There’s no place like home, especially as we get older. Some 87 percent of people over the age of 65 want to remain in their own homes and communities as they age, according to AARP.
Yet for many, that hope isn’t fulfilled. Some 1.3 million Americans live in nursing homes at the moment, and an additional 835,000 live in residential care communities, according to the Centers for Disease Control and Prevention. An estimated 35 percent of Americans over the age of 65 will enter a nursing home as they get older.
With health issues being the typical trigger that forces families to move a loved one to a nursing home or assisted living facility, it may seem as though the decision about where to grow old is beyond your control. But that assumption isn’t necessarily grounded in reality.
“If you want to age in place, it’s extremely important to take a planful approach,” said Jim Murphy, vice president of innovation at UnitedHealthcare Medicare & Retirement.
Not sure how to start planning? The following tips can help increase the odds that you’ll be able to age in the comfort of your own home.
Talk honestly—and early—about family support.
Even the most independent people will need help as they get older, and that help will most likely come from family members.
Some 34 million Americans provided unpaid care for an adult over the age of 50 within the last year, according to a study published by the National Alliance for Caregiving and the AARP Public Policy Institute. Eighty-five percent of those caregivers were helping a relative, and nearly half were caring for a parent or a spouse’s parent.
Too often, family caregivers step in during a crisis, rather than after discussion and careful planning—and that increases the odds of dissatisfaction on both sides.
“The biggest problem with aging is that people don’t want to talk about aging,” said Marty Bell, executive director of the National Aging in Place Council (NAIPC). “They want to ignore it and pretend they’re going to stay young forever.”
In talking to family members about the future, communicate your wishes clearly. Start by discussing how long you want to remain at home and under what circumstances, Murphy suggested. From there, you can discuss what you will need to accomplish that goal.
Empower the helpers to ask for help.
If you wish to remain at home, it’s important that your caregivers have adequate support.
“We hear frequently that when the caregiver gets to the breaking point, that’s when they start to say, ‘This just isn’t working anymore,’” Murphy said. “That’s when they may have to make a decision on behalf of mom or dad that they’re not capable of living in the home anymore.”
As the baby boomer generation enters their retirement years, a crop of new resources and programs are emerging designed to help alleviate the stress of caregiving for the younger generations who will be caring for aging boomers in the coming decades. Often these programs are available through health insurance plans.
UnitedHealthcare, for example, offers Solutions for Caregivers through many of its health plans. The program provides a host of online resources, including articles and videos on illnesses and challenges many people experience as they age as well as a marketplace where caregivers can purchase things like home safety products and home-delivered meals.
Solutions for Caregivers also offers support and case management services to stressed-out caregivers. Shared calendars, secure messaging and task management trackers can help caregivers coordinate their loved one’s care and connect with other family members. The program’s case management services can help caregivers create and follow through with a care plan.
Some people call Solutions for Caregivers with specific questions that an experienced case manager can answer over the phone—tips for finding a home health aide, for example. In more complex situations, the case manager may send someone to your home to assess whether it is still safe and beneficial for you to live there and what resources might help you do so. Sometimes, this will involve mediating among family members with differing ideas about your care. Such objective assessments can help caregivers find solutions to their thorniest problems.
More information about Solutions for Caregivers is available at https://www.uhcforcaregivers.com/. Call your health plan to ask if similar resources are available through your plan.
Take a critical look at the place where you’ll be aging.
Imagine a future in which you can’t get around as well as you do now. What would you have to change to live comfortably in your home?
The burden and expense of major home renovations sometimes scares people away from these discussions, but there are many simple and relatively affordable steps you can take to prepare your home.
Murphy suggests that older adults think about installing nonslip floor surfaces and “grab bars” for the shower or bath, as well as replacing doorknobs with easy-to-open lever handles. If possible, consider moving your bedroom to the first floor. In its planning guide, the NAIPC also suggests changing outside steps to a ramp, lowering kitchen counters to make it easier to cook while sitting down, and eliminating rugs and carpets to prevent falls.
Take advantage of tech.
Advances in technology are bringing drastic changes to many aspects of our lives, and aging is no exception. Smartphones, tablets and laptops can not only help you stay in touch with friends, family and caregivers, thereby helping to avoid isolation and loneliness, but they can also connect you to a doctor through telemedicine services, giving you access to medical care without leaving the house.
Virtual care tools are also being used more frequently to help people manage their medications, such as by monitoring how frequently pills are being taken and sending prompts when needed. Other tools can monitor a person’s biometrics (including heart rate, blood pressure and weight) through sensors, sending real-time data to your doctor and enabling quicker intervention if the numbers signal that something may be off with your health.
Some tech solutions specifically target falls, a serious health risk as we age. Motion-sensitive lighting can keep you from tripping at night, while personal emergency response systems, including medical alert necklaces and bracelets, allow you to immediately alert emergency services as well as your caregiver in case of a fall or other medical issue.
Technology can also be a boon for caregivers. Calendar apps make it easy to keep track of appointments, and other apps allow caregivers to monitor their loved ones from a distance. Some apps, for example, allow a senior to confirm that he or she has taken the correct dosage of medication at the proper time and send a message to inform the caregiver.
Think about community resources.
“While someone’s ability to remain in their home is an aspect of aging in place, it isn’t the only aspect,” said Murphy. “Being able to remain in your home becomes a huge issue if you’re not also able to access your community.”
Your car is likely your primary mode of transportation today, but researching other options can help you avoid isolation in case you decide to stop driving at some point in the future. Find out if community organizations or local government programs offer free transportation services that can take you to doctor’s appointments and social events. Programs like Meals on Wheels can also bring services to your doorstep.
If your community has a senior center, schedule a visit to learn more about the programs and services they offer. Even if you’re not yet in need of those services, it’s good to be aware of them in case your needs change down the road.
The NAIPC organizes community groups, local governments and businesses to help older adults age in place. Check to see if your area has a chapter that might be able to help you identify community resources. The AARP also has a quick and simple guide to public benefits.
Don’t forget the money factor.
Health issues aren’t the only reason many people move to a nursing home. In many cases, money becomes a hurdle to aging in place, given the costs associated with the home modifications and in-home care that are often needed to stay at home safely. Bell of the NAIPC recommends you start saving as soon as possible and have frank conversations with family members not only about how much your care may cost, but also about how to manage those expenses.
To get a sense of how much you may need to save to pay for your health care costs in retirement, check out the AARP’s Health Care Costs Calculator. The Solutions for Caregivers site also has information about financial and legal planning.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage and Prescription Drug Plans: A Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare.