Tag Archives: aging in place

April 30, 2022 · 1:22 pm

Tips on hiring in-home care aides

In order to honor our elder’s wishes to age in place, it’s important to make sure they have the proper support. That may include hiring in-home care aides to perform housekeeping and some basic medical tasks. This is especially true for those of us who are long-distance caregivers.

Finding a good fit can be a challenge. Some elders may resent the idea that they need help and sabotage any hopes of securing care services. Those with dementia may become more confused or combative with a stranger in the house. Even those who are willing to accept a care aide in the home may find their routines are disrupted, which may cause short-term distress.

I was fortunate that my mother’s aide, hired through a local home health care agency, was a wonderful woman who clicked with my mother. Not only did she offer my mother a helping hand, she offered her companionship. My mother had a very set way of doing things so I know she probably was a challenge for the aide at times, but I so appreciated the aide’s services. I knew I could trust her and that my mother was receiving the support she needed to stay in her home.

MarketWatch published an article that has helpful tips on what you should look for when choosing an in-home care aide. Beyond the basics like a background check, it’s important to know the aide’s skill set, availability, and career aspirations. Going through a home health agency can offer some peace of mind, but can be more expensive. Word of mouth can be a good way to find a caregiver in your community. When it comes to hiring a care aide, hands-on experience may be more key than formal education.

There are websites and apps that allow one to hire a caregiver remotely, which can be useful for long-distance caregivers but can be a bit more of a gamble without that in-person assessment. Long-distance caregivers should consider a video call before making any hiring decisions. Don’t overlook your gut instinct; if you feel an aide is not the right fit, don’t hesitate to take action. It’s not unusual to cycle through a few care aides before finding a good fit.

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December 11, 2021 · 12:00 pm

How pandemic helped motivate interest in ‘virtual assisted living’ technology

One aspect of the pandemic that could be seen as a benefit to family caregivers is the embrace and expansion of technology that assists with basic tasks in our daily lives. While some of us were already utilizing such services before the pandemic, many others learned the convenience of having groceries delivered to their home, for example.

A sandwich caregiver interviewed by MarketWatch recounted what a major benefit it was to have groceries delivered. She used to spend a good chunk of her day off taking her elder parents to the grocery store. When the pandemic struck, she shifted to grocery delivery and signed up her own family as well. Sometimes it is the simple things that can make all the difference. A caregiver reclaiming a few hours of her life each week can have a major impact on her wellbeing and those in her care.

Of course, there is always a price to pay for that convenience, and I never forget the fact that there is a human being who is picking out my groceries and delivering them, putting their own lives at risk to complete a chore for me. I always make sure to tip well.

Zoom and other video calling tools also exploded in popularity during the pandemic. While some are understandably suffering from Zoom fatigue at this point, for those families who were able to get their elder loved ones comfortable with the technology, video calls served as an important lifeline for those separated during the pandemic. Being able to check in on an elder loved one from afar with a simple video call helped put a family caregiver’s mind at ease. Of course it’s not the same as being able to hug and socialize in person, but for elders who otherwise may have been completely isolated, video calls kept the connection to family intact.

Remote tools, whether for working, socializing, or caregiving, are now receiving greater public interest, which is sparking investments from major technology companies like Amazon, who has developed a caregiving hub called Alexa Together. While there are security, privacy, and ethical concerns when it comes to monitoring technology, overall I think these tools can be helpful for the long-distance caregiver.

From my experience, I found tools such as a cellphone designed for older people, fall-sensing technology, and automated shipping of supplies to be of great help as a long-distance caregiver. As I wrote in my book, The Reluctant Caregiver, I was able to convince my mother, long skeptical of high-tech gadgets, to embrace these tools to help keep her living at home safely, versus having to enter assisted living.

As I grow older, I will be watching this growing field of technology with interest.

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November 20, 2021 · 1:38 pm

When aging in place becomes stuck in place

A new AARP survey found that older Americans continue to have a strong preference to staying in their homes as they age, even if they have found themselves stuck at home for long stretches of time during the COVID-19 pandemic. Over three-quarters of those age 50 and over (77 percent) prefer to remain in their home as they age, according to the survey results. That statistic has remained steady for over a decade, according to AARP.

However, there is another way in which older people get stuck in a living situation that doesn’t meet their needs as they age. A third of survey participants said they’d need to modify their homes in order to accommodate a physical limitation. These modifications can be pricey and not feasible for those on fixed incomes. The same financial challenges apply to moving into a more aging-friendly home or moving into a senior living facility.

When my father landed in the hospital for emergency surgery, he had a difficult recovery due to his mid-stage dementia and could no longer walk. The condo that my parents had was not safe for him to return to, so the hospital would not release him home. One had to access a staircase to get to the entrance and the rear entrance was wooded land that was not safe for unsteady gaits. Any modifications would have to be approved by the HOA, a lengthy process. Instead my father got transferred to a skilled nursing facility and then, a memory care facility an hour and a half away from home.

Another solution to these housing challenges was met with support from survey participants. Sixty percent of those polled said they would consider living in an accessory dwelling unit (ADU), sometimes referred to as a “granny pad” or a tiny house. These affordable, small-footprint homes can be built adjacent to a primary home (depending upon local permitting) and allow independence and privacy while also benefitting from having loved ones nearby for help with daily chores and activities and for companionship.

According to the AARP survey, “access to clean water, healthy foods, quality health care and safe outdoor spaces” were important considerations when it came to what communities offer those aging in place. High-speed internet service was also deemed important. Developers and city planners should take note as they build communities and offer flexible, adjustable housing options that can meet the needs of an aging population.

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July 25, 2021 · 10:52 am

Staff shortages a growing hurdle for home care

Those of us who have utilized home health care for our loved ones are well aware of the staffing challenges in the industry. The pandemic intensified the problem and has moved the issue into the national spotlight. Will we find solutions as the demand for home health care is likely to increase in the coming years?

My father’s journey with Alzheimer’s ended a decade ago. Like the woman interviewed by the New York Times for a recent article on the shortage of home care options, my mother cared for my father at home for as long as she could. Her preference would have been to care for him at home, with adequate outside support. There were sporadic home health care visits to address physical health issues, but the bulk of the care fell on my mother. My father ended up being hospitalized for a medical condition which required surgery and was not physically well enough at the time to be released home. He was placed in a memory care center an hour-and-a-half drive away from my parents’ home. It was the closest facility with an opening. The distance put a huge strain on my mother, who didn’t have personal transportation and had to take a bus to visit my father.

My mother used home health care while she was recovering from cancer, but in her rural community, staffing shortages and high turnover meant limited visits and the bulk of daily care falling on my shoulders. I had to quit my job in order to provide that care, and while I’m grateful I was able to be there for my mother, it created a significant financial burden that I’m still trying to pay off several years after her death.

Most people’s preference is to age in place at home, but people are in for a rude awakening if we don’t adequately address the problems within the industry. While staffing has rebounded to pre-pandemic levels for the most part, demand continues to grow. According to the New York Times, “More than 800,000 older and disabled people who qualify for Medicaid are on state waiting lists for home care.”

That’s a lot of people, and the ripple effect that it causes for family members who have to drastically alter their lives to fill in the care gaps cannot be ignored. There is a lot of talk about “elevating the profession” and that is long overdue. Better pay, better benefits, a career path that offers further training or certifications would help attract and maintain staff. Adjusting our immigration policy to welcome those who want to work in the care industry is another option being discussed. At some point soon, we must move beyond just mere talk and take action.

In the meantime, families are left scrambling and our loved ones in need of care suffer.

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November 28, 2018 · 8:00 am

Don’t overlook the importance of bathroom safety as a caregiver

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Pixabay

Every time I hear about an older celebrity who suffers a serious injury or dies after a fall in the bathroom, I’m reminded of how treacherous that room of the house can become for those aging in place. I became personally familiar with the danger the bathroom can present when my mother broke her shoulder after falling off the toilet in the middle of the night.

The good news is that there are fairly simple and inexpensive ways to make a bathroom safer for an elder loved one. BuyMedical.com offers the following five recommendations from Invacare Homecare for helpful bathroom aids.

Transfer bench: When I began to help my mother get baths at home after her surgery, I realized how precarious the transfer from the bathtub to the bathroom could be. Getting a transfer bench made all the difference, allowing her to easily transfer herself from tub while seated. She would just swing her legs over the tub to the bathmat, then hold on to the bench as she lifted herself upright.

Shower chair:  I can vouch for the benefit of a shower chair, as my mother used hers for the last couple of years of her life. Bathing can become a real chore and risky as we get older, and our mobility fades. But good hygiene is important both physically and mentally. A shower chair reduces the risk of falling by allowing one to sit comfortably while getting a shower, instead of trying to lower themselves into the bathtub.

Toilet seat frame: A toilet seat frame offers sturdy support for those who have trouble getting up and down. This helps reduce the risk of falls, slips and injuries.

Raised toilet seat: This is one of those things you don’t think about until you need one. Whether due to recent surgery or just difficulty in lowering the body, a raised toilet seat offers affordable convenience.

Commodes: I wish my mother had received her portable commode sooner, because I think it would have made the last few weeks of her life easier. Unfortunately, the home hospice group didn’t deliver it until she was almost bedridden, and she only used it once. Supporting an elder loved one’s continence is vital for their well-being.

Not only do these bathroom safety aids help your elder loved one, they make your job as a caregiver easier as well.

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July 10, 2018 · 8:52 pm

Stay or move, that is the question

I was recently introduced to a resourceful website called StayorMove.org. The site focuses on what is are the most crucial questions as we grow older, such as do we stay put in our current homes or do we move on to a different location or live in an assisted living facility?

It’s questions we all should ask ourselves, but many people wait until a health issue makes the decision for them. That’s why I like the approach found on the StayorMove website, which is easy to navigate and uses a series of videos to address the pros and cons of a variety of housing options.

>>READ MORE: Can America afford to age in place?

I also appreciated the fact that growing old in a rural environment was addressed. Those who follow this blog know this is an issue that’s important to me, because my parents’ health care was compromised by living in a small town with limited medical resources. They have a series of videos on the Village movement, which seeks to connect neighbors and volunteers to help elders age in place, while valuing the contributions of elders to the community. I’d love to see this concept expand.

The videos are brief but informative, and hopefully will encourage the “stay or move” conversation to continue. The more people are educated, the better decisions they can make about their own aging and housing choices.

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January 8, 2018 · 7:00 am

Taking care of our ‘elder orphans’

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Photo: Pixabay

Now solidly middle-age and reflecting more upon my own mortality after the deaths of my parents, aging well is a top concern of mine.

Aging well means something different to everyone, but living independently with as little assistance as possible is a priority for me.  I read an article about “elder orphans,” a term used to describe older people who live alone without a support network. As our society has moved away from the nuclear family model, and more people are deciding not to have children, the number of elder orphans will likely grow dramatically over the next several decades. The author of the article believes that baby boomers will also experience an uptick of elder orphans.

Not only are modern families smaller, but members are more likely to be spread out geographically, which can complicate caregiving situations. Women, traditionally the caregivers in the family unit, have demanding careers that limit their ability to be caregivers. (Though we know there are plenty of family caregivers who work full-time and care for a loved one, which can lead to burnout.)

Some people, like my mother, become an unwilling elder orphan after their spouse dies. My mother was able to take care of herself until the last few months of her life, but she did not enjoy living alone. She missed the daily companionship and experienced loneliness living in a rural community without friends or family nearby. Yet even when she was still in good health, I couldn’t convince her to visit the community senior center.

So how can we better take care of our elder orphans? I’ve written before about aging in place and how some communities are being proactive in addressing the needs of their aging population. Infrastructure needs like housing and transportation is integral, but so are communities with residents who have an awareness and dedication to helping their elders age safely. Programs like Meals on Wheels isn’t just about receiving food, but serves as the only regular safety check that many older people living alone receive. The frigid winter weather has encouraged people to check in on their elder neighbors, and that’s something we should be doing all year long.

While we can’t predict how our own health issues will impact our hopes of aging well, we can plant the seeds now to create a safe and welcoming environment for elder orphans.

 

 

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October 30, 2017 · 1:20 pm

Can America afford to age in place?

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Joe Zlomek/Freeimages

While many people, including myself, would prefer to age in place, for financially strapped communities throughout America, the trend is straining limited resources.

An article about my mother’s home state of Tennessee and its struggle to care for a rapidly growing older population is a scenario taking place in many states. Many state, county and city budgets are already overwhelmed with issues ranging from high unemployment to the opioid epidemic. I read one article that said older people calling 911 due to falls at home was straining EMS budgets. While the federal government contributes money to elder care each year via the Older Americans Act, it’s simply not enough to address the needs of a growing elder population.

In Tennessee, thousands of older people are on waiting lists for government assistance programs. The organizations do the best they can, but those cited in the article said more resources are needed, and officials are going to have to address the issue soon.

Transportation was listed as a major issue. While some older people may be physically healthy and not need in-home assistance, they may no longer be able to drive and need transportation options to maintain their quality of life and independence. This of course was an issue for my parents. Thankfully, they did have a county-funded shuttle service that they used for years. (Most county officials were against the idea of the shuttle, however. Its funding is always on the verge of being cut.)

Meal delivery was another major need. The meal delivery service also serves as a status check on the older person, so it has a dual purpose. For those in rural areas, this can be a lifeline.

In Tennessee, supporting someone staying in their home costs $3,000-$15,000 annually, while putting a person in a facility costs over $50,000 annually. You don’t have to be a math whiz to see what is the financially efficient solution. Unfortunately, the federal  government has not been proactive in addressing the issue. Tennessee reports some success at the state level, working with community organizations.

Has your community addressed aging in place issues? I’d love to hear about programs that are working in your area.

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October 2, 2017 · 9:00 am

Addressing aging issues, village by village

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Anna Wolniak/Freeimages

While the concept that “it takes a village” has become a platitude in popular culture, there are people out there actually putting the village concept to the test. I’m now following the village concept in earnest, and will be interested in seeing how it develops.

I first heard of the concept through Kay Bransford, who has the excellent Dealing with Dementia blog.  She lives in McLean, Virginia, which is home to an active village community. The village is volunteer-based, and supports the needs of its inter-generational community members, with an emphasis on the aging population and the special needs of those with disabilities.

The idea of a grassroots movement that allows one to age-in-place without heavy government involvement is intriguing. The local, community-based approach makes the most sense to me, because neighborhoods have their own individual challenges and opportunities. We also shouldn’t hold our breath that the federal government is going to address the needs of our rapidly aging population anytime soon, no matter who’s in office.

The village movement began over 15 years ago, and the Village to Village Network was established in 2010. Over 200 villages now exist in 45 states. Members help each other by looking out for one another, making sure those who need help aging in place have access to affordable, dependable services for things like home repairs and running errands. Village communities work with existing government and community agencies to address any gaps in care and resources.

I think about how much a strong village model could have helped my parents as they dealt with medical issues and aging concerns.

What do you think about the village concept?

 

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October 24, 2016 · 8:00 am

Aging in place not just about home’s interior

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The “portal to hell” aka the crawlspace where the water heater is located.

As I wrote about in my last post, caregiving can give you tunnel vision, and while I was busy tending to my mother’s every health need, I overlooked some basic household duties, like changing that darned furnace filter.

But another thing I had to deal with on my recent visit to what was my parents’ condo made me realize that aging in place is not just about retrofitting a home’s interior. When I arrived and turned on the kitchen faucet, I immediately noticed that the hot water had a very strong sulfur odor. I Googled the issue and found that it is common in cabins and other kinds of vacation rental homes, where the water sits unused for long periods of time. Basically, the water sitting in the water heater tank is an ideal incubator for bacteria, which, while harmless to humans, creates that godawful rotten eggs smell.

The simplest solution involves flushing out the water heater with bleach or hydrogen peroxide, which kills the bacteria.

As I searched for plumbers, I began to wonder, where the heck is the water heater?

By process of elimination, I figured the square door underneath and to the side of the condo must be where the water heater was located. The photo above is actually a neighbor’s unit, but it looks just like mine. What I couldn’t picture was how a water heater fit in such a small space.

When the plumber came out, the mystery was solved. The wood door had to be unscrewed with a power tool, and then the plumber, a pretty tall guy, angled his way through the portal. I stuck my head inside and saw that the crawlspace was quite large, the entire length of the two condos that are connected together. There were several discarded water heaters under there, a virtual graveyard. The plumber wanted to show me how the water heater was leaking, which required me to climb inside.

I wasn’t sure I was going to be able to do it; I’m not claustrophobic and am in decent shape but I am clumsy, and this was a very awkward hole to crawl through. Somehow, I managed to squeeze through without injuring myself, then was immediately concerned about how I would get back out.

The plumber told me I could flip the breaker on the water heater when I was headed out of town so I didn’t have to crawl back down there. That was another adventure, finding the circuit breaker. It was located in a storage closet outside the condo, and inexplicably placed in the back corner, meaning you had to be careful about what you stored in the closet so you could squeeze your way to the back and reach the breaker panel.

The entire debacle made me think about aging in place, and how important it is to examine the exterior and the interior of the home your aging loved ones are residing in or wish to move to, and look for red flags like this bizarre water heater setup. Take into account things like stairs, crawlspaces and anything else that is difficult for someone with limited mobility to access. Ideally, a homeowner would have convenient access to things like the furnace, the water heater, air conditioner, circuit breaker, etc. in case of emergency.

It’s definitely something I’ll think about when looking for a retirement property. No creepy “portals to Hades” for me!

 

 

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