Aging in Place. Has anyone successfully managed to allow their parents to remain in their own home?

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I have been reading a lot about the "Aging in Place" movement. The research seems to confirm that his healthier and less traumatic for seniors, if it can be managed. It is also more cost effective especially since assissted living centers are now charging between 2,500 and 5,000/month (and, frankly, I cannot see the value in these facilities). The problem is, I cannot find too much specific information about how this is accomplished.

I would appreciate hearing from anyone who has managed to to this and, if so, could you please share your experiences? how do you organize care? does Medicare or Medicaid support these programs? did you make modifications to the home? how mobile is your parent?
thanks,
Lilli

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Successfully for them, sure, but to the caregiver, it can be very draining. I think you should start gathering information about different programs, to decide what is the best care.

Medicare alone may not cover much. My mother and I decided on Secure Horizons to pick up where Medicare falls short. Basically, Medicare pays Secure Horizons (which, I believe, is Pacificare) to cover the medical costs.

She has quite a bit of coverage, but not out-of-home care, unfortunately. It does cover hospital care and short-term convalescent care. They do provide some basics, like wheelcahairs (that don't fit through the doorways). As far as home modifications, that is solely up to you, unfortunately.

The type of care, your parent needs, can only be determined by what is best for both YOU and them. I stress the word "you" because it can be very draining and you really have to come first and this is a selfless act, if nothing else.

I think that's what it really boils down to. How old is your parent? Are they in the "last stages" or are they somewhat healthy with one or two ailments? The diseases, my mother has, drag on for years and that isn't something to take lightly. You give up your entire life for long-term care. When it's finally "over", you may find yourself alone and aging, yourself. Family, friends and the medical profession forget about the caregiver. You're left there to pick up the pieces.


My mother has multiple sclerosis, congestive heart failure, osteoporosis, arthritis and spondilosis (Good god, I could be missing something). Considering how bad she is, she can move around in a wheelchair, but she has been in and out of the hospital too many times to count. She broke her foot and that required me to literally transfer her everywhere, with my bad back.
I've been doing this seven years (longer if you count certain things from chilhood), following my father's death. I am literally her nurse and parent. To list all of what she needs, could take days, as it would for any long-term caregiver. Bedsores, cleaning up "accidents" and becomming a personal taxi, are to name just a few.

Depending upon the amount of care, your parent requires, I'd even check into a reverse mortgage (if your parent owns or is close to owning their home), to help pay for outside care. What you may not see as a "value" now, you may see it different, after a couple of years. Just keep every possible option open. In my persoonal experience, I am starting to see other options and wished I had went that route.
AliceCat: I am both in awe of and humbled by you. Thank you so much for taking the time to respond...it means so much to me to get a bird's-eye-view from you and others who have tried in-home, independent, care.

My mom has osteop., heart issues, and Parkinson's. Like your Mom, she does well considering. She now lives independently with lots of help from us. It does take a lot of my time, but she is much happier and healthier in her own home. She does not want to live with family, so this narrows my options a bit.

My thought is (and this may be naive) that instead of using her savings at an assisted living center, that really provides little "customized" care (ie: she would not be able to get to a cafeteria to eat, etc.), she could use those funds to pay for in-home care combined with what we are already doing for her. My hope is that this would allow her to stay in her home, we would have help, and her funds would last longer. She does not need 24hr. care right now so that 2,500 to 5,000 at assist. living could pay for a lot of individualized care. Not having gone through with this plan, I may be oversimplifying things....on the other hand there is no harm in "creative brainstorming."

I agree, I am trying to keep my options opened and think outside the box (heaven knows the system is all about "boxes.") I hate that there are so few humane housing options for seniors right now. I may take a look at models in Europe to see if there is something that I am missing.

Thanks again...sending you good wishes,
Lilli

P. S.: You may already know this: Medicare pays for one mobility device (ie: scooter, motorized chair - some come with lifts in the seat) and will also pay for part of the mechanism in a lift lounge chair. The scooters and chairs get through the doors easier and are easy to maneuver. The medical supply company really helped with the paper work, etc.
Not to throw a monkey wrench in anything but I got the bill for my moms in home care services and for 2 weeks the bill is $1,900.00. For the first week it was $963.00. It's still cheaper than a facility but I know with medical what they do is consider her income and pay the balance and give her $30.00 misc. What can a person do with $30.00 I ask.

About those scooters, I'd been trying to get my mom to get one of those for the longest but she kept saying she didn't want one even though everytime she saw someone in one she'd say "I don't want one of those". Tried to do the same thing with a wheelchair so it would be easier than walking a foot a minute when we take her out, but again no she didn't want it. Although when I'd take her to the market she'd ride those little motorized baskets. She'd run into everyone towards the end and then one time she ran into an entire display and complained because someone at the store had the audacity to put a display so far out!!!! Can you believe that I still laugh at that one.

But all in all she seems to be content being at home. In the beginning after her stroke she would say that she wanted to go somewhere if just for a while. Ke't wanting to go to a rehab center. But she can olny be transferred there from the Hospital so that was out. When she wanted to go I went and investigated a few facilities. They were just too sad for me though and I couldn't see putting her there. Now I feel differently. If she was there I'd be able to go see her without seeing those volchers who live in her house. But I would be at the facility all the time and they would have no choice to treat my mom with dignity.

Keep me posted on what you do as I'll keep you posted on my situation.

Again I'm so glad I found this site. It's really been a help for me.
Pamela,
I am going through the same thought process: what is best for mom vs. what is the best and most suitable housing. I am not ruling out a facility as, at some point in the future, she may need that level of care. But, for now, I would like to help keep her in her home as long as possible. So little information out there about how to do this!

Right now Mom does not need 24hr. care...so I am hoping that in the future I can supplement the time I devote to her with paid caregivers who are trained to do the things that I am not.

My mom resisted chairs, walkers, and even getting one of those handicapped parking stickers for the longest time. But time IS on your side. As her mobility issues became more pronounced she agreed to a walker to help with her with balance. (I reminded her that the walker was better than ending up in the hospital with a broken hip) I also got her a bathtub seat and handles, etc. which she thought looked "awful" in her bathroom...but she now sees how much easier it is to bathe.

The electric chair came along after she injured her foot. She gave the salesman such a hard time. So I told her that she could pick out any color then I rode in it myself and did "wheelies" to show her how much fun it could be...whatever works, right? (Medicare does pay for one morotorized mobility device if you have not already used this benefit) She also uses a motorized lift lounge chair...this has been a Godsend...bless the person who invented it! (Medicare pays for part of the mechanism..apx. $300.)

Something I found extremely useful is a "transport chair." It is not a clunky wheel chair but someone needs to push it. It is very light weight (14lbs.) and collapseable so I can easily get it into the car. It is also really cute with plaid seats and metallic paint. Mine cost about $175.00. (It is by the DRIVE company, called "Fly-Lite") I take this along shopping and for some reason Mom does not resist because it does not look like a wheel chair.

Seniors resist things because, as they lose mobility, etc. they also lose dignity. If I put myself in their shoes I would feel the same way. This country is not kind to seniors...they would rather that they disappear. I just noticed recently that I see so few seniors when I am out and about. When I was little it was much different...all age groups interacted. How said that we now have separate neighborhoods for single people, young marrieds with children, and the retired. I think so much of what we term dementia comes from social deprivation.

Anyway, back to the subject: If anyone has more success stories of allowing parents to stay in their homes, I would love to hear from you. All suggestions are helpful, since I am just beginning this investigation.
It depends on how much care your parent needs and their mobility. My Mom is 87, can still drive, and has full cognitive thinking. She pays her own bills, drives, etc. So that I can have a life, we hired a caregiver company to come in 4 hours a day/5 days a week. You can choose however many hours and the cost depends greatly on what part of the country you live in. Medicare covers a lot of the cost and she has a supplemental that then matches what it would cost to stay in assisted living. The company I chose is right at home They are the 3rd largest in the nation. The caregiver they match to your parents' personalities will do light housekeeping, drive your mom to doctor visits, grocery shopping, read to her, provide companionship. They are there on a timely basis as they must call from the customer's phone to let their homebase know they have arrived. If Right at Home doesn't get a call within 7 minutes of when the caregiver is to get there, they will call you and get someone else to your home immediately.

Our cost in the East Texas area is $12-14/hour.

We did modify my mom's home slightly to avoid a step that she trips on consistently. We merely did this by moving furniture from one room to another. Also, we put a banister down the hallway so if she tripped she would have something to grab. In the bathroom, we put grip bars in front of the commode so she could pull herself up. I will be happy to answer more questions if you have them.
My husband and I made the move from the east coast to the west to take care of my in-laws in their condo. We were the only ones in his family with the ability to do so - and felt that his parents deserved the right to spend the remainder of their years in dignity in their own home. They could not afford assisted living either - it is just so outrageously expensive for most of the elderly to afford.

One thing we have found, which makes things difficult, is that there really is no outside assistance (my husband's brother and sister live back east in other states, but do make trips here once a year) from any organizations...with the exception of one situation - if either of them were to be hospitalized...then there would be home health care afterward for a period of maybe six weeks. It is indeed a shame that that is the case, as there are many of us from the 'sandwich generation' with both parents and children to look after.

My husband and I have managed with great difficulty - we have the rails and the seat in the shower, the wheelchair and walker. His Mom passed away in our second year here, and in the past six months now, his Dad has gone down hill as his heart is giving out. We finally got him to use the walker in the house, but he will not use it when he goes out...and, he states, the wheelchair is out of the question - so my husband patiently walks with him when he goes to the doctor, etc. Other than the doctors, the only other thing his Dad enjoys is going to his favorite casino...and while we do not want to constantly spend our time in casinos, we do this for him. We think it's important to let him enjoy the remainder of the time he has left.

And, while insurance covers some things, it is a shame there do not appear to be any organizations - at least here in Nevada - that offer assistance to family caregivers...it is a sad commentary on the way we treat not only our elderly, but the forgotten family members who care for them at great mental, physical and financial cost.
cherryle: thank you for your comments and advice. Mom is in her 80s too...and up until a few years ago was driving, etc. When it all became too much for her, and the sib didn't want to be involved, she moved near me and insisted on her own place. She is very happy there. We do have a caregiver (similar company as you mentioned above: charge $20./hr) that comes once a month - as you wrote, it gives me a little break.

I do have a few more questions if you do not mind:
1) I was not aware that Medicare payed for any in-home care unless it was after a hospital stay or if you we needed to transition to Medicaid...could you please tell me how it works, or if it is a program, which one?
2) where did you attach the bars in front of the commode? Mom's faces a wall with not much room...but this could really help her. (she has no room on the sides.)

thanks,
Lilli
ndolan: I could not agree more with your statement: "his parents deserved the right to spend the remainder of their years in dignity in their own home" I know that this arrangement is not always possible, because of medical/safety issues, but I would like to try keeping Mom in her home for as long as possible. I think that her mental health will be much better if she can stay in familiar surroundings and have more control over her life. Her mind is so sharp, I wish her physical health was too!

My heart breaks for the way we treat seniors in this country...I just think the government wants to warehouse them or count on family care until they die and, as the character Scrooge says, "decrease the surface population."

Mom didn't want any walking aids for a long while. She said she felt better holding on to my arm. But, you should see the grumpy looks in doctor's offices when I am helping her without a walker or chair...I feel like telling them, "walk in my shoes for awhile." (and by the way, why don't doctors offices have lower exam tables for elderly or less mobile patients?)

Now she is better about using the walker or I push the transport chair.

thanks for your comments...keep in touch
Lilli
Oh Lilli, I am a lot like you, just trying to figure out what's best for everyone. I only just found this board after years of feeling so very alone. I find it helps a little to know that there are others that feel the same way that I do.
Sometimes I find it hard to believe that there are daughters out there that have these great relationships with their mothers and I find myself jealous of them. So, I guess, it makes me more prone to be a bit negative about the caregiving situation, as a reflection of my own caregiving experience.
All I can say is best of luck to you and I hope you figure things out, to give you some piece of mind. :)

You know, I had been trying to get her insurance to get her a scooter and they won't cover it. I can't even get the crappy insurance to cover catheters! The catheter thing is just wrong on the insurance part. She's had sepsis from these filthy things.

Pamela, my mother is the same darn way about scooters and wheelchairs.
Lilli: My mom's "pull-up strap" is installed in front of her on cabinet doors. Your situation would be even better because it would be a sturdy wall. You can buy at Auto Zone the old rubber/leather straps that used to come on cars long ago. It is the perfect length to screw it into the wall at each end of the strap. Also, what would work would be a handicapped bar made for bathtubs, etc.

My mom's husband had a special kind of insurance that pays for their care; however, your supplemental insurance to Medicare will pay a portion of the caregiver service. Check with Medicare on that.

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