Most people want to avoid nursing homes and age independently at home for as long as possible. But, despite those wishes, many seniors find themselves in nursing home care sooner or later. Where’s the disconnect?
As care professionals, we find that prospective clients express a desire to age-in-place, but struggle with putting a plan in action. That’s why we’ve put together this blog post to share three ways seniors can avoid nursing homes and age independently.
Step One: Identify Any ADL or IADL Deficits
Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) represent key life tasks that people need to manage in order to live at home and be fully independent.
Deficits in ADL’s or IADL’s can inform how much help, supervision, and hands-on care an older person needs. This can help a family caregiver or older adult determine what kind of support is needed at home and even if someone is considered “safe” to live at home. If you want to avoid nursing homes, you’ll need to ensure you get the help you need to live safely at home.
This list of (ADLs) and (IADLs) pulled from Better Health While Aging is a great checklist for seniors to reference:
Activities of Daily Living (ADLs)
- Walking, or otherwise getting around the home or outside. The technical term for this is “ambulating.”
- Feeding, as in being able to get food from a plate into one’s mouth.
- Dressing and grooming, as in selecting clothes, putting them on, and adequately managing one’s personal appearance.
- Toileting, which means getting to and from the toilet, using it appropriately, and cleaning oneself.
- Bathing, which means washing one’s face and body in the bath or shower.
- Transferring, which means being able to move from one body position to another. This includes being able to move from a bed to a chair, or into a wheelchair. This can also include the ability to stand up from a bed or chair in order to grasp a walker or other assistive device.
For each ADL, people can vary from needing just a little help (such as a reminder or “stand-by assist”) to full dependency, which requires others to do the task for them.
Instrumental Activities of Daily Living (IADLs)
These are the self-care tasks we usually learn as teenagers. They require more complex thinking skills, including organizational skills. They include:
- Managing finances, such as paying bills and managing financial assets.
- Managing transportation, either via driving or by organizing other means of transport.
- Shopping and meal preparation. This covers everything required to get a meal on the table. It also covers shopping for clothing and other items required for daily life.
- Housecleaning and home maintenance. This means cleaning kitchens after eating, keeping one’s living space reasonably clean and tidy, and keeping up with home maintenance.
- Managing communication, such as the telephone and mail.
- Managing medications, which covers obtaining medications and taking them as directed.
Once you identify any gaps in the above, you can begin working to identify care professionals and service providers to assist with the gap. To avoid nursing homes, it’s much better to bring in help before you think you need it. Often, by the time an emergency occurs, it’s too late or difficult to assemble a team.
Many older adults use geriatric care managers or services like CarePods to help them source and manage their team of care professionals as their needs change.
Step Two: Design an Emergency Response Plan
An Emergency Response Plan is distinct from your everyday ADL/IALD plan. This plan is specifically designed to act as a safeguard for you in the event you are incapacitated and/or injured.
To keep things simple, we recommend older adults set up an emergency binder that they keep in a highly visible location with pertinent information. This information is not limited to but should include:
Basic Bio Overview: Your name, address, phone number, a picture of you if possible, various contact information for anyone you’d like contacted.
Advance Directives/Planning Documents: Please put a copy of any living wills, Power-of-Attorney documents, Medical directives, DNR orders, etc. in the binder. If you live with pets, please don’t forget care instructions here!
Medical Information: Please write down a rough overview of any medical conditions you may have, any allergies you have, and the dosage and name of any medications you are taking. Add a date when you update any medications so emergency medical professionals can see it is current.
Insurance Information: Include the policy name, number and a copy of your insurance card if possible.
In addition to the binder, we recommend older adults living alone invest in a monitoring or emergency alert system. At CarePods, we recommend and use Stay Smart Care for our clients, but GreatCall is another popular option.
Regardless of which product you use, you’ll want to sign up for fall detection and 24/7 emergency response services. You’ll receive some type of device to wear and/or the company will install some technology in your home. In return, you’ll have the peace-of-mind of knowing you’re never alone in an emergency.
Step Three: Evaluate Your Home Environment
Now that your personal and emergency care needs are addressed, you’ll want to evaluate your physical environment. Focus on primary living areas and set aside a small budget to make improvements as needed. In general, we recommend clients focus on the following:
- One-level bedroom + bathroom access: Relocate to a lower-level bedroom if you have two stories. If possible, convert shower/bath to a walk-in unit instead of a step-up/in unit or add a shower extension to your bathtub. Install grab-rails as needed to help you get in and out easily. If possible, find a place to move your washer and dryer near to your kitchen or your master bedroom for easy use.
- Trip Hazards: Remove trip hazards like rugs. Keep plenty of bright lighting around you so you can easily see your surroundings. Install nightlights in high traffic areas.
- Mail and package delivery/retrieval: Put a small table outside your door so you don’t have to bend all the way down for packages. Leave a basket out and notes for your mail carriers in inclement/icy weather to ask them to place your mail in the basket instead of your mailbox. Consider relocating your mailbox closer to your house.
In general, a little bit of thoughtful design, de-cluttering and a good handyman go a long way towards making your home more comfortable and suitable for your needs.
In closing, we tell all our clients: “if aging in place is your first choice, then planning can’t be your last priority.” We hope this serves to encourage you and your family that with a little work and preparation, aging independently at home can be a reality.