Fifteen years ago, we moved closer to my parents, since they were in their eighties at the time and we anticipated that they would need help eventually. Fast forward ten years, my Dad was going through cancer treatment at 90 y.o. and my Mom fell down the stairs in their home, landing in the hospital and then a Rehab facility, That evening, we moved my Dad into our home with all of his things. It became instantly 1000% easier to care for him in our home, and he was getting care 24x7. There were no more falls or emergencies. Mom remained in rehab for five more weeks, during which time my Dad passed away. He "knew" and was happy to be in our home with us and being taken care of. Mom came home from rehab a week later and moved in with us. We tackled the process of cleaning out their house over the next year, then painting, repairing and prepping the house for sale. The house was sold, and we brought Mom's favorite furniture pieces and bedroom and re-did our entire upstairs, making it 'her own'. That was 2017. Mom's incontinence issues which she hid for years became immediately apparent and we rallied to get her home health care assistance two days a week. She has been diagnosed with dementia, and has been on medication for two years for that. She has gotten progressively worse, but nothing we haven't been able to deal with effectively. I promised my parents years ago that I would never put them in 'a facility' as long as I was able to care for them, and I intend to keep my word. We have adjusted our life to care for my Mom, as much as it tries our patience some days, but I know she would not still be here had she been placed in assisted care or a nursing home. She is here with us, she has around the clock care and she is in her comfort zone, surrounded by her family and her granddogs, and very content, in spite of her decline in her quality of life due to her dementia. I try to give her all the things that comfort her, we spend time looking through family photo albums, doing small projects together and sitting outside when the weather permits. Yes, it is a sacrifice, but my parents always did so much for me, I feel this is the very least I can do. I treasure our time with my Mom, and am grateful for the time we are able to spend together. I know there will come a time when these days will no longer be possible due to her cognitive decline, so I embrace this time while I have it. While it can be frustrating some days, I remind myself that she is still my Mom, plagued with the horrible disease of dementia that confuses her as well, and has her reaching out to me for help. She still has very lucid, super-aware days and then there are some days when she just has difficulty functioning. We try to focus on the good days and just comfort her as much as possible on the not-so-good days. This is part of life, and I consider it an honor to take care of my Mom every day. It is certainly not the easiest choice, but it is the only choice for me.
My mother is 89yo, in very good physical health, and her cognitive decline is only considered "age-related" meaning she does not have a dementia diagnosis, but does have considerable decline compared to 10, 5 even 1 year ago. Her short term memory is increasingly poor, but she has no personality changes that make her irritable, paranoid or delusional.
Six years ago, at my suggestion, my mom moved near me and lives in her own home 1 block away from where I live with my bf (he is fully invested and enjoys my mom and we do not have kids). We picked a house which met most future mobility needs, and modified things we needed: the biggest reno was removing a tub and put in a walk in shower. She gladly complies with a fall detection button, and multiple smart devices (video doorbell, Alexa, smart thermostat, and smart bulbs) to keep her safe, support her memory, and allow me to check on her remotely. When she was driving, I had a tracker on her phone to know when she left home and returned (like parents use for their teens).
I consider my mom to be successful living in her own home with support. She cooks for herself - if I keep her stocked with her familiar packaged foods, and does her own ADLs and laundry. I do everything else from taxes to scheduling hair and medical appointments, routine maintenance and cleaning of her home (I have a robotvac at her home and her cleaning lady comes only every few months these COVID days), and larger projects on her home and yard. Even her pet (her cat recently died and we got her a kitten that can be challengng) us under my care. I have a list I share with friends that has weekly, monthly, quarterly, semi annual and annual things I do for her. My mom is in decent health and my work is intense - I call her daily, it is a rare day that I do not visit her, I have not taken a vacation in 4 years.
In this time of COVID, my bf and I ensure we are socially isolated so I can be around her. I am her main social connection and I drive her around town at least once a week, we take walks around the neighborhood a few times a week, and my bf and I have family dinner 1-3 times a week with her. My mom is healthy, happy and safe and I truly enjoy being the person to support her. I suggested that she come to live near me because it was practical, but I did not expect to enjoy the work (yes, it is work) because my mom and I never got along when I was a kid or even as an adult - until now.
When she first moved near me I was working full time. Then, the transition was simply too much for me; I left my job and tightened my belt. As I restructured my life for her my professional goals changed, and I worked pt as a researcher in aging care which was a great work/life balance before COVID changed a lot of things.
My mom has healthy financial resources, but Assistend Living facilities are very expensive, and it would have been intense work to downsize her to a tiny apartment. My mom's cost of living is a faction of the cost of AL, even after she pays me for my work as her pt Geriatric Care Manager. But, it does take money for people to age in their home. My mom did not "age in her home" she moved near to me. We bought a recently renovated home with new appliances, HVAC, and insulated windows/doors. Then, we modified things to ensure she can live there safely for as long as possible. One thing I tell everyone to remember is, if your parents are living in the home you grew up in, everything may be old and you need to financially and physically plan for things like a new AC, a new roof. Be mindful that learning a new appliances when the old ones go out can be very challenging.
I am committed to keeping my mom safe, healthy and happy. I do a lot for her (A LOT), and will keep her in her home as long as I can with hired assistance and sleeping at her home when that need comes. But, if I cannot keep her safe, healthy and happy in her home, she and I know there is a continuum of care facility a few blocks away.
Living in a retirement community in Independent Living means that you are FREE from the favors of friends, dependence on your adult children, expense, risks, and hassles of hired help, burden of managing cooking, cleaning, transportation with the diminished physical capacity that usually accompanies aging, and so much more. You can get back in charge of your own life. That's true independence.
Aging in place in your single family home is a very, very dependent lifestyle.
I think it matters how close they are to you. At some point the kindness of friends and neighbors isn't enough. My moms support system was great, but the dementia reached a point that even in her small town it wasnt safe for her to drive. I Went down every 6wks or so to help sort the bill's, or take her to dr apt, , and called daily to help her understand mail. But I went on vacation and my sister went down after about 3 weeks and things had fallen apart. She had called neighbors in the middle of the night.
She lived 200 miles from me, and I couldn't imagine trying to manage caregivers long distance, and she doesnt realize the extent of her cognitive decline, so I don't think she would be receptive to them anyway.
I think parents are nearby, and the help they need is more mobility or med management, sure. You could come over to help maybe with showers and stock their fridge or bring over a meal. You could hire a caregiver to check in for a few hours, or to sit in the house overnight.
But bedbound, or more medical needs or dementia? Demanding job that doesn't allow for you to leave at a moment's notice? Uncoorperative with help. Then no.
I live in a rural area where most people are farmers. They would nail themselves to the floor before risking inheritance or farmland to pay for care. My husband and I planned well. Even have paid all along for Long Time Care insurance. It pays some but not all. Inflation takes a big hit. Adequate cash savings also. Regardless we went wrong somewhere because my grow children do BARELY enough to keep us home so they will not loose any inheritance. They don't make a secret of their greed. Not very gracefully done either. Surprise kiddos! We will hire it all done with the best money can buy!! Then will check ourselves in the very best assisted living home. Just sign me off as hurt and sad.
Sounds like you “planned so well” to burden your children by Expecting them to care for you at home! It sure sounds that way because someone who planned so well otherwise wouldn’t have a problem with their children doing the bare minimum. Didn’t you raise your children to be grown adults who are productive members of society? Who have jobs and families? If you planned so well, you shouldn’t need or expect them to do anything for you.
What IS a successful final outcome of a decision to "age in place"?
Thinking about these definitions has a serious point, which is discussed in detail in Atul Gawande's essential-reading book "Being Mortal."
Whose wellbeing and welfare is the concern? If you consider aging in place unrealistic because your parent's frailty is making your hair stand on end and your nails are bitten to the quick, it's your nerves at risk, not your parent.
We have a lovely client (I think he's just managed to get rid of us, actually). He is 93. He served in submarines as a younger man. He lives alone. His house is *immaculate.* He deals with all personal care, domestic tasks and meal preparation independently, apart from occasional help with heavier tasks such as changing his bedlinen (large double bed) and mowing his lawn. I spent four or five morning calls with him, and two or three evenings, monitoring and supporting his routines. My heart was in my mouth, observing this frail elderly man stepping into his bath, showering head to foot (he got shampoo in his eyes, that was the only moment I had to assist by passing him a flannel), stepping out and drying himself... as I say, my heart was in my mouth. But he didn't put a foot wrong, not once. The only reason we were there is that he had had a fall one night (not injured, just stuck) and because he doesn't - and won't, grrr! - wear a falls alarm he wasn't found till late the next morning when his family member visited. His children duly tore their hair out and insisted that he allow home visits. Our short-term reablement service was the agreed compromise. He had a point to prove, that he was safe living alone, and he proved it.
He is quite unusual, by the way, in being willing to prove his point, with good grace and very sweet appreciation of our help. Many seniors resent the intrusion when they don't want us there.
So. What will be "success" for this gentleman, pursuing his wish to age in place?
"success" for your lovely Gentleman could be whatever he values couldn't it? What a spirit - keep on keeping on (until you really can't). Good on him!
As we age, it maybe still driving safely, or gardening. Or maybe catching a taxi safely & being able to arrange a gardener. It may be making decisions about what to do with your day. Or just which window to sit next to.
From the other end...
The elderly man I met this week, lives in his house & values this fact very highly. But his 24/7 needs have outstripped his wife/carer's ability & he is now hoping his son & wife move in to assist also. He asks to be spoon fed, despite having two working hands. Is this successful aging in place? If *living in his own home* is the ONLY measure - maybe it is.
What if your dog kept biting you & all visitors, making messes & walking it through the house, chewed up your furniture, kept barking all night, escaping & running out onto the road? What if your dog was 100+kg & required 3 people to turn & lift with a device, required daily feeding by teaspoons, required frequent enemas?
As notgoodenough and NobodyGetsIt say, "it depends" and "no one-size fits all". Clearly there are examples posted of those who managed to do it. I've known/read of others, but these days it isn't likely the "norm", partly due to the tsunami of dementia. So many factors need to be considered. For starters:
What are the physical and mental conditions of the elders? What is the layout and condition of the home? What assets are there available for help and care-givers? What family is available AND willing to help and care-give? What other resources are available? Is there a friend network and/or socialization activities available?
If the home is "safe" and the condition of the elders isn't compromised, it's a start. With some minimal help, they can likely stay. If there are many stairs or other hazards and physical or cognitive issues, then one has to consider these in the "plan." If there are not enough assets to hire help and care-givers, how can they stay in their own home if they need help and/or care? Then again, how can they afford a facility? Despite what some think, 24/7 care in home is (most of the time) MUCH more expensive than a facility (and you need to factor in cost of the home, utils, food, etc with the cost of care.)
Although many families often want to help their parents age at home, there are constraints - logistics (where each lives), ages (are they in work/childrearing ages), capabilities (personally I could not support my mother's weight, so that was a gate), knowledge (some aging issues require more than just helping care for the home and making meals!)
Some seniors are quite capable of staying safely in their home and combining taking care of it and themselves with minimal help. Others are not.
My mother lived alone in her condo to just over 90. Shortly after/around that time dementia crept in, so we had to make plans. The first was to bring in help, but 1 hr/day didn't last 2 months and she refused to let them in. So, she was probably 93 when we moved her. I had already taken over finances, and helped with transport for groceries, appts, etc when we had to take the car away, but she wasn't capable of being alone for long. It was also draining for me, as it was 1.5 hr each way plus whatever task was at hand.
Days before the move to MC she managed to injure her leg and develop cellulitis. She didn't have enough sense to understand how bad the injury was or to seek help - she only mentioned bruising her leg to a neighbor, who told me. If it weren't for the planned move, this could have quickly killed her!
My place would not have worked. Repairs are half done and still on hold. Full stairs to get in/out, which she couldn't do. No way to handicap the bathrooms (too small.) As noted, I can't support her weight. So, staying in her own place was not an option, nor was moving to my place. Bros? One is abusive and not local, wouldn't want her there! The other is still working and doesn't really fully comprehend what care is needed and also tends to be a bit scatter-brained.
So, I would think a person would need to be mostly self-reliant and relatively healthy in order to accomplish aging in place. There really isn't any way to say how "realistic" it would be without knowing all the factors. Understand all the current and potential future needs and work from there. If it can be done, great. If not, there should be a plan B. However for most these days it is not ideal, esp when dementia is involved (but in some cases, with lack of finances, there are no other options.)
My 86 year old mother is currently "aging in place" in her home, although I don't know how much longer this will last. She enjoys the meal prep, grocery, personal item shopping, mail & newspaper fetching, housekeeping, doctor appointment navigating, medication change pick up service, butler, companion, night sitter, and other AL in home services for free (by me, mostly; my brother and SIL help some - yard work every third week, home repairs now and then, and have been mom-sitting on weekends). Soon I suspect she will have to sell her house to pay for assisted living. She does not want to do this. She says that AL is for old people "waiting to die." So for me, it's successful (for her) inasmuch as my brother and I put up with it. She's had PT multiple times and does not do the exercises independently to help make her stronger and more self-sufficient. That's the goal, right?
When an older adult relies so heavily on others, that's not aging in place and certainly not independent living. She can do some things for herself, like make her own breakfast, but she does not like to. So much easier if I do it! I stopped just to see what she would do - and lo and behold - she managed. I am fortunate enough to still have my job (working remotely) so I have a full plate. I'm widowed and the only daughter so of course it is expected that I do the bulk of the work.
I've told my own kids that under no circumstances are they required to babysit me when I am old. I've taken care of it. Why intrude on them? They do not owe it to me to take on this enormous burden. My two cents.
"They do not owe it to me to take on this enormous burden."
AGREED! But try telling that to those who chastise us for considering anything else! But, but, but, they cared for you, changed your poopy diapers, wiped your poopy butt... It isn't the same, not even close!
As for not wanting to move, I KNOW my mother's plans had included moving to AL at some point. She had said several times that she needed to "clear out" the place in case she had to move. When I asked where, she said to AL. Enter dementia. That was the LAST place she would ever consider! She used to do the free tours/meals at local places. With dementia, those places became AWFUL and she would NEVER live in one! A snake pit might have been more acceptable. My brothers each offered to take her in (NOT a good idea!), but nope. She was fine, independent and could cook. Nope, Nope, and Nope.
My mom was in great shape till about 98, then we moved her in with me. If you wait till they are in moderate to severe dementia, I think they will not remember where they are, and you have better luck if you move them earlier. Just my two cents
Agreed wholeheartedly! If I could step back in time, I would have moved my parents in with us five years earlier, not in a panic at 10 at night with police and ambulances involved. It is much smarter to discuss and agree with your parents while they are still somewhat healthy and independent to start transitioning them before it is an emergency situation. Much easier on everyone involved. Speaking from first-hand experience.
Is it possible, yes. But is it the norm? I’m not sure. It all depends upon the health and functioning of the parent, the ability for them to manage their home on their own and safely navigate the house. Their finances, their cognitive functioning, the ability to feed and dress themselves and so on. At 63 we just built a new home that would allow us to age in place for as long as we can. We have finances to cover in home care. And we have also planned for institutional care if that is our reality. We have discussed our wishes with our families. And we do not plan to be a burden. We did this because of my experience with my own mother who made no plans for her care and is not realistic about her needs. It has been very stressful. I would say that aging in place takes a lot of planning. Expect the best but plan for the worst!?
I agree that fear plays a huge role in their behaviors which is one of the reasons I think we see the majority of them having severe problems with anxiety as well as depression and the question "who would you trust?" is a problem we all can face in any situation health related or otherwise.
I'm only 58 and I feel fearful about when I get older and the thought of who will take care of me (as well as trust being an issue) if my husband should pass away first terrifies me to say the least. We have no children and my extended family is non-existent on my dad's side and my mother's side the only one who I'm in contact with is a cousin who I just got reacquainted with after 40 years of losing touch. Over the years, I've reached out to many of my cousins but, never get a response. This is a sobering thought for sure.
It really, really depends on their health. My 91 y/o next door reclusive neighbor on the left died about a year ago. She'd been a widow for 11 years. Her house was immaculate, she drove and got her hair done every week (in the most unnatural shade of brown!) until two weeks before her relatively peaceful death. She was diagnosed with cancer about 2.5 months before she died, but just went quickly.
On the right side, my 97 y/o male neighbor was spritely and still managing his own one-acre yard up until about 3 months before he died. He was a dynamo! He had been a widower for 16 years! He was still chasing "girls" (in their 80s) when I met him when he was just 94. He was strong, lean, active, vibrant and had his mind intact. He went from having swelling in his hands to his grave in about 20 days. He spent only the day before he died in hospital, but then went home with his son and died in his house. He was astonishing! I miss him often.
So yeah, aging in place is certainly possible. It depends on the people and the place. Both neighbors had only 1-2 steps into their homes and had family close by just in case.
I had no success in aging in place with my parents. After reading and participating in this forum for years and talking with friends my age with elderly parents I think aging in place for most elders is not feasible .
The immediate issue is cooperation from our elders. My folks, like most of their generation, would not accept any help, not even meals on wheels. They were just fine. Didn’t want strangers in the house. I could only do as much as they would allow which was me driving 12 hours each way and running myself ragged. They were fine with that.
And even if your folks are cooperative it takes some big money to keep elders in their home until the end. You basically have to fund your own mini nursing home.
And there’s the issue of the home. Is it a wreck? Need to spend major bucks fixing it up? Priced a new senior friendly bathroom lately? I see people spend thousands on upgrades that are used for a couple months or in some cases not at all.
How about the kin folk? Everybody on the same page? No sibling feuds?
My folks are gone now. I’m going through the probate process for my dads estate. My folks were sweet people but it’s been a tough few years.
You've made a lot of good and valid points for people to consider. The aging parent always makes it "seem" so simple but, your post from your own recent experience prior to your dad recently passing away proves otherwise.
Even though I'm turning 58, my parents were from the depression era so I know all about not wanting to accept outside help but, it's ok if I run myself ragged going back and forth for ten years. My mom didn't want strangers in the house either so I get it.
A lot of things have to be in "perfect" alignment for it to work and as we all know, nothing is perfect.
You're still in my thoughts and prayers as you continue in the grieving process. I know going through probate is no fun.
My mom passed away in March, she was 87. She passed at home surrounded by my brother, me, and a couple of friends. She was able to stay at home independently until about 15 months before her death.
Starting in the summer of 2018, I could see that she was having some trouble with bills. I put everything on autopay and hoped for the best.
In fall of 18, she was having some pain and we had a part time caregiver that helped her occasionally and drove her where she needed to go.She could still drive locally.
By March of 2019, I was staying full time and she was diagnosed with chf and afib. Hospice was called in and she had a good summer with part-time help every day. By the end of December, we had hired full-time help at home.
My mom fortunately had some money and some pensions that could pay for care. I was driving the 750 mile trip between my mom’s and my house. It was a killer. My brother was 2 1/2 hours away and came as often as possible.
We were very fortunate to find great caregivers locally, I also had a person that was willing to manage scheduling caregivers when I couldn’t be there. It allowed me and my brother to be her children instead of her caregivers.
It wasn’t easy due to the long distance, and wouldn’t have worked without mom’s savings, but it can be done. I’m very grateful that she was healthy and independent until the last 1 1/2 year of her life. A longer illness would have been much more difficult to deal with.
I'm so sorry for the loss of your mother back in March especially as the pandemic was just getting started but, I'm so glad she was surrounded by you, your brother and a couple of friends.
I'm glad you all were able to make it work but, as someone else has alluded to - it takes a village - and that's what your mom had.
Prayers for you and your family as you go through the grieving process.
Reading all your different comments and experiences has helped me immensely! It is comforting to know that I'm not alone and so many of you are going through or have gone through similar situations. Thank you so much for all your support and advice!
Wow, I just went looking & found this link to the 5 Stages of Aging by Mark Frankel.
This really makes sense to me: the phrase Aging in Place (place = position/point ie static). While Aging Process (process = series of steps ie movement).
Beatty: You raise a GREAT point. Case in point - my late mother wanted to remain in her own home even though it was 7 states from mine and all the way across the country from my sole sibling. While we certainly tried to plan for her to live with my husband and I, she flat out declined. Even though I telephoned my mother every day, she never once spoke up. It was the driver of the van taking her to the food/grocery store that said "N---- needs help/she is struggling."
After having cared for my mom, I do not wish that life on my own child. I have told her, her responsibility will be to get me into a good facility and monitor my money.
They can age in place in their own home if they are competent. My 96 year old mother lives alone in her own house. She told me she is going to die in that house. She said the only way she will go into a nursing home is if she gets Alzheimer’s.
They broke the mold when your mother was formed! LOL
You should write a book on her life. I guarantee her story would go viral and there would be one of those ‘victim of the week’ Lifetime movies made on her story! Hahaha
I hate those movies and don’t watch them.
Your mom sees herself as the victim. My husband’s grandmother was like that. They will never change, right? It’s sad. It really is so very sad.
My mom lives with me but she requires and has 24/7 care through Medicaid. It is possible if you have the financial means, or can be approved for the CDPASS program through Medicaid, which provides reimbursement for in-home care. We went through a lawyer to do this. My neighbor’s dad lives with them but he was able to be home alone for hours at a time. Every situation is different. You have to be very patient and flexible.
Very very few states provide 24/7 care through Medicaid. I think only 2 states do-NY and MI. For everyone else, they are lucky if Medicaid provides more than 20-30 hours a week of home care.
I have been my mother's 24/7 primary care giver for over 20 years, but that's because I live with her. It is virtually impossible to do it remotely. She gets up every night to use the bathroom, and she tends to fall. So, someone needs to be there at night. Of course, the family still thinks that I should pay rent - even the ones who never show up to care for her. They are waiting for her to die to collect their share from the sale of the house. I will be displaced, and I will not have the money for a house again. I have given my mother the care that she would have had to pay for. Instead of the money going to the nursing home, the sale of the house will benefit all 8 siblings and grandchildren. But I am still not recognized or appreciated for this. I lost my home due to the downsizing of the defense industry over 20 years ago, and then I aged out of the next two industries I entered.
I'm so sorry that you are in this type of situation. It is a sad commentary when family members are waiting in the wings to "collect" their fair (more like unfair) share of the proceeds from the house when it eventually is sold.
I commend you for being your mother's caregiver for over 20 years and I'm sorry you lost your own home due to the downsizing in the industry you worked for.
I just want you to know you are not alone when it comes to not being "recognized" or "appreciated" for all you've done - it's extremely common no matter how unfortunate it is. In order for that to happen amongst other family members, there has to be understanding, empathy and a willingness to at the very least give you emotional support or lend a helping hand. It takes a level of maturity though - however, selfishness usually prevails in these types of situations.
God bless you for all you've done - when it's all over, you'll be able to look yourself in the mirror and know that you gave it your all!
With the help of hospice nurse, aid, social worker and volunteers, plus self pay aids four hours a day, cameras both inside and outside I was able to manage 2 parents, both with dementia to age in place and die at home 4 months apart. I managed Everything for them from finances, home, healthcare, shopping, laundry and also provided care to them 2 shifts a day, every morning and every evening Including weekends. For two of the seven years I managed, my mother was totally bedridden and Incontinent and was in the last stages of dimentia. I could never leave my mother alone so I relied on hospice volunteers to stay with her while taking my father to doctor appointments. Fortunately my father’s dimentia has not progressed as quickly as my mother’s but he still needed help with showering and dressing. I was able to qualify him for hospice for cancer so for about 1 year they were both on hospice together. To undertake aging at home is a major commitment requiring much sacrifice. With the exception of my husband, family members did not share in the responsibilities. Looking back, Caring for both my parents so the could remain at home was difficult, challenging, exacerbating, but an experience that taught me so much about myself and others. I would do it again for them.
You are a wonderful, amazing daughter. My experience with my parents was much the same, two siblings who did absolutely nothing but wait with their hands out for their inheritance, which at my Dad's appropriation, never came. I cherished the time I spent with my Dad and would give anything to have him back just for a day! My Mom currently lives with us and we are her caregivers 24x7. She has dementia at age 93 and has some perfectly lucid, amazing days interspersed with days where she struggles to function. I treasure our time with her and wouldn't have it any other way. Yes, it can be trying and frustrating, but as I said, I wouldn't have it any other way. She is here with us, her only remaining family, her granddogs who she enjoys immensely, and we are able to keep her comfortable in this stage of her life where she has lost her husband and life partner, and is scared and lost with dementia affecting her mind and cognitive abilities. She is where she belongs, and where she is content and happy.
I think it's entirely possible as long as the parents know that in order for them to do that, things will need to be adapted and done differently as time goes on. Safety measures need to be put in place and someone needs to be involved, preferably a family member, who will be able to take notice of changes and be able to get the help and advice needed for each stage. I work in Home Health and have a degree in Human Services with an emphasis on gerontology. My stepfather has Alzheimers and ended up falling at home and then it was one thing after another and ended up in a facility and we were told without 24 hour care he couldn't go home. Taking my mom up to see him everyday and then picking her up and seeing then hug and kiss each other good bye and saying I love you to each other was hard. Especially when he would ask why he isn't going and where she was going. After a few months I decided I would move in with them to bring him home. My sister and stepsister were supportive and I got him set for Adult Day Care 3 times a week to give me a break. Stepsister was to come once a month for 4 days to give me a bigger break. Well 2 weeks after we brought him home the coronavirus hit and everything shutdown. It's been a difficult time without any breaks but I would do it again. I got him a hospital bed which was paid for by Medicare with the Doctors diagnosis. Got safety bars which I installed myself. I have a monitor that has a camera in the bedroom and one in the living room. I have alarms on the patio door and door going out to the garage. I keep him on a strict schedule as it helps with Alzheimers patients. He knows when its time for dinner, time for pjs and time for bed and he is ready and cooperative. He doesn't wander other than wanting to go out onto the patio which he needs help doing because of a couple of steps. Adult Day Care has started again and their housekeeper now comes and while she is here I go to my place and do things. Still no get away time but every night they tell each other goodnight and give each other a kiss and say they love each other smiling....So it may take some doing, but if at all possible to keep them at home I would do that over anything else...The hospital bed was free with the Doctors diagnosis Medicare paid for it. I got the safety bars and installed them myself and got the high rise toilet seats....there are many things and resources to help make it happen. Once tried, if it doesn't work then decide next option. It does help to have a plan for all stages right up to the end. There are many agencies, private and county and federal, that can help. Social workers can help implement plans. It is worth it if at all possible. Being at home with their familiar things and place, makes it much more easier and pleasant for all.
I think the question is more like “is it realistic” rather than “is it possible”. It’s always “possible” but not always realistic. If that makes sense. For many elders, aging at home requires a village and money. A lot of elders have neither of those.
Six years ago, at my suggestion, my mom moved near me and lives in her own home 1 block away from where I live with my bf (he is fully invested and enjoys my mom and we do not have kids). We picked a house which met most future mobility needs, and modified things we needed: the biggest reno was removing a tub and put in a walk in shower. She gladly complies with a fall detection button, and multiple smart devices (video doorbell, Alexa, smart thermostat, and smart bulbs) to keep her safe, support her memory, and allow me to check on her remotely. When she was driving, I had a tracker on her phone to know when she left home and returned (like parents use for their teens).
I consider my mom to be successful living in her own home with support. She cooks for herself - if I keep her stocked with her familiar packaged foods, and does her own ADLs and laundry. I do everything else from taxes to scheduling hair and medical appointments, routine maintenance and cleaning of her home (I have a robotvac at her home and her cleaning lady comes only every few months these COVID days), and larger projects on her home and yard. Even her pet (her cat recently died and we got her a kitten that can be challengng) us under my care. I have a list I share with friends that has weekly, monthly, quarterly, semi annual and annual things I do for her. My mom is in decent health and my work is intense - I call her daily, it is a rare day that I do not visit her, I have not taken a vacation in 4 years.
In this time of COVID, my bf and I ensure we are socially isolated so I can be around her. I am her main social connection and I drive her around town at least once a week, we take walks around the neighborhood a few times a week, and my bf and I have family dinner 1-3 times a week with her. My mom is healthy, happy and safe and I truly enjoy being the person to support her. I suggested that she come to live near me because it was practical, but I did not expect to enjoy the work (yes, it is work) because my mom and I never got along when I was a kid or even as an adult - until now.
When she first moved near me I was working full time. Then, the transition was simply too much for me; I left my job and tightened my belt. As I restructured my life for her my professional goals changed, and I worked pt as a researcher in aging care which was a great work/life balance before COVID changed a lot of things.
My mom has healthy financial resources, but Assistend Living facilities are very expensive, and it would have been intense work to downsize her to a tiny apartment. My mom's cost of living is a faction of the cost of AL, even after she pays me for my work as her pt Geriatric Care Manager. But, it does take money for people to age in their home. My mom did not "age in her home" she moved near to me. We bought a recently renovated home with new appliances, HVAC, and insulated windows/doors. Then, we modified things to ensure she can live there safely for as long as possible. One thing I tell everyone to remember is, if your parents are living in the home you grew up in, everything may be old and you need to financially and physically plan for things like a new AC, a new roof. Be mindful that learning a new appliances when the old ones go out can be very challenging.
I am committed to keeping my mom safe, healthy and happy. I do a lot for her (A LOT), and will keep her in her home as long as I can with hired assistance and sleeping at her home when that need comes. But, if I cannot keep her safe, healthy and happy in her home, she and I know there is a continuum of care facility a few blocks away.
Aging in place in your single family home is a very, very dependent lifestyle.
Very well put. This answer should be poster.
She lived 200 miles from me, and I couldn't imagine trying to manage caregivers long distance, and she doesnt realize the extent of her cognitive decline, so I don't think she would be receptive to them anyway.
I think parents are nearby, and the help they need is more mobility or med management, sure. You could come over to help maybe with showers and stock their fridge or bring over a meal. You could hire a caregiver to check in for a few hours, or to sit in the house overnight.
But bedbound, or more medical needs or dementia? Demanding job that doesn't allow for you to leave at a moment's notice? Uncoorperative with help. Then no.
realistically
possible
(and most of all)
success
What IS a successful final outcome of a decision to "age in place"?
Thinking about these definitions has a serious point, which is discussed in detail in Atul Gawande's essential-reading book "Being Mortal."
Whose wellbeing and welfare is the concern? If you consider aging in place unrealistic because your parent's frailty is making your hair stand on end and your nails are bitten to the quick, it's your nerves at risk, not your parent.
We have a lovely client (I think he's just managed to get rid of us, actually). He is 93. He served in submarines as a younger man. He lives alone. His house is *immaculate.* He deals with all personal care, domestic tasks and meal preparation independently, apart from occasional help with heavier tasks such as changing his bedlinen (large double bed) and mowing his lawn. I spent four or five morning calls with him, and two or three evenings, monitoring and supporting his routines. My heart was in my mouth, observing this frail elderly man stepping into his bath, showering head to foot (he got shampoo in his eyes, that was the only moment I had to assist by passing him a flannel), stepping out and drying himself... as I say, my heart was in my mouth. But he didn't put a foot wrong, not once. The only reason we were there is that he had had a fall one night (not injured, just stuck) and because he doesn't - and won't, grrr! - wear a falls alarm he wasn't found till late the next morning when his family member visited. His children duly tore their hair out and insisted that he allow home visits. Our short-term reablement service was the agreed compromise. He had a point to prove, that he was safe living alone, and he proved it.
He is quite unusual, by the way, in being willing to prove his point, with good grace and very sweet appreciation of our help. Many seniors resent the intrusion when they don't want us there.
So. What will be "success" for this gentleman, pursuing his wish to age in place?
As we age, it maybe still driving safely, or gardening. Or maybe catching a taxi safely & being able to arrange a gardener. It may be making decisions about what to do with your day. Or just which window to sit next to.
From the other end...
The elderly man I met this week, lives in his house & values this fact very highly. But his 24/7 needs have outstripped his wife/carer's ability & he is now hoping his son & wife move in to assist also. He asks to be spoon fed, despite having two working hands. Is this successful aging in place? If *living in his own home* is the ONLY measure - maybe it is.
Such a good discussion thread.
What if your dog kept biting you & all visitors, making messes & walking it through the house, chewed up your furniture, kept barking all night, escaping & running out onto the road? What if your dog was 100+kg & required 3 people to turn & lift with a device, required daily feeding by teaspoons, required frequent enemas?
What are the physical and mental conditions of the elders?
What is the layout and condition of the home?
What assets are there available for help and care-givers?
What family is available AND willing to help and care-give?
What other resources are available?
Is there a friend network and/or socialization activities available?
If the home is "safe" and the condition of the elders isn't compromised, it's a start. With some minimal help, they can likely stay. If there are many stairs or other hazards and physical or cognitive issues, then one has to consider these in the "plan." If there are not enough assets to hire help and care-givers, how can they stay in their own home if they need help and/or care? Then again, how can they afford a facility? Despite what some think, 24/7 care in home is (most of the time) MUCH more expensive than a facility (and you need to factor in cost of the home, utils, food, etc with the cost of care.)
Although many families often want to help their parents age at home, there are constraints - logistics (where each lives), ages (are they in work/childrearing ages), capabilities (personally I could not support my mother's weight, so that was a gate), knowledge (some aging issues require more than just helping care for the home and making meals!)
Some seniors are quite capable of staying safely in their home and combining taking care of it and themselves with minimal help. Others are not.
My mother lived alone in her condo to just over 90. Shortly after/around that time dementia crept in, so we had to make plans. The first was to bring in help, but 1 hr/day didn't last 2 months and she refused to let them in. So, she was probably 93 when we moved her. I had already taken over finances, and helped with transport for groceries, appts, etc when we had to take the car away, but she wasn't capable of being alone for long. It was also draining for me, as it was 1.5 hr each way plus whatever task was at hand.
Days before the move to MC she managed to injure her leg and develop cellulitis. She didn't have enough sense to understand how bad the injury was or to seek help - she only mentioned bruising her leg to a neighbor, who told me. If it weren't for the planned move, this could have quickly killed her!
My place would not have worked. Repairs are half done and still on hold. Full stairs to get in/out, which she couldn't do. No way to handicap the bathrooms (too small.) As noted, I can't support her weight. So, staying in her own place was not an option, nor was moving to my place. Bros? One is abusive and not local, wouldn't want her there! The other is still working and doesn't really fully comprehend what care is needed and also tends to be a bit scatter-brained.
So, I would think a person would need to be mostly self-reliant and relatively healthy in order to accomplish aging in place. There really isn't any way to say how "realistic" it would be without knowing all the factors. Understand all the current and potential future needs and work from there. If it can be done, great. If not, there should be a plan B. However for most these days it is not ideal, esp when dementia is involved (but in some cases, with lack of finances, there are no other options.)
When an older adult relies so heavily on others, that's not aging in place and certainly not independent living. She can do some things for herself, like make her own breakfast, but she does not like to. So much easier if I do it! I stopped just to see what she would do - and lo and behold - she managed. I am fortunate enough to still have my job (working remotely) so I have a full plate. I'm widowed and the only daughter so of course it is expected that I do the bulk of the work.
I've told my own kids that under no circumstances are they required to babysit me when I am old. I've taken care of it. Why intrude on them? They do not owe it to me to take on this enormous burden. My two cents.
AGREED! But try telling that to those who chastise us for considering anything else! But, but, but, they cared for you, changed your poopy diapers, wiped your poopy butt... It isn't the same, not even close!
As for not wanting to move, I KNOW my mother's plans had included moving to AL at some point. She had said several times that she needed to "clear out" the place in case she had to move. When I asked where, she said to AL. Enter dementia. That was the LAST place she would ever consider! She used to do the free tours/meals at local places. With dementia, those places became AWFUL and she would NEVER live in one! A snake pit might have been more acceptable. My brothers each offered to take her in (NOT a good idea!), but nope. She was fine, independent and could cook. Nope, Nope, and Nope.
I agree that fear plays a huge role in their behaviors which is one of the reasons I think we see the majority of them having severe problems with anxiety as well as depression and the question "who would you trust?" is a problem we all can face in any situation health related or otherwise.
I'm only 58 and I feel fearful about when I get older and the thought of who will take care of me (as well as trust being an issue) if my husband should pass away first terrifies me to say the least. We have no children and my extended family is non-existent on my dad's side and my mother's side the only one who I'm in contact with is a cousin who I just got reacquainted with after 40 years of losing touch. Over the years, I've reached out to many of my cousins but, never get a response. This is a sobering thought for sure.
So your points are duly noted!
On the right side, my 97 y/o male neighbor was spritely and still managing his own one-acre yard up until about 3 months before he died. He was a dynamo! He had been a widower for 16 years! He was still chasing "girls" (in their 80s) when I met him when he was just 94. He was strong, lean, active, vibrant and had his mind intact. He went from having swelling in his hands to his grave in about 20 days. He spent only the day before he died in hospital, but then went home with his son and died in his house. He was astonishing! I miss him often.
So yeah, aging in place is certainly possible. It depends on the people and the place. Both neighbors had only 1-2 steps into their homes and had family close by just in case.
he never wanted to go anywhere else and I promised him he wouldn't have to.
He would be miserably unhappy wouldn't last a few months in a Senior Home.
The immediate issue is cooperation from our elders. My folks, like most of their generation, would not accept any help, not even meals on wheels. They were just fine. Didn’t want strangers in the house. I could only do as much as they would allow which was me driving 12 hours each way and running myself ragged. They were fine with that.
And even if your folks are cooperative it takes some big money to keep elders in their home until the end. You basically have to fund your own mini nursing home.
And there’s the issue of the home. Is it a wreck? Need to spend major bucks fixing it up? Priced a new senior friendly bathroom lately? I see people spend thousands on upgrades that are used for a couple months or in some cases not at all.
How about the kin folk? Everybody on the same page? No sibling feuds?
My folks are gone now. I’m going through the probate process for my dads estate. My folks were sweet people but it’s been a tough few years.
You've made a lot of good and valid points for people to consider. The aging parent always makes it "seem" so simple but, your post from your own recent experience prior to your dad recently passing away proves otherwise.
Even though I'm turning 58, my parents were from the depression era so I know all about not wanting to accept outside help but, it's ok if I run myself ragged going back and forth for ten years. My mom didn't want strangers in the house either so I get it.
A lot of things have to be in "perfect" alignment for it to work and as we all know, nothing is perfect.
You're still in my thoughts and prayers as you continue in the grieving process. I know going through probate is no fun.
Take care -
Starting in the summer of 2018, I could see that she was having some trouble with bills. I put everything on autopay and hoped for the best.
In fall of 18, she was having some pain and we had a part time caregiver that helped her occasionally and drove her where she needed to go.She could still drive locally.
By March of 2019, I was staying full time and she was diagnosed with chf and afib. Hospice was called in and she had a good summer with part-time help every day. By the end of December, we had hired full-time help at home.
My mom fortunately had some money and some pensions that could pay for care. I was driving the 750 mile trip between my mom’s and my house. It was a killer. My brother was 2 1/2 hours away and came as often as possible.
We were very fortunate to find great caregivers locally, I also had a person that was willing to manage scheduling caregivers when I couldn’t be there. It allowed me and my brother to be her children instead of her caregivers.
It wasn’t easy due to the long distance, and wouldn’t have worked without mom’s savings, but it can be done. I’m very grateful that she was healthy and independent until the last 1 1/2 year of her life. A longer illness would have been much more difficult to deal with.
I'm so sorry for the loss of your mother back in March especially as the pandemic was just getting started but, I'm so glad she was surrounded by you, your brother and a couple of friends.
I'm glad you all were able to make it work but, as someone else has alluded to - it takes a village - and that's what your mom had.
Prayers for you and your family as you go through the grieving process.
This really makes sense to me: the phrase Aging in Place (place = position/point ie static). While Aging Process (process = series of steps ie movement).
https://www.iris.xyz/viewpoints/understanding-the-5-stages-of-aging-from-self-sufficiency-to-end-of-life/
"I want to stay in my home as long as possible". I asked a question (? last year) about what does "as long as possible" actually mean"?
For some it may be a sudden crises, but for others a very slow progression in declining ability.
What happens when 'aging in place' turns from thriving, into coping, into struggling, into self-neglect/danger?
They broke the mold when your mother was formed! LOL
You should write a book on her life. I guarantee her story would go viral and there would be one of those ‘victim of the week’ Lifetime movies made on her story! Hahaha
I hate those movies and don’t watch them.
Your mom sees herself as the victim. My husband’s grandmother was like that. They will never change, right? It’s sad. It really is so very sad.
I'm so sorry that you are in this type of situation. It is a sad commentary when family members are waiting in the wings to "collect" their fair (more like unfair) share of the proceeds from the house when it eventually is sold.
I commend you for being your mother's caregiver for over 20 years and I'm sorry you lost your own home due to the downsizing in the industry you worked for.
I just want you to know you are not alone when it comes to not being "recognized" or "appreciated" for all you've done - it's extremely common no matter how unfortunate it is. In order for that to happen amongst other family members, there has to be understanding, empathy and a willingness to at the very least give you emotional support or lend a helping hand. It takes a level of maturity though - however, selfishness usually prevails in these types of situations.
God bless you for all you've done - when it's all over, you'll be able to look yourself in the mirror and know that you gave it your all!
There is no right or wrong way. It is whatever works for the individuals involved.
I think Cali wrote an excellent answer to this thought provoking posting. Great answer, Cali.