The number of Americans over 65 is expected to double in the next three decades, reaching 88 million people by 2050, according to the National Institutes of Health.
Many of these older people will need some type of long-term care which Medicare doesn’t cover.
Nursing Homes Are Not Your Only Choice
When most people think of long-term care, they think of nursing homes.
But nursing homes are not the only choice for older people who need extra help with activities of daily living (such as cooking, cleaning, bathing, shopping) or specialized medical care. In fact, even elderly people with complex, chronic diagnoses, such as dementia, may be able to access programs aimed at keeping them in their own homes or communities.
When you’re able to stay in your own home, instead of going to a long-term care facility, this is called ‘aging in place.’
The Centers for Disease Control and Prevention defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level”.
Unless there are no other safe options, nursing homes should be a last resort for long-term care. Keep in mind, however, that in some situations it may be safer for an elderly person to reside in a skilled nursing facility.
Here are 9 ways that you, or your loved one, may be able to ‘age in place’ instead of going to a nursing home.
1. Home Modifications
Sometimes, older people can’t get around safely in their homes anymore. This is when many people think it’s time to pack up and move to a nursing home.
But there are lots of things you can do to make your home safer and more accessible.
Home modifications are physical changes made to a residence that makes it safer and more accessible. These changes can be simple, such as removing slippery rugs and installing bath rails. Or they can be as comprehensive as a complete renovation to your property to accommodate your changing physical needs.
For a wealth of information to help you understand more about home modifications check out this excellent resource from the University of Southern California’s School of Gerontology.
2. Assistive Products
There’s an array of products out there to help elderly people stay safer at home. Here are a few examples:
The Hartford Center created this amazing, comprehensive guide to over 200 products that can help you modify your environment to be safer and more accessible.
3. Community Programs
Community programs are a great way for seniors to stay active and continue thriving in their own homes. These include social and recreational programs as well as domestic assistance.
Here are a few services to consider. Check with your local Area Agency on Aging to see if these resources are available in your area.
- Home Delivered Meals (such as Meals on Wheels)
- Companion Services
- Day Health Services
- General and Medical Transportation
- Senior Centers (Recreational Activities and Socialization)
- Group Respite Care
Also, most grocery stores, and companies such as Fresh Direct, offer online ordering. Groceries can be delivered straight to your door. Check to see if there are stores in your area that offer this service.
4. PACE Programs
Programs of All-Inclusive Care for Elderly (PACE) programs provide comprehensive health and wellness services for folks 55 and over who have been deemed ‘nursing home eligible’ by their state’s Medicaid program. You can check the PACE website to see if you may qualify and if there is a program in your area.
If you are eligible, the services offered are robust and include everything from medical care to recreational activities.
5. Home Health Care
Home health care is medical and/or domestic care that is provided in your home.
The level of care you receive will vary depending on your specific needs and budget. For example, you may require a registered nurse to do medical care such as administering intravenous medications or managing a complex wound.
If you need assistance with activities of daily living (ADLs) such as bathing, dressing or cooking, then a home health aide may be able to help.
Use this tool from Medicare to find and compare home health agencies.
6. Adult Day Care
Adult day care programs provide care and companionship for older adults who need assistance or supervision during the day. They also serve to provide respite for caregivers.
Adult day services usually include:
- Recreation and social activities
- Varying levels of medical services
- Transportation services
Find out more about adult day care services in your area with this Eldercare Locator.
7. Assisted Living
Assisted living facilities offer a type of housing, and services, that address various levels of medical and personal care for older people. The living spaces may be entire apartments, shared units or individual rooms.
Services vary widely among different facilities, but may include:
- Personal care (help with dressing, bathing, cooking)
- Medication monitoring
- Emergency medical care
- Limited medical services
- Social and recreational activities
You can find out more about assisted living facilities in your area with this Eldercare Locator.
8. Granny Pods
Granny pods, as they’re often called, are small homes (usually between 300 and 500 square feet) that sit in the backyards of main houses. They allow older people to be closer to loved ones while maintaining their own space and sense of independence.
Granny pods are typically simple setups that include a living/sleeping area, bathroom, and kitchenette.
But not all of these mini abodes are made equal.
Some come decked out with high-tech monitoring systems that measure and record your blood pressure, glucose levels, heart rates and more. There are even homes that remind occupants to take their medications!
Sold on the concept of tiny houses that can take your blood pressure and tell you when it’s time for your 10 am pill? Here’s a list of a few companies that manufacture these popular dwellings:
9. Underestimate Prevention
Many older people think that their ailments arise from simply “being old.” This is not entirely true.
Yes, there are certain faculties, such as our vision and hearing, that can be affected by our age. But many conditions that elderly people suffer from (and that land them in nursing homes) can be averted.
Chronic illnesses, such as heart disease, diabetes, and even some cancers are largely preventable. The CDC and the World Health Organization (WHO) report that many chronic conditions are caused by just four behaviors:
- Smoking (including secondhand smoke)
- Poor nutrition (diets high in saturated fats and sodium but low in vegetables and fruits)
- Lack of or complete absence of physical activity
- Excessive alcohol use
It’s never too late to modify your habits. Quit smoking, eat healthy, exercise and limit your alcohol intake.
As the old saying goes, ‘an ounce of prevention is worth a pound of cure.
How Much Does It Cost To ‘Age In Place’?
The options I’ve listed here run the gamut when it comes to prices. Some can be very expensive, such as assisted living facilities and granny pods. But other resources are completely free for eligible patients.
When exploring different options, make sure you know upfront what the costs will be. Always check with your insurance company, Medicare or Medicaid to see what is and what isn’t covered.
Keep in mind that nursing home fees are often much more expensive than any of these alternatives. As I mentioned, Medicare doesn’t cover the cost of long-term care. The only exception is when patients have a ‘medical need’ for a skilled nursing facility. This usually occurs after hospitalization and is typically for a short-term stay.
In the long run, it usually works out to cost a lot less if you can avoid going to a nursing home. And most people are happier if they can stay in their own homes (or with a loved one) and continue to be actively involved in their communities.
- National Council on Aging
- Area Agencies on Aging
- Eldercare Locator
- Home Modification Resource
- Medicare Home Health Compare Tool
- The Hartford Center Product Guide
For a more comprehensive list of resources, head right this way.
I hope this has helped shine some light on the various resources you can leverage to help you, or a loved one, ‘age in place’ and avoid going to a nursing home if possible.
Have a question for me? Or just want to share your experiences with the healthcare system? Email me firstname.lastname@example.org
I’d love to hear from you!