Aging in Place and Aging in Community

If you desire to live at home as you age, or if you’re trying to help your mom or dad live independently, chances are you’re running into a few challenges. What should you do and where should you start to make this happen? Everyone’s circumstance is different, but there are common situations that most people face. Here are some strategies for dealing with them and some exciting housing options to consider.

ADLs and Prioritizing Safety

“Safety is the most important,” says geriatric psychologist Linda Ercoli, PhD, UCLA Semel Institute of Neuroscience and Human Behavior. “Also consider if the individual has the mental and physical capabilities of living a safe life and a quality life.”

Activities of daily living, or ADLs, is a term healthcare providers use to describe fundamental self-care tasks. ADLs vary for each person, but some of the vital tasks are bathing, dressing, eating, functional mobility, and managing money.

Taking care of finances means paying bills on time and not falling prey to scams. If a person needs help paying bills in a timely manner, setting up auto pay for utilities and mortgages can help keep finances managed.

Unfortunately, seniors are top targets for scammers because many are believed to have lots of available cash and can be easily manipulated. Among the top 10 scams identified by the National Council on Aging are reverse mortgages and fraudulent anti-aging schemes. To become more familiar with them, go to the website noca.org and enter the term “scams” in the upper left search box.

Eating healthfully is important at every age. Some elderly people simply don’t eat enough and subsist on a few simple foods, which can lead to malnutrition. If a person can’t drive or shop, there are meal delivery services, such as Meals on Wheels. Area grocery stores may deliver orders, and there are online grocery delivery services as well. Still, just because the fridge is full, that does not guarantee a person is eating well.

“Loved ones need some kind of assessment,” says Dr. Ercoli. “This can be informal. Just check things out, Is the food in the fridge spoiled? Is the house in disarray? Make it a casual observation, you don’t have to be militant.”

Safety includes the ability to take care of one’s home and self. That includes the ability to do laundry (or having it done), and the awareness to wear clean clothes. The home should be kept in good working order, the furnace and air conditioner functional, and the home’s interior and exterior maintained.

Because falls can be more common as a person gets older, it’s wise to also assess the home for fall risk. Get rid of anything that is a tripping hazard, such as throw rugs and clutter in the pathways. Make use of night lights and ensure there is good lighting throughout the home. Any rails, such as on stairs, should be secure and not wobbly. Walk-in showers are safer than having to step into a tub. Either way, install grab bars in the shower/tub. Handheld showerheads and seats in the shower are also helpful.

Managing the Car Keys

No longer being able to drive is, for many people, a major loss of independence. And it’s a difficult situation, especially if a person has some dementia. This again, is a very good reason to plan. Dr. Ercoli suggests that having a loved one sign a piece of paper may make the process easier when the time comes. Seeing their own signature can help convince them that they agreed to trust you with the decision.

How do you know if it’s time to stop driving? If you wouldn’t be in the car or allow your children to be in the car while a loved one is driving, that’s a huge clue. Look at your loved one’s car to see if there are any dents or scratches, and take seriously any police citations.

Planning for the Unexpected

Some forgetfulness is a normal part of aging, but people can become fearful that it’s a sign of Alzheimer’s. Losing things from time to time, forgetting a name occasionally or missing a monthly bill are all normal aging, according to the National Institute on Aging. It’s also important to note that forgetfulness can be related to medications, emotional issues, or medical conditions. Of course, it’s also possible that some mild cognitive decline or dementia is occurring. That is why planning for the future is crucial for everyone as they age.

“You don’t want to be in a situation where your loved one has loss of insight and yet nobody can step in and help them because they haven’t made any arrangements for this, and they are not in a place mentally now where they are willing to agree,” advises Dr. Ercoli. “If they have awareness it is much easier to manage situations, such as whether to keep living at home, having home care, or putting into place financial support, such as automatic debit to pay bills.”

A healthcare power of attorney, also called a healthcare proxy in some states, is a legal document that enables loved ones to step in and help make health care decisions when a person is no longer able. For example, if someone has a stroke and can’t speak for themselves, a loved one can legally help guide care. Without such documentation, it can be chaotic and go against a person’s wishes. Two siblings may be at odds for what kind of care their parent should receive, for example. Also, physicians are charged with keeping a person alive, whatever it takes, if no directives are in place. Feeding tubes, ventilators, and tracheal intubation (breathing tube placed in the throat) are common life-saving and sustaining procedures that a person may or may not want, especially if the brain has been adversely affected. A health care directive defines circumstances for your care when you can’t speak and allows others to follow your instructions.

Expanding Housing Options

Aging in place can also be achieved within senior communities. Many are set up to provide levels of care within a home or an apartment. For example, you may choose a maintenance-free home that includes all the safety features, and includes options like assisted living and memory care services delivered to the residence. That negates the need to move again, which can become more challenging as a person gets older. Many of these communities often focus on active living, with tennis courts, golf courses, gyms, arts and crafts, restaurants, mini markets, and transportation to area shops and sites.

Cohousing refers to communities where people have their own residences but share communal spaces, such as gardens, common rooms, and other spaces for gatherings. Some of these developments are retrofitted in existing communities to make homes more senior-friendly. Others are new developments, which may be age-restricted or multigenerational. The goal in either case is the same: creating senior-friendly intentional communities where there are common facilities and shared spaces. Learn more about this concept and existing communities at cohousing.org.

House sharing is another idea to consider. Older adults desiring to stay in their home may take on a tenant or invite a family member to live with them in lieu of moving. The exchange for housing can be monetary or include a combination of caregiving, transportation, and/or home maintenance. Of course, it’s wise to have the parameters of the arrangement spelled out in a lease so that all parties are in clear agreement.

The options for how to live in your senior years continue to expand. Best friends are moving in together, and niche communities for special interests and lifestyles such as arts, LGBTQ, and Buddhism are increasingly springing up. It’s no longer a choice between staying at home or going to a nursing home. Rather, it can be an exciting journey into a new way to live.

Thinking about and planning for how you’d like to live in your later years is best begun sooner rather than later. And if you’re helping a loved one, knowing these options exist can help ease the transition to a residence better suited to a person’s physical and mental health, as well as their lifestyles and interests.

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