When we talk about “aging in place” it’s a general term that describes an adult’s goal to stay in their desired living space. This can be their own home, a family home they share with others, or within their community. According to a 2018 AARP Research survey 76% of Americans aged 50 and older state they prefer to remain in their current home as they age. Another 77% cited living in their community if possible as a goal for their aging process. Sadly, however, only 59% of those surveyed reported they thought they would be able to stay in their home. Only 46% anticipated staying in their current home with just 13% expecting they could stay within their community.

Having worked in home health in San Francisco I am not surprised by these numbers given the challenges stairs, narrow doorways & hallways and hills present for the aging process. I’ve professionally witnessed how a home can turn into confinement due to environmental barriers. I once worked with a woman who lived on the 4th floor of a building in San Francisco that did not have an elevator. She hadn’t left her home in 3 years because she could no longer safely navigate stairs. When we discussed moving, she was too emotionally and financially attached to her apartment to consider moving, even though she admitted feeling tremendous loneliness, isolation and sadness. The irony was that the apartment she was clinging to so desperately was actually decreasing her quality of life.

For many, early planning can help mitigate some of the challenges for aging in place. Home modifications are best installed before you actually need them. Things like a grab bar in the shower can be an easy solution to promoting independence with bathing as people age. If staying at home is important for you or a loved one, consider how accessible the home is in terms of bathing, accessing living areas and getting in and out of the home. Stairs are often associated with falls, so is there potential to live on one story if need be?

My Grandmother did not want to give up her home of 40 years in Seattle. However, navigating the stairs to get in and out of the car port and front door were becoming risky. After two freak snowstorms that left her trapped in her home for days (due to a steep driveway), she began reconsidering whether she truly needed her two story, 3-bedroom 2-bathroom house any longer. Although the decision was difficult for her, it’s not one she regrets to this day. Moving to an accessible retirement community improved her social life dramatically, which in turn improved her mood and quality of life. She also lives in a one-story apartment that makes it easier for her to navigate with her walker. When she moved, we didn’t know she would come down with Macular Degeneration years later and become nearly blind. However, having had several years in her new environment while she still had her sight made the transition to loss of sight easier for her in terms of navigating a familiar environment. She also has a walk-in shower with a big tub transfer bench, grab bars and a handheld shower head. Her bathroom is big enough to take her walker into and has a grab bar next to her toilet.
Although she didn’t anticipate using these things when she moved in, she now relies on them daily. Planning for the unforeseen can be an empowering part of the aging process for those that want to stay independent.

Not everyone will favor moving away from their home as they age. For those that do not, I encourage you to think about what can be changed in your home environment now to make it more accessible in the future? Who would you feel comfortable getting assistance from if you had a surgery, accident or decline in abilities? Would you feel comfortable relying on your family? Would your family feel comfortable assisting you?

For my Grandmother, she did not want her family to take care of her and was adamant about reminding us of her wishes. I gently urged her to get caregivers for years to help with things like cleaning, ensuring her safety when she walked outside in her urban neighborhood in downtown Seattle, making her meals on occasion, however, she refused for years. It wasn’t until she turned 99 and she was nearly blind that she finally decided to give caregivers a try, “but only temporarily” she told us. Her caregiver trial took place during the pandemic, and this was a relief to the family as we hadn’t been able to visit her. First, she didn’t’ think she needed them, but then she was willing to try them. Once she got a regular daytime caregiver that she enjoyed she still refused to have one at night, which was worrisome to me as I knew she was at higher risk for falls at night. However, as I’ve mentioned, just because I have my doctorate degree and get paid to do this for other people does NOT mean my Grandmother needs or wants to listen to me. However, in the end, and most importantly – on her own terms – my Grandma decided having 24/7 caregivers was the best option for her safety.

This can be expensive for many, and my Grandmother was not happy about the price tag. For once, however, she listened to the family when we reminded her that she can’t take her money with her when she dies. We want her to spend it on herself to improve her quality of life now. This brings up another question I encourage people to consider, have you budgeted for the unexpected with aging? Many people end up living longer than they think they would for various reasons. Consider what types of resources you have, and not just financially. Do you have a family, community and/or friends that can assist with things you might need if you become suddenly ill or have an accident?

Aging in place draws upon a myriad of supports – environmental, social, financial and emotional. Have you had those conversations for yourself and your loved ones?
I’m still having them with my Grandma, and they change daily, especially during the pandemic. I hope you’ll share your thoughts and the conversations you’re having so we can learn from each other and empower one another.

One Response

Leave a Reply

Your email address will not be published. Required fields are marked *