Is Making Aging in Place Easier and Safer Than Ever Before
  • The Care and Services to Support Aging in Place
  • How to find a caregiver
  • Cost Comparisons: Home vs Assisted Living
  • Adult Daycare
  • Loneliness & Isolation: The Challenges of Living Alone
  • Food: Groceries & Meals
  • Transportation
  • Helpful Technology:

When is aging in place the right choice?

While most older adults report wanting to stay in their homes as they age, whether it’s the right fit is largely determined by whether the person, the place, and the social support network are aligned to create a livable environment for the older adult. Aging in place is ideal if the older adult is physically and mentally capable of living on their own, lives in an environment conducive to their needs, as well as, has a strong social support network within their community.

Aging in place is a particularly good fit for those who like to take-charge and make their own decisions. The ability to communicate one’s needs is an especially important trait for staying in the home because the older adult – and those within their network – will be providing the services that might otherwise be available to them at a senior living facility.

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When Aging in Place Might Not be the Best Choice

Often times, older adults will find themselves at a stage in their life in which they want to keep their independence, but are not physically, mentally, or emotionally up to the challenges of keeping up a household on their own. While physical challenges alone do not preclude someone from living independently, there are factors that can undermine one’s ability to successful age in place.

In many cases, older adults are in an awkward in-between stage in which they want to be independent, but physical, emotional or cognitive issues interfere with their ability to function. Poor health alone does not preclude aging in place, but the following factors can decrease the chance of success:

 

  • For a host of reasons, the primary caregiver is not able to provide the support needed for the older adult (e.g., they live out of town, work fulltime, are not in good health, etc.)
  • There is not a strong social support network to watch out for and care for the older adult
  • You or your loved one is not able to build a network of informal and/or formal caregivers
  • The older adult or their loved ones do not have the financial means to cover the cost of living at home
  • The home requires extensive home modifications in order to live in the house comfortably and safely that may make staying in the home cost-prohibitive
  • The older adult can no longer drive and does not have easy access to transportation
  • You or your loved one feels isolated and lonely

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Steps to take to successfully age in place

The most important thing you, or your loved one can do is to first determine if aging in place is the right choice. And second, if it is the right choice, consider what needs to be done in order to prepare for a happy and successful experience.

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Steps to take to help in the decision-making process

Once you, or your loved one has decided on the option of aging in place, sit down with family and others to talk through what needs to be addressed in order to age in place successfully. Bringing in the important members of one’s social network early in the process will help ensure a favorable outcome. To help prepare for the meeting, consider referencing resources, including:

  • The local Area Agency on Aging staff can offer insights and resources
  • Review books to guide in the process:
    – How to Age in Place: Planning for a Happy, Independent, and Financially Secure Retirement
    – The Senior Years Master Plan

Assess the strengths and risks of the current situation

  1. Schedule a doctor’s visit to determine overall health and physical capabilities
  2. Habits and Routines: When you look at an average day, what habits contribute to your wellness? What habits hinder your wellness? What does mealtime look like? How about exercise and taking medication?
  3. Home safety: Are stairs posing a challenge? How is the lighting throughout the home? Keep in mind how the home is being used as well as what improvements might make the living experience easier and safer.
  4. Transportation: Can you or your loved one still drive? If not, what are alternatives to getting around town?
  5. Financial health: Getting a clear sense of what the costs associated with staying in one’s home, including estimates on the costs of caregiving and the cost of keeping up the home (e.g.; utilities, lawn care, etc.).
  6. How do you or your loved one envision spending their time? Gardening? Traveling? What makes the current living situation fun, meaningful, and fulfilling?
  7. Plan B: If at any point, you or your loved one decides that aging in place is no longer a viable option, having a conversation well in advance of what a Plan B could look like is an important move to ensure a smooth transition into the new plan.

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Financial Health Assessment and Alternatives

An important part in making the decision to age in place is to honestly evaluate you, or your loved one’s financial health. This involves looking at income and assets much as a company looks at their profit and loss statement. Assuming you, or your loved one has savings and retirement income, long term care insurance or is a veteran that qualifies for Aid & Attendance, then these are the funds that will be used to pay for needs in retirement.

A starting point may be to look at the Social Security Administrations life expectancy calculator. The calculator does not take into account a wide number of factors such as current health, lifestyle, and family history but it does give you a snapshot of how long you might live. From there you need to look at your income and assets and do the math on how much you can spend annually before you might run out of money.
Website: https://www.ssa.gov/oact/population/longevity.html

Also, look at the Genworth website so you understand the cost of care for both in home care and higher levels of care in case your needs change and you need assisted living or skilled nursing.
Website: https://www.genworth.com/

If you find your income or savings lacking, now is the time to learn about support services for low to moderate income older adults and how to handle your assets in case you need to apply for Medicaid. To find out more information visit.
Website: https://www.medicaidplanningassistance.org/

Also, if you are a veteran, you may qualify for VA Aid and Attendance benefits and a Housebound allowance. For details, visit. https://www.va.gov/pension/aid-attendance-housebound/

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Deciding Whether to Make Home Modifications or Downsize is a Big Decision

One of the most important questions to answer when deciding to age in place is – should you, or your loved one stay in your, or their, existing home and make modifications, or move into a new place that already offers these accommodations? Typical challenges that need to be addressed in the home include: too many stairs, slippery floors, dim or no lighting in high traffic areas, doorways that are not wide enough for walkers and wheelchairs, and bathrooms that are too small.

Of the nation’s 115 million housing units, only 10% are ready to accommodate older populations. Source Given this astounding statistic, chances are that you or your loved one’s home will need at least a few modifications. It’s imperative that aging in place plans includes assessing the home’s safety level and addressing key issues as early as possible.

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How Smart Technology Is Making Aging in Place Easier and Safer Than Ever Before

Aging in place has always had its challenges; fortunately, in the past few years, an abundance of new tech gadgets and tools have come on the market that can make it easier to help older adults and their loved ones manage the various aspects of aging in place.

Many of these tech innovations have culminated into making homes “smart”. These smart homes are equipped with a variety of devices that automate tasks normally handled by humans. Some might be built into the structure itself and others are added later with homeowners operating them through applications, voice commands, and automation.

The advantage to having a smart home is that tasks like turning on lights, listening to the news, monitoring the front door, and a whole lot more are done for you or your loved one. Another advantage to smart home technology is that it’s easy to keep in touch with one’s social network.

Loved ones can check to make sure that an older adult is doing okay by checking smart devices to find out when they got out of bed, last opened the refrigerator, and more. Older adults can easily call loved ones to ask for help or to simply say hello.

Another developing advantage to smart technology in the home is that it can collect data on one’s daily habits and note when that behavior has changes. This could flag a possible progression in the disease for someone with dementia, or it could flag another health issue that can be addressed early on with this new form of information.

As the Baby Boomers head into their later years, the need for caregivers is expected to increase sharply. Finding tech solutions that can enhance care is paramount to meeting demand. Smart homes, remote activity monitoring, and other technological advances are making it possible to help out with much-needed tasks at home that used to require a human touch.

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The Care and Services to Support Aging in Place

To ensure that the home is safe for an older adult, the physical environment is not the only issue that needs to be addressed. For example, thinking through how social networks communicate with each other, transportation options, how grocery shopping will be done, as well as, housekeeping are just a few considerations that will need to be built into any aging in place plan.

The good news is that every county in Colorado has a network of resources that help older adults to remain in their homes. Some resources are free community based services available to all older adults regardless of income, some you will need to pay for and other resources are restricted to those who are low-to-moderate income and/or disabled.

In addition to your local Area Agency on Aging (AAA) there are other good resources to help you find the services you or your loved one need such as Benefits Checkup, United Way 2-1-1, and other local non-profit and for-profit organizations.

If an older adult needs a significant amount of care and there is not a network of family and friends to help out, consider hiring a professional caregiver. Here are the different kinds of in-home care options:

 

  • Care Companions: Provide company for an older adult who lives alone. Companions might spend time talking with or playing cards with their older client. They can also take them out to enjoy a meal at a restaurant, bring them to a local museum, or even take them to a doctor’s appointment.
    In-home caregivers: These caregivers are considered “non-skilled”, meaning they cannot provide medical care, but are available to help older adults with activities of daily living, that includes everything from personal care like toileting to bathing to grocery shopping and house cleaning
  • Home Health Care: These skilled caregivers are provided under a physician’s order. The care is short-term and is delivered or supervised by nurses and therapists (physical, occupational, and speech). This type of care is typically provided while someone is recovering from a serious illness, surgery or accident.

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How to find a caregiver

You have a few options to help you find an in-home professional caregiver, including:

  • Word of Mouth: Ask around your social network to find recommendations on good caregivers and good caregiving companies.
  • In-home care companies: Colorado has many professional caregiving companies. There are more of these companies in the metro areas of Colorado, but there are some organizations that serve the more rural areas of Colorado.
  • Resource Directories: There are a variety of resource directories both online and in-print books that provide lists of in-home care companies. Licensed in-home care companies can also be found on the state of Colorado website. AgeWise Colorado can also be a resource in locating these services.

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Cost Comparisons: Home vs Assisted Living

It’s also worth noting, that if an older adult needs professional caregiving it might make sense to do a cost comparison – at home care vs. care in a senior living facility. A good website to look at to understand the costs of higher levels of care is Genworth. Genworth sells long term care insurance and as part of their services they maintain a cost of care database. As an example, for 2019 the average cost of assisted living in Colorado was $4,095 per month, while a nursing home semi-private room was $8,197 a month. Understanding the cost of higher levels of care, often helps a person and their family get better sense of what they can afford and therefore create a realistic plan as to how and where they want to live.
Website: https://www.genworth.com/

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Adult Daycare

For those that need an alternative to fulltime in-home care, Adult Daycare Programs can fill the bill. They can offer supervised support to an older adult including those with dementia or who otherwise need additional care and attention. Many adult day programs offer assisted transportation, at least one hot meal, and opportunities to socialize with others. They also provide for activities ranging from painting to trivia games to fitness and movement activities like stretching and chair exercises. Some centers even provide a limited range of health services.

In Colorado, the cost of full-time adult day care in 2019 according to Genworth runs $1,625 per month. Some centers allow you to pay hourly rates of around $25 an hour as well as create a part-time schedule customized to your needs. Also, a number of adult day programs have a sliding fee scale for lower-income participants.
Website: https://www.genworth.com/

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Loneliness & Isolation: The Challenges of Living Alone

For those aging in place and living alone, staying engaged with family and friends can becoming challenging especially as they get older. It can become more challenging if they can no longer drive, or have a health issue that holds them back from interacting with their social network. Isolation and loneliness are serious issues that need to be addressed as soon as possible. There may be changes in the home and community outreach programs that can be tapped into that can alleviate the source of the problem, but it may also be a sign that it’s time to look at Plan B.

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Food: Groceries & Meals

One of the most crucial aspects of maintaining an independent life is how an older adult is able to obtain and prepare healthy food. A big part of any aging in place plan needs to address how food will be provided if the older adult is no longer able to secure food for themselves. There are a number of options for older adults to get groceries and prepared food delivered right to their home.

  • Ordering Groceries & Meal for Delivery
    GoGoGrandparent now offers grocery and meal delivery services, in addition to transportation and medication pickups. It works by having the older adult call the service and a GoGo team member will take their order and manage the logistics of getting their order delivered to them.
  • Meal Kit Delivery Services:
    Companies, such as, Blue Apron and Dinnerly will deliver meal kits to your home. All the recipient needs to do is add the ingredients together and cook.
    Meals on Wheels Colorado is a nonprofit that offers low-cost delivery that is ready-to-eat or easy-to-heat meals for caregivers and their homebound loved ones. Some also offer other services like nutritional counseling and social and personal care services. Contact the local Area Agency on Aging for referrals for services in your area.
  • A Little Help
    A Little Help is a Colorado nonprofit that connects neighbors to help older adults live independently, with a high quality of life.
    Website: https://www.alittlehelp.org/

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Transportation

What are Good Alternatives to Driving for those who are Aging in Place? Devising a plan for if and when the time comes that an older adult can no longer drive themselves and must instead find alternative forms of transportation is an important part of having a good quality of life while aging in place.
Having a neighbor or friend drive the older adult to a doctor’s appointments, or on other errands from time to time is perfectly fine, but again, having a more reliable, formalized transportation plan in place critical.

Another possible solution would be to find a roommate with a car that could help solve the issue of transportation. There are home-sharing website directories plus a few local non-profits that help locate and vet roommates. Depending on physical capabilities, budget constraints, and geographical location, , here are some additional options:

Ride Sharing Services:

Over the past few years, Uber and Lyft, have both targeted services toward older adults including those without smartphones. Lyft is working on its outreach for older adults and access for people with disabilities, and Uber offers UberAssist vehicles that can accommodate folding wheelchairs, walkers and collapsible scooters. Taxis are another option. For those that don’t use SmartPhone, there is GoGoGrandparent, a service that connects older adults to ride sharing services.
Website: https://gogograndparent.com/

Public Transportation:

If you or your loved one live in an area in Colorado that has a good public transit and are interested in finding out more about various routes, etc. visit the state’s public transit site for more details.

Other options:

  • Area Agency on Aging can connect you to other transportation resources including agencies that operate wheelchair accessible vans for seniors with limited mobility.
  • Via operates on a social enterprise business model and serves the metro region by providing transportation programs including the HOP, Access-a-Ride, and FlexRide (formerly Call-N-Ride) under contract to local municipalities and the Regional Transportation District (RTD)

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Helpful Technology

Personal Emergency Response Systems
For those older adults living alone, a personal emergency response system (PERS) can be a lifeline, ensuring they get help in the event of a fall or other medical emergency. PERS come in the form of lightweight pendants or wristbands that you or your loved one can wear while going about their normal daily routine. With some PERS, one must press a button to contact emergency services, while other systems automatically activate when a fall is detected.
Once an incident is detected, an operator at an emergency response center will respond, determining the seriousness of the situation and deciding whether to call an ambulance or a designated caregiver to check on the older adult. If you buy a PERS for yourself or a loved one, there is an installation fee and a monthly monitoring charge. It’s worth noting, that Medicare, Medicaid, and most insurance companies typically don’t pay for the equipment, though you may be able to get a subsidy if your income is low.

Telemedicine
Keeping as healthy as possible is vital for anyone aging in place. With telemedicine, patients can communicate with healthcare providers from home using two-way video calling equipment. Telemedicine has become particularly popular during the pandemic because it eliminates traveling to clinics or medical offices, making it easier and safer for older adults to take care of their health.
Medication Reminders Help Older Adults Stay on Track

Medication Reminders
Like many older adults, you or your loved may be on several prescription medications – all of which need to be managed to ensure proper dosage.
Using medication reminders can make this process simpler by letting you or your loved one know when it’s time to take medication and keeping track of missed doses. Among the options to choose from are a dedicated set-up, such as a pillbox that vibrates when it’s time to take meds, or one of the many smartphone apps that send out digital reminders. Also, not all medication reminders require using technology. For example, PillPack uses technology to send you meds separated into packets with the time on the front.
Website: https://www.pillpack.com

For more information visit our “AgeWise Action Plan on Technology”
https://agewisecolorado.org/agewise-action-plan-technology

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AgeWise Colorado – along with dozens of other nonprofits, government agencies, and your friends and neighbors – want to help all Coloradan Age in Place when it’s the right choice for the individual and their family. Check back here often to find suggestions, ideas and resources to help you do just that!
If you’ve got a resource to offer, consider becoming a member!

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