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Guide to Aging in Place

by AgeWise Colorado

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

AARP

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.

As defined by the CDC, aging in place is the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.

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, the condition of the home, and more in order to decide what is the best environment for that individual.

While there are a number of issues to think about when determining the best place for an older adult to live, they essentially boil down to three factors, which are:

  1. Person
  2. Place
  3. Social support

Venn diagram of Aging in Place with Person, Place, and Support in outer circles and Stability at intersection of the three.

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.

Deciding to stay in the home 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.

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 stay in one’s home.

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 7 factors can decrease the chance of success:

  1. 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.)
  2. There is not a strong social support network to watch out for and care for the older adult
  3. You or your loved one is not able to build a network of informal and/or formal caregivers
  4. The older adult or their loved ones do not have the financial means to cover the cost of living at home
  5. 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
  6. The older adult can no longer drive and does not have easy access to transportation
  7. You or your loved one feels isolated and lonely

Steps to Take to Successfully Age in Place

If you or your loved one decides staying in the home is the right choice, consider what needs to be done in order to prepare for a happy and successful experience.

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:

7 Steps to take to help decide whether to age in place

  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 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 decide 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.

Finance and Legal

Photo of older woman consulting woman on legal matters.

Maintaining financial security throughout retirement is an important part of enjoying one’s later years. Another key component is having legal matters in order to benefit both the older adult and their loved ones.

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.

Also, look at Genworth’s Cost of Care Survey so you understand caregiving costs for both in-home care and higher levels of care in case your needs change and you need assisted living or skilled nursing.

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.  Also, if you are a veteran, you may qualify for VA Aid and Attendance or Housebound benefits.

Legal Matter: Getting the Jump on Estate Planning

Older adults often face critical and complex issues such as income security, housing, utilities, protective services, abuse, neglect, and age discrimination, which is why advanced planning is so important.

Early legal planning for seniors can make a big difference. Some of the benefits of early planning include giving all interested parties the chance to express their wishes about future care, eliminating the guesswork for families, and allowing the designation of decision-makers.

Planning should include:

  • Preparing for long term care and health care needs.
  • Making arrangements for finances and property.
  • Naming another person to make decisions on behalf of the person with dementia.

Healthy Aging

Photo of woman doing exercises on mat.

The goal of aging in place is to continue to thrive as you grow older in your home, which is why factoring in healthy aging plans is important. This plan includes exercising regularly, eating the right foods, and staying engaged with your social network.

Benefits and Importance of Staying Active as You Age in Place

The benefits and importance of exercising and regularly moving your body regardless of age are numerous. However, it becomes even more important as you grow older.  Some of the benefits of staying active include reducing the risk of developing chronic diseases such as diabetes, osteoporosis, and heart disease.

If you have one of these chronic conditions or others such as arthritis or high cholesterol, exercise may help you manage these conditions so that they don’t advance or interfere with your quality of life. According to the National Council on Aging, about 80% of older adults have at least one chronic disease, and 68% have at least two.

Additionally, exercise can help boost your mood, maintain a healthy weight, help you sleep better, as well as provide an opportunity to socialize and stay connected to others.

Ensuring Seniors have Easy Access to 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. There are a variety of options from grocery and meal delivery services with some that are free services while others come at a cost.

Loneliness & Isolation: The Challenges of Living Alone

For those aging in place and living alone, staying engaged with family and friends can become challenging especially in your later years.  It can become even 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.

Home Life

Photo of elderly man climbing stairs using handrail.

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?

“Of the nation’s 115 million housing units, only 10% are ready to accommodate older populations.  – U.S. Census Bureau

Typical challenges that need to be addressed around home life 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.

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.

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 – among many other things –  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 another health issue that can be addressed early on with this new form of information.

As 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.

A Growing Trend: Seniors Taking in Roommates

While you may have thought that roommates were just for college kids or young adults, a growing number of older adults across the U.S. are looking for someone to live with as they age.  According to a recent American Community Survey, over 40 percent of seniors age 55 to 75 years, and 38 percent of seniors age 75 and older live in 3-bedroom houses, which implies there is plenty of room for one more.

When you think about it, roommates for seniors make a lot of sense. Roommates can share expenses, keep an eye out for each other, reduce the risk of loneliness and isolation, and help each other with house maintenance.

AARP agrees citing the current recession, rising health care and housing costs, and longer lives are all great reasons that house sharing among the 50 plus crowd is getting more popular.

In-Home Care

Photo of older woman helping elderly woman with dressing.

Types of Care & Services for Seniors 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 or disabled.

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 companionship 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 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.

Adult Daycare

For those that need an alternative to full-time in-home care, Adult Daycare Programs can be a great solution. Programs can give 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.

Mobility and Transportation

Photo of elderly couple on bus.

Having access to transportation is critical to staying connected to family and friends and to pursuing day-to-day activities, both those that are essential and those that enhance one’s quality of life. That is why it is so important to find the right solution to solving transportation challenges before they arise.

If you or your loved one comes to the decision that it’s time to stop driving, keep in mind the end of driving doesn’t mean the end of mobility independence. Many resources and affordable transportation options are available so older adults can age in place while maintaining independence, health, and connection to the community.

When you begin your search for transportation options, consider eligibility, accessibility, reliability, and affordability to make a confident decision about which options are best for you and your loved one.

12 warning signs for when to stop driving

Use this National Aging and Disability Transportation Center’s checklist to see if the older driver exhibits any of these warning signs before making a decision about putting the keys away.

YesNoAsk Yourself
__________Other drivers honk at me.
__________Busy intersections bother me.
__________I avoid left-hand turns.
__________Other cars seem to appear out of nowhere and drive too fast.
__________I have been stopped by the police recently for my driving.
__________Turning the steering wheel is difficult for me.
__________I’ve had more “near misses” lately.
__________I have trouble seeing street signs in time to respond to them.
__________I have recently caused a car accident or fender bender.
__________I get confused or lost in familiar places.
__________It’s hard for me to look over my shoulder when I am backing up or changing lanes.
__________My friends and family tell me they are worried about my driving, or that they are afraid to ride in the car when I am driving.

Technology

Photo of elderly black woman on tablet device.

Smart Technology is Helping Seniors Live Independently

As the aging population continues to grow in the coming years, there will be a sharp increase in demand for technologies to help people live safely and comfortably in their own homes as they age. This demand for new, smart technology will be met with a variety of apps, services, gadgets, and more that will likely change the way older adults age in place for the better.

PERs or Personal Emergency Response Systems Have Come a Long Way

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 another 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.

How Telemedicine or Telehealth is Helping Seniors Stay in Their Homes

Telehealth, also called telemedicine, is an umbrella term that refers to a wide range of health services delivered virtually. As it becomes more widespread, telehealth offers numerous benefits to seniors living at home, including lower costs, increased accessibility, and the convenience of not having to drive to an office or clinic.

In addition, Mobile Health, or mHealth, is a growing field that allows you to text or email questions or even a photo to your provider for quick answers without having to drive to the office. Some, but not all, telemedicine services are covered by Medicare.

Medication Reminders Help Older Adults Stay on Track with Meds

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.

Conclusion

Let AgeWise Colorado Connect You to the Right Information and Providers 

AgeWise Colorado wants to help older Coloradans age in place when it’s the right choice for them and their loved ones. Check back here often for the latest information related to aging in place, as well as to be connected to the resources you or your loved ones needs to safely and happily stay in their homes.

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