The great majority of our elderly loved ones will tell us they wish to stay in their homes. Actually, surveys show more than 90% of seniors desire aging in place. However, the brutal truth of aging may mean that can’t happen without facing up to some things.
Nearly 70% of Americans over age 65 will need assistance to care for themselves at some point. Additionally, the home environment may present many dangers. Falls are the leading cause of fatal injuries in older adults at home. Non-fatal falls often result in fractured hips, broken bones and injuries or health changes that force seniors to leave their homes. Even for those without major injuries, they may become fearful or depressed and therefore isolated and unhealthy.
However, facing these brutal truths can be just the ticket to aging in place. We’ll share some stories from a client who, together with her family and the care manager they hired, faced the brutal truths to make her hopes of aging in place a reality.
Your Beloved Home Could Kill You (Or Wear You Out)
Mary’s daughter contacted EasyLiving because she had recently had some falls. Fortunately, nothing horrible had happened yet. But, her daughter could see that she was in danger. It was hard for Mary to face the fact that she was having difficulty, and hard for her daughter to bring up. But, she talked to her Mom about her worries and the fact that she wanted to support her to stay at home. She asked Mom simply to meet the care manager and see what she had to say.
Our care manager visited to do an assessment. She took a genuine interest in what Mary had to say. She listened and observed. Fortunately, care managers are adept at handling these situations. They know it’s not easy for elders (or their families) to face the harsh truth that things are changing. Also, they realize the importance of listening closely to the various feelings and perspectives…hidden fears, unspoken worries.
There were a number of dangers in Mary’s home environment. Her bathroom had no grab bars and both the tub and floor were very slippery. In addition, she was getting on a step stool in her pantry often to reach items she needed. She said she got up 3–4 times/night to go to the bathroom, a walk which took her down a dimly lit hall with a throw rug. It was just lucky Mary hadn’t been seriously injured.
Additionally, it was clear the housekeeping was suffering. Mary wasn’t physically able to clean all the rooms. She couldn’t reach to make her bed, which really bothered her. Mary wanted to iron her blouses but could no longer do it after a shoulder surgery.
Fortunately, by facing this situation everything was easy to remedy. This meant preventing just the outcomes Mary dreaded. The care manager suggested some simple rearranging, new lighting, grab bars and non-slip bathroom items. She created a care plan based on needs and wants to bring in the household help that would make Mary’s life safer…and easier.
You Are What You Eat: New Challenges with Nutrition and Digestion When Aging in Place
Another area the care manager pinpointed was Mary’s nutrition. She noticed the plethora of snacks and lack of fresh food in the house. Worse yet, she found quite a bit of expired food and spoiled leftovers.
Part of Mary’s weakness may have been related to her eating habits. She said she rarely had an appetite. The care manager made an appointment to get Mary’s medications reviewed and an overall health check. She also guessed that loneliness was a factor. And, Mary shared how difficult grocery shopping had become since her shoulder surgery. In addition, her daughter shared that Mary had been hospitalized for a bowel obstruction a couple months back. And Mary admitted to continued stomach pain and constipation.
In addition to getting a thorough check of Mary’s medical status and medications, the care manager helped put some preventative measures in place. First, she helped set up a grocery delivery service. Mary’s daughter would help manage it, but they also showed Mary how to easily place an order. Then, they decided that it might be useful to have the caregivers who would be coming in assist with meals. They scheduled it so that the caregiver would be there for a few meals, and be able to prepare others for Mary to eat between visits. The caregiver also helped to check in on Mary’s digestion and follow her doctor’s protocol to prevent future bowel obstructions.
Mary almost immediately began eating more (and better) as she had delicious smelling and tasting meals being prepared in her kitchen again. She ate even better on the days she shared meals with the caregiver. The care manager had guessed correctly. It is quite common that older people who live alone experience decreased appetite and worsened nutrition.
The Dream of Aging in Place Can Become the Nightmare of Aging in Loneliness
Appetite was just one symptom indicating Mary’s loneliness. It became clear during the assessment that Mary was mildly depressed. Her daughter didn’t believe it at first because Mom never expressed it. But the care manager pointed out that her memory slips and withdrawal were likely signs. Mary had even stopped her favorite daily activity of taking short walks in the neighborhood. And, she rarely did any other activities. She’d been aging in place while barely leaving that place.
To begin addressing this, her caregivers would provide some companionship and structure. Her care manager also arranged a ride service and schedule to take Mary back to the senior center where she used to go. Since motivation can be a challenge when depressed, she pre-arranged visits when the center had a regular walking club. This helped Mary get back into activity and also socialize. At the same time, they addressed the depression with her doctor. He ruled out other issues and decided to monitor how Mary was doing in a few months after these various changes had time to take effect.
Let’s Talk about Driving
At the time of the assessment, Mary had her license but wasn’t driving much. She never drove at night and had stopped going out much at all.
It was time to have the difficult conversation about giving up the car. However, in Mary’s case, it was clear she knew it was an issue and was afraid. Fortunately, therefore, the conversation went well. Mary had been and still was reluctant to give up her car and “freedom”. But once she saw that her daughter and the care manager could arrange for all her needs, she agreed. In reality, she had so much more freedom now that she didn’t have to rely on driving herself with self-imposed limitations.
By facing the reality of the situation, Mary and her family were able to make sure she could stay at home. Aging in place doesn’t happen by accident. But, it can easily be derailed by an accident (that could be prevented). The 90% of elders who want to remain at home must be proactive and take an honest look at their situation. Better yet, they can benefit from a neutral, professional view and recommendations.
To learn more about aging in place, read Eleven Habits of Successful Aging.