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There are many things to consider when you and your family would choose this option.
These may include personality traits, geographical considerations, and even the layout of the elderly's home.
So today, I'll be sharing a great guide to help you and your mom make aging in place much easier.
Temperament: Mom’s personality and how she interacts with the world can demonstrate if aging in place in her home is a good fit for her. The first thing to consider is how does she handle being alone? If she needs some amount of alone time and uses it to recharge, aging in place may be a good fit. Does she enjoy reading, crosswords, knitting or have other productive hobbies that help pass the down time? On the other hand if mom recharges best by being around lots of people and always enjoys having something going on, aging in place may not be the best idea. The increased isolation at home can lead to loneliness, anxiety and depression. Though it is common to want to remain at home, these extraverts tend to thrive in more communal living environments. Looking into an active seniors community or apartments may give mom another setting to age in place in and set her up to thrive.
Cognition: Mom’s mental capacity is a major factor in her ability to safely remain at home. There are normal cognitive declines that occur with aging such as increased word finding difficulty or forgetfulness. While these can be frustrating for mom and those around her, this does not indicate that she is unsafe at home. Using lists and written reminders can be good tools to help her operate safely at home. If larger cognitive problems occur, such as getting lost while driving somewhere familiar, leaving the stove/oven on or an inability to maintain proper hygiene, she may need help. This help can be as simple as having someone around to assist with light household duties and keep an eye out for safety concerns. This family member, friend or sitter can provide stimulating companionship while assisting with supervision and routine chores.
Fitness: There are two parts of fitness to consider; health and activity level. Health concerns related to aging in place can be thought of as how many medical conditions does mom have that need to be managed by a doctor? If the answer is none, that's awesome! It is still a good ideal to routinely have a physical to check for underlying conditions before they become medical complications. This preventative approach will give mom the best chance to avoid serious health issues. If mom has multiple comorbidities and takes 5+ medications to manage them, her need for quick access to healthcare may be a concern. Activity level is the next part of fitness and it is closely correlated to ability to age in place. The more active a person is, the more likely they are to be able to safely get around their home to perform activities of daily living. This will keep mom safe at home longer. Increasing activity level is a good idea for those who are currently minimally or moderately active. This exercise has been shown to help maintain a healthy body weight, increase/maintain bone density, improve cardiovascular function, increase strength and improve cognition. Is there a neighborhood recreation center close by where classes, hobbies, and activities can be enjoyed with others?
Finances: This is an important factor to consider when looking at aging in place. Mom may be on a fixed income without much in savings. There may be ways to supplement retirement income with additional funds from non traditional measures. Utilizing the equity in your home is one example. It is a good idea to speak to a fee only fiduciary financial planner. This will be someone who charges you for their time, but is not commission based. They can be valuable teammates when assessing/planning for financial concerns. The XY Planning Network is a great place to find this person who can help.
Location: The most difficult thing to change about mom’s home is the location. While it is possible to pick up some smaller homes from their foundation and transport them to a new location and hook them back up, it is fairly expensive to move an entire home. Not impossible, but definitely impractical so let’s assume the house remains in place. The location of the home will determine many things such as access to medical care. Is there a hospital nearby? How difficult is it to get to her primary care physician’s office? Are there specialists around if needed? Are home services provided in this area? Access to transportation can also be related to location. If mom can no longer drive, is family close to assist with transportation needs or are there rideshare services available such as lift, uber or gogograndparent?
Support Network: Who is around to help mom age in place? Friends and family nearby make all the difference in quality of life. A trip to the grocery store, cooperating with making a meal, or a game of cards with a friend can be a great way to have some fun and strengthen quality relationships. Other parts of a support network would include the availability of community services. Churches and nonprofit organizations can at times assist with transportation, caregivers, meal delivery and or housekeeping and cleaning. Seeing what is available for mom locally can help her stay safe at home longer!
Many of the homes lived in by the aging population were built 40+ years ago. Very often a house built in the late 40’s or 50’s (post world war two) is still where mom calls home. She has lived there for what feels like forever and intends to remain there no matter the consequences.
Is there a way to make this home more suitable for aging in place? Yes! But even a minor bathroom or kitchen remodel can seem exceedingly expensive. A thirty to fifty thousand dollar remodel can feel astronomical to someone who remembers buying the entire home for less than $10,000. Even if mom has no intent to move, it is likely a good idea to show her the cost of newer construction homes geared towards the 55+ community and built with universal design. This serves two purposes, first, it will show her the cost of a newly constructed home. Those built for aging in place can be 5 to 10x more costly than even a large remodel. Second, it can give her ideas for changing the layout or function of her home to incorporate universal design.
Another way to present the affordability of a home remodel is to compare its cost to the cost of living somewhere such as an independent living facility, assisted living facility or skilled nursing facility. The median semi-private room in a skilled nursing facility costs nearly $75,000 per year and that average price is increasing year over year. Be careful using this tactic, as it can come across as a threat if not properly worded. Try: “You can potentially avoid hundreds of thousands of dollars in costly care with this bathroom remodel”. Avoid: “You will be paying $75,000 per year when you slip and fall and end up in a nursing home!”
When it is decided that a remodel is necessary and agreed upon, the next step is to determine what needs to be changed to improve safety within the home. The bathroom is usually a great place to start. This is where the most injurious falls occur when home. The tub/shower combo usually needs to go. It is dangerous to step over a 12 to 18” tub wall, especially when wet. A standup shower with a bench or a chair and a low profile entrance or a seated walk in tub are much safer options. Preference for soaking vs. aesthetics of a tile shower can help make this decision. The height of the toilet can also be improved to reduce difficulty and improve safety. Older homes were built with very short (often 14”) toilets. This can lead to an uncontrolled lowering (last few inches of sitting) or need for momentum to get off/on the commode. Neither is safe and can be fixed with a new raised toilet and a grab bar or 3-1 bedside commode which can be used as a frame to raise the seat height and provide chair style arm rests for standing. Good lighting is needed in every room, but can be forgotten about in the bathroom. The more well lit the room is, the less chance of an unnoticed tripping hazard.
The next place to consider changes to improve safety and accessibility is the kitchen. Mom’s height and ease of working overhead vs. below her hips will determine how to best utilize the space. The counter height should be a comfortable level for her to be able to reach the back, while preventing the need for bending over to reach items. Rearranging the storage, cabinet and counter space is also a good idea to have her most used utensils and appliances within easy reach. The microwave should likely be on the counter if it is difficult for her to reach above the stove. The oven may need to be installed in a cabinet to be easily accessible for mom and prevent the need for bending and reaching to retrieve all those tasty hot baked goods! Good lighting is essential for this room as well to reduce risk of tripping.
There are two other items of note to consider when making the home as safe as possible for our aging parents. The first is consistent flooring throughout the home. If possible, this eliminates doorway transitions which can be tripping hazards due to the change in height of the floor. Sunken rooms, and unmarked steps should be removed if at all possible. Obviously carpet in bathrooms and kitchens is a bad idea, and it's not easy to have a single type of flooring throughout the entire home, but anywhere a change in level or surface can be eliminated is a step in the right direction. The other item to consider is widening doorways. Bedroom and especially bathroom doors in older houses can be exceedingly narrow. Often a walker or wheelchair may not fit through this door. This can lead to someone who is rushing to the toilet leaving behind a necessary assistive device. Which will lead to greatly increased risk of fall and injury.
Check local prices for the work needed to be completed and be sure to get multiple bids and check a few references from each contractor or company. The quality of the team you hire can prevent many headaches down the line, even if they seem more expensive upfront.
That's all for today.
Do you have any tips to make aging in place easier for moms? Share it with us below.
Take care, keep mom safe, and have a great day!