Aging in Place at Home or with Family

Most adults would prefer to age in place - that is, remain in their home of choice as long as possible. In fact, 90 percent of adults over the age of 65 report that they would prefer to stay in their current residence as they age. One-third of American households are home to one or more residents 60 years of age or older.

The biggest challenge to remaining in the home is the need for long-term care services. Other issues are important as well such as social support, receiving medical care, maintaining proper nutrition and avoiding the risk of falling. These issues are discussed in more detail in other articles on this website. We will focus here on the challenge of caregiving as an issue for aging in place.

Care Provided By Family or Others at Home

Care in the home provided by a spouse or a child is the most common form of long term care in this country. About 73% of all long term care is provided in the home environment typically by caregivers who receive no compensation for their labor.

The supervision of care or hands-on care from informal caregivers is limited to activities that don't require a skilled background. Unfortunately, lifting, bathing, dressing, diapering, toileting and helping with walking can be a challenge to family caregivers because they don't have the proper tools or are not trained in this area. Or the children of elderly care recipients may have difficulty dealing with cleaning messy bottoms or bathing their parents. Another problem may be handling errant behavior from dementia or depression.

Because of this, some caregivers bring in paid providers to help with lifting, walking, bathing, incontinence, toileting, dressing and supervision.

Another home care arrangement is for family members, who are not living close by or who are employed fulltime, to become coordinators of care and to offer only limited, personal, hands-on care. These people might hire a care manager to act on their behalf.

Home care is almost always provided in the home of the recipient or the home of a family member or friend. Home care may under certain circumstances be offered in other settings such as group homes or independent retirement communities. Below are some of the activities provided by or supervised by family caregivers.

• Help with walking, lifting and bathing
• Help with using the bathroom and with incontinence
• Providing pain management
• Preventing unsafe behavior and preventing wandering
• Providing comfort and assurance or arranging for professional counseling
• Feeding
• Answering the phone
• Making arrangements for therapy, meeting medical needs and doctors' appointments
• Providing meals
• Maintaining the household
• Shopping and running errands
• Providing transportation
• Administering medications
• Managing money and paying bills
• Doing the laundry
• Attending to personal hygiene and personal grooming
• Writing letters or notes
• Making repairs to the home, maintaining a yard and removing snow

Communal Arrangements for Aging in Place

In large urban areas where neighboring families have lived together in an apartment complex and grown old together, there is a possibility for residents in the complex to band together and watch out for each other. This might also include limited caregiving services for neighbors. But it more likely would include helping neighbors with such things as light housekeeping, shopping, companionship, medication reminders and transportation.

Another arrangement popular in Europe is for the elderly to share an apartment or home together and provide for each other's needs. In Europe there are agencies that bring together interested elderly parties who desire to share living arrangements. We're not aware of these services in the United States, but the trend will probably be to provide the same living arrangements here. There are currently all kinds of agencies providing roommate sharing service around the country so it is only a matter of time before some of these services start specializing in bringing together elderly people who can provide support for each other.

Formalized Communal Arrangements--Shared Living Residence

A shared living residence provides private rooms and shared kitchen and living areas in a family home environment for 3 to 10 older people who share rental expenses and homemaking activities.

A shared living residence may be owned or sponsored by a community organization and rented to residents. Additional supportive and household assistance for residents will vary according to the independence level of the residents. No government licensure or certification is required unless personal care is charged for or provided by the sponsoring organization. Charges or rents may be priced at market rates or subsidized with government assistance.