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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I'm not sure if it's a success for the seniors to remain in their home if they are suffering and at risk. My parents are still in theirs and so far, it's okay. I've been there for the last couple of years, but they are still able to manage pretty independently, though the costs for home maintenance and repairs are going up. I know that eventually, it won't make sense to stay there. There is a lot of land and requires lots of upkeep. I don't think it will be feasible to stay there, even though things are on one level. Still, if they need easy access to bathroom and kitchen, wide hallways, etc., it's not likely to work for them.
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My parents [90's] were doing ok aging in place in their 3-story home UNTIL the time came when they were having issues trying to get up and down the stairs. And UNTIL my Mom refused to let caregivers or house cleaners come in to help her.

So I helped as much as I could but I never moved in, gosh I was a senior citizen myself with my own age decline issues, but my parents still viewed me as some whippersnapper who could still do everything :P I must have aged 20 years in those past 7 years of dealing with my parents who refused to move and live in an elder friendly environment.... why on earth are you still in that house???

As usual it was a medical crises that changed everything. Mom passed and Dad accepted caregivers but having 24/hour caregivers was costing him $20k a month. Dad decided to move to Independent/Assisted Living for $4k a month and brought along his caregivers but shorten their days and hours to $2k a month. Still was cheaper then living at home.
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So well put. My parents have been aging in place. My father was able to stay in his house until his death. My mother wants to do the same. I've been with them for 6.5 years and feel 20 years older than I did when I started. I look it, too.
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I have been supporting my mother's decision to age in place for more than 16 years. She has resisted every attempt to make things easier. She has had two knee replacements but wouldn't do the rehab. Needed hip replacement but wouldn't. Then she fell and broke the "good" hip. She has an ostomy from rectal cancer 25 years ago. She has severe to profound hearing loss which could have been treated and stopped progressing with hearing aides which she refusex to wear. I hurt my back helping her in and out of wheelchairs whenever she left the house.She finally started using a w a lker after breaking her hip. She broke her arm and it didnt set right so she cant put in the hearing aide she finally wants when its just about too late. I retired early in exhaustion and now need back surgery. She just moved into assisted living after a rehab stay after a bowel obstruction caused by ignoring her doctors instructions to stop irrigation of her colostomy. I have been called by lifeline at 2 am more times than i can count to find my mother covered in excrement when her bag burst in the night and she had removed the depends for comfort. She has fired or alienated homecare workers and now shes working on getting herself kicked out of AL for bad behavior. She has been assessed for dementia but instead was pretty much assessed as stubborn and narcissistic. She is developing some paranoia now. She has aged in place and i have been an idiot
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deb: Thank you for your eloquent post. In all honesty, there is a big gulf right now between what I think is best and my skill level. I do not come from a medical background at all (wish I did) so every event is harrowing for me right now. But it all comes back to the same question: what is best for Mom. And for right now, it is best for her to be in her home. (btw, I appreciate the very specific information...so hard to find "been-there-done-that" advice online. The roll-in shower is a great idea.)

My sib has quietly bowed out - more like buried head in sand. So I help Mom make most of the hard decisions...not sure which is worse family who butts in all the time or one that is absent.
Anyway, I feel overwhelmed most of the time...and, as many have experienced on this site, my friends have taken a leave of absence until this period in my life is over...frankly, I don't know if I have time to socialize anyway. Regardless, I feel that it is well worth the sacrifice.

Thanks to all who have posted to my query...it is nice to hear about options and pitfalls. You all do not realize how empowering it is to have this support.
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I think the idea of allowing elders to stay in their home is the very best for most. Unfortunately the limiting factor is usually finances and personality.

My mom lived independently until 2 years ago. At that time she began falling (advanced Parkinson's) and could no longer stay alone. To hire a care giver 24/7 in her condo would have depleted her finances in a very short time. The alternative was to have her move in with me and my husband. She now has someone with her while I work and we hire addition hours when we want to get out. She is unable to transfer herself at this time, so it is really 24/7 care.

We remodeled the first floor bedroom and bath. Built a ramp off the sundeck. Alot of resouces online, but be careful some of these are lots of money. If you are serious about long term the bathroom should have a roll in shower.

At this pace finances will last a few more years but she will most likely deplete her funds and I will have to quit work or work to pay a caregiver.

Like most on this site, my only sibling bailed early. His expectations were for me to quit my job and save his inheritance.

While I really like this site and appreciate the sharing and support I think you should realize that at least some families do handle caregiving together and it works. Unfortunately those people don't usually go to the internet for support. They don't need to.

It sounds like at least right now your family is working together and looking ahead. 2 factors that mine never had.

For example, if your mom will accept help now you may be able to postpone a crisis. My mom knew she was living over the edge but refused to make her condo more fall proof. The rugs were more important. One fall later she lost all of her independence.

Back to caregivers. I know many will respond with bad experiences, but it is worth a try.

I read some books about hiring your own help, paperwork, taxes etc. I then went to the local hospital, churches, etc and posted an ad. I interviewed and hired a great woman who has been here now 2 years.

As far as I know medicare does not help with any of these expenses. Medicare is for acute, short term help. If some one has no financial resources every state has a form of medical assistance. But this is very limited and not user friendly to say the least.

I have been a practiceing RN for thirty years (wow I feel old). I have arranged home care, hospice and worked with many patients as their families tried to provide the best care for them.
For my mom I saw 2 lawyers and was counseled by a pastor. I know our situation is much much better than what many on have on their plate.

Yet being responsible for a parent is still a major life event. It can happen at any moment and last for decades. God's grace to you and your family as you start this journey.
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I am currently the primary caregiver for my 93yr old mother. Until May of last year when my sister was diagnosed with Lymphoma and needed surgery and chemo, she and I shared this responsibility. Mom lives in my home with my husband and I. She has severe Artial Stenosis, a colostomy bag due to an Ileostomy more than 50 yrs ago, and suffers from the beginning stages of Dementia. Two and a half yrs ago she fell and fractured her right shoulder. Because of severe osteoporosis, the bone was not able to be set or pinned and was left to heal on its own. Within a couple of days of the fall she experienced a stroke, (we are thinking due to the fall/shock of the broken shoulder) and now has muscle atrophy in the right hand, she will need surgery the to release the nails from digging into the palm of her hand. It is easy to see that she is certainly not able to care for herself at all. We get no financial assistance, but we do have a semi-electric bed (which Medicare paid for)to make it easier to move her, but she needs to be lifted, walked, and laid down when she gets in and out of bed. We purchased a lift chair for her living room to make it easier for us. I don't know if everything we do for her is how outside medical personnel would be doing it, but we are doing it to the best of our ability. I am sure that if the decision had been made to place her in a facility rather than keep her home, she would not be here today. The depression alone of being away from us would have done her in.
My husband, although not able to bathe and dress her, helps to lift her, get her in and out of her transport chair when there are appts. and make meals for the three of us if I am busy with her. I couldn't ask for a more supportive person. It is overwhelming, it is tiring, and sometimes so emotional that I ask myself, "why"? But then I look at her sitting in HER living room, visiting with her great grandchildren in the surroundings that are HER personal surroundings and answer, "because it was right".
I am not saying that it is right for everyone, but it was the decision we needed to make. It is a promise I will not go back on and with my husband by my side and the support of this community, I know it is something I will continue to do until she no longer needs me.
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Cat: ...so well said...thank you.

I have never accepted that there is only one way of doing things (in fact, it makes me suspicious). I know having my mom in a facility right now might make my life easier...but, for now, it is not what is best for her.

The reason that "aging in place" is not at the forefront of our nation's psyche is because no one can make a profit off the seniors who choose to stay in their homes. (It is also the reason why the powers that be do not want to reimburse family caregivers.) As I mentioned above, Medicare staff just want to inundate you with their "services" and facilities are not at all customized...Mom would get very little from either right now.

Because I am such a novice at this, I just put myself in my Mother's shoes and think about how I would like to live out my final days. As you mentioned, if a NH can figure out how to make safety modification to their client's environment, so can I. And I will hire help whenever I need it. I realize that I cannot do it all or Mom may need a differnt placement in the future...but, for now, all I can do is my best.

I would certainly appreciate any advice or comments you have about this movement. I agree, boomers will not be taking kindly to the limited choices we now have for our parents. Perhaps it will start a movement for alternatives...I am also interested in some of the grassroots movements: such as people who come together, communally, and pool their resources so that they can customize and have control over their care. In this way, they do not have to depend on relatives or the government....such a radical idea - I love it!
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Lilliput:

There is an aging in place movement and many states are considering PACE programs. You are wise to begin researching - dear lindsey is so king to post the articles on this board. You can also find alot of information on modifications to the home and even tips and tricks others use to accomplish it. Not everything requires the services of LTC or home health agencies. Beware of non-medical agencies that offer services like "remembering and opening mail". Instead, you might want to start with talking to a geriatrician who is involved with the movement.

Concretechange.org is a group that deals with universal design and has good links and advice. It was started by a woman who found handicapped accessiblity was the key for her own quality of life.

I can only add that I have found in caregiving other than the usual learning curve and realities of dealing with help & medical , personal assistance the only real hurdle is attitude. If you don't let the LTC industry sell you on 'the only option', and get along well with your parents, then you will be amazed at how many others are also out there. Safety is a concern of course, but usually that can be addressed in many ways, including simple modifications, up to having a companion. A person can fall at a nursing home just as easily as at home - depends on how much attention is paid and thought given to prevention.

I will come back to this board tomorrow with some other resource links. Good for you asking the question - it is the same one an entire generation of baby boomers will be asking for themselves shortly.

Cat
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Sand: A facility may become necessary for my mother in the future especially for medical/safety reasons - or for basically anything I or in-home care cannot handle. (and I pray that I can figure out my limitations when that time comes.)
However, for the near future, I am hoping that mom can stay in her home where she feels safe and independent. Assisted living is not a possibility - even now...mostly because they require that residents be able to get to a "cafeteria." Also there is very little "assisted" in assisted living...everything she would need is "extra."
I wish I had your experiences with long-term care facilities. I have had elderly relatives fall out of bed, have mysterious bruises appear, be given incorrect meds., and end up sitting in soiled clothing for hours - and these were the "nice" places!

It is a blessing that you found a great placement for your mom...thanks for your comments!
Lilli

Dear AC Editor: thank you for the great articles. I was happy to see that we are doing most things on the list...however, a few escaped my notice...so it was great to have the checklists.

Question: I have had a difficult time finding old-timey "land-line" telephones (the princess style with the numbers on the handset)...ones with big numbers would even be better...any ideas?
I am also looking for a lifeline-type company that allows the customer to speak directly into the device...I read about them somewhere, but cannot find the post
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