What is "Aging in Place"

We are using the term "aging in place" in reference to living where you have lived for many years, or to living in a non-healthcare environment, and using products, services and conveniences to allow or enable you to not have to move as circumstances change. More recently "Aging in place" is a term used in marketing by those in the rapidly evolving senior housing industry. CCRCs, (Continuing Care Retirement Communities), by definition offer the chance to age in place, but first you must move to their community to "start aging". Multi-level campuses market "Independent Living, Assisted Living and perhaps Alzheimer's care and Skilled Nursing in one location, and claim to offer the opportunity to "age in place", but again you must move there first. In many cases you must also move from one wing of the campus to another to receive the increased services.

Here we address issues and needs related to "aging in place", without first relocating.

What is a NORC?

NORCs In a community or neighborhood where residents remain for years, and age as neighbors, a NORC or Naturally Occurring Retirement Community develops. A NORC may refer to a specific apartment building, or a street of old single family homes. Residents would just have stayed in their home or apartment for many years, and evolved into a senior community.

It is possible to band together and develop, or seek help to develop, access to services to aid those needing assistance, to retain the highest quality of life as they age.

Some 27% of seniors live in a NORC.

Fair housing laws provide for a complex with 80% of its residents over 55, to become officially age restricted.

For many years the law required an age restricted community to offer significant amenities and services if it was age restricted. That is no longer the case, but to compete, and attract residents, we still see most age restricted communities offering amenities and services to serve their residents. Significant amenities and services may include:

• Social and recreational programs
• Continuing education programs
• Information and counseling
• Outside maintenance and referral services
• Emergency and preventive health care programs
• Meal Programs
• Transportation on a schedule

To "age in place" successfully requires planning. To accommodate physical, mental, and psychological changes that may accompany aging, physical changes should be made in your home.

Changes Related to Aging

Physical changes:

• Decreased mobility and dexterity
• Decreased strength and stamina
• Reduced sensory acuity: vision, hearing, thermal sensitivity, touch, smell

Social changes:

• Isolation from family and friends
• Due to loss of peers
• From children living far away
• Changing neighborhood

Read about good changes related to aging

Remodeling Your Home

There are a number of items to consider when remodeling your home. You may wish to consult a professional early in your evaluation process. No one is going to make all of the modifications, but be wise regarding those you focus on. i.e. if you already know your eyesight is failing, focus on modifications that benefit poor, or poorer eyesight the most. If you have arthritis that impairs mobility, focus on modifications that cater to your mobility limitations.

General

• Adapt lower floor of home for possible one level living
• Increased incandescent general and specific task lighting
• Easy garage or parking access
• At least one entry is without steps
• Doorways 36" wide with off-set hinges on doors
• Levered door handles instead of knobs
• Electrical outlets at 18 inches instead of 12
• Easy to open or lock patio doors and screens
• Light switches at 42" instead of 48
• Adjustable controls on light switches
• Luminous switches in bedrooms, baths and hallways
• Strobe light or vibrator-assisted smoke and burglar alarms
• Lower window sills especially for windows on the street
• Programmable thermostats for heating and cooling
• Contrast colors between floor and walls
• Color borders around floor and counter-top edges
• Non skid flooring
• Matte finish paint, flooring and counter-tops
• Non-glare glass on art work
• Peep hole at a low height
• Incorporation of emergency response system installed or wearable

• Lever faucets and faucet mixers with anti-scald valves
• Temperature controlled shower and tub fixtures
• Stall shower with a low threshold and shower seat
• Grab bars at back and sides of shower, tub and toilet or wall reinforcement for later installation
• Bathrooms with turn around and transfer space for walker or wheelchair (36" by 36")
• Higher bathroom counters
• Telephone jack
• Installation of medical response device

Kitchen

• Kitchen cabinets with pull-out shelves and lazy susans
• Easy to grasp cabinet knobs or pulls
• Task lighting under counters
• Cooktop with front controls
• Side by side refrigerator
• Adjustable upper shelves and pull out lower shelves
• Variety in kitchen counter height - some as low as table height (30 inches)
• Gas sensor near gas cooking, water heater and gas furnace
• Color or pattern borders at counter edges

Living Room

• Seating at least 18 inches off the floor
• Chairs with sturdy arms

To "age in place" one should be aware of community help and services available to deal with increasing frailty or age related problems. They may also be needed in the event of illness.

Services can provide:

• Outdoor home maintenance and gardening
• Indoor home maintenance
• Heavy and/or light cleaning and housework
• Driving
  • Trips to the grocery store
  • Other shopping trips
  • Home delivery of groceries
  • Transportation to doctors appointments
• Homecare
  • Meal preparation
  • Bathing and dressing
  • Personal care assistance
  • Home nursing
• Emergency call/response systems
  • In your home
  • To wear on your person

Non-medical in home support services provide an opportunity for frail or ailing people to stay in their home and perhaps maintain a more independent lifestyle than a group home might offer.

Agencies can provide experienced caregivers who can assist these seniors in a number of ways. Reputable agencies are bonded and insured and their employees are covered by workers compensation and are regularly supervised. Caregivers may work for a client a few hours per day or 24 hours seven days a week. They prepare meals, do housekeeping, medication reminders, run errands, manage incontinence, give baths and help clients transfer. They also provide valuable companionship and encourage clients to exercise and participate in activities. They are a help when a caregiver lives at a distance, or with the frail senior, and just cannot be do all the services necessary.

Non-medical homemaker services are often confused with licensed home healthcare agencies. Some of these agencies also offer non-medical care, but generally they offer nursing types of services on an intermittent short-term basis. The client usually has a medical need that requires the expertise of a RN, physical therapist or some other medical specialty. In home supportive companies often work hand in hand with home healthcare companies to help their clients.

In home support services range range from $13 to $20 dollars per hour and $140 to $200 dollars for 24-hour care. Long term care insurance policies can be helpful in meeting some of this cost . People who cannot afford this cost may hire people privately for less money. However, they are taking a risk and will have to manage these caregivers with no professional assistance. However, reality sometimes dictates that this is the only viable choice.

Whether you hire an agency to send you a helper or hire one directly - read on:

• Interview the candidate and/or the agency.
  • Inquire if there is a charge for the interview.
  • Get 3 work references for the candidate.
  • Get client references for the agency.
  • Is the care provider or agency bonded.
  • Obtain the Department of Motor Vehicle print out from their driver's license.
  • Do a Felony Background Check or know that the agency has conducted one. An Investigating Service will do this for a small fee.
  • Ask for proof of provider (or agency) worker's compensation insurance.
  • Ask for proof of care provider (or agency) full professional liability insurance.
  • If the care provider is unable to work one day, will the care provider (or agency) provide a substitute care provider?
  • Among other questions, ask:
    • How many years have you been in home care?
    • What were your duties for your last 2 patients?
    • What is your favorite duty while taking care of a patient?
    • What is your least favorite duty?
    • On a scale of 1-10, 10 being best, how do you rate your:
      • Cooking skills?
      • Housekeeping skills?
      • Personal care?
      • Ability to following directions?
      • Flexibility?
      • Ability to work with other family members visiting or living in the home?

Meals on Wheels Association of America is one organization providing nutritional meals to shut-ins or ailing seniors with low incomes.
America's Second Harvest can locate a nearby food bank for low income seniors.
Nutrition Screening Initiative can help family members evaluate if a loved one is malnourished.
Remodeling Directory - Your one-stop destination for anything you can think about remodeling. This Remodeling Directory is designed to help its users find the remodeling information, articles, source, companies, products and services.
Care Pathways is a resource for extensive care related information. It is written from the perspective of professional RNs.