Aging in Place
Numerous studies have indicated that most older adults would like to stay living in their current home for as long as they can—and new data from the University of Michigan National Poll on Healthy Aging reinforces this, with 88 percent of respondents between ages 50 and 80 saying that it was very or somewhat important to them that they live in their homes as long as possible.
However, the poll also reveals that many of us don’t plan or prepare in advance for aging in place. Only 15 percent of respondents said they have given a lot of consideration to how their home may need to be modified as they age, while 47 percent have given it little or no thought. Other poll data suggests that a significant number of older adults likely would struggle to afford in-home care if it was needed. This kind of care is a vital resource for people who live alone in their older years. About 48 percent of poll respondents who lived alone said they don’t have someone in their lives who could help them with personal care, such as bathing and dressing if needed, compared with 27 percent of respondents who lived with others. When it comes to hiring a caregiver to help with household chores, grocery shopping, or personal care, about two-thirds of poll respondents who reported their physical or mental health status as being fair or poor said they were not confident or not very confident that they could afford to pay for such help.
The poll results underline that many people ages 50 and older should be thinking about the adaptations their homes might need to account for age-related changes and disabilities, and about the services they might need in the future. With these factors in mind, I recommend you discuss any health issues you have with your health-care provider. Even if conditions like diabetes, arthritis, and high blood pressure aren’t causing you too many problems right now, they may progress and cause more troublesome symptoms. Ask your doctor what the worst-case scenario for you might be given your individual health status, and what you can do to preserve your physical function. And don’t forget your mental wellbeing, either. Depression can contribute to loss of function in older age because it may sap you of the motivation to eat right, get enough physical activity, follow your doctor’s advice when it comes to taking medications, and socialize with others. All of these behaviors can help prevent depression and also are associated with a lower risk of dementia. The latter is a major reason older adults are unable to age in place. Unfortunately we don’t yet have a way to cure the condition, but there is fairly solid evidence associating lifestyle measures (such as eating a heathy diet and getting plenty of exercise) with a lower risk of dementia.
Disabling injuries due to falls are also a major contributing factor to older adults losing their independence, so avoiding falls should be uppermost in your mind if you do hope to age in place. Research has suggested that many older adults perceive their fall risk as low even if they already have suffered a fall. Even if you are still physically spry, try to think objectively about what your risk of falls and fractures might be. The National Council on Aging has a handy online tool that can help with this (visit https://tinyurl.com/FallCheck). Some risk factors that make falls more likely include previous falls, taking multiple medications, and suffering from dizziness when you stand up suddenly. If you do fall, you are more likely to sustain a fracture if you have the bone-thinning disease osteoporosis.
You may be able to mitigate osteoporosis by getting plenty of weight-bearing exercise, such as walking, and consuming plenty of calcium in your diet. Your doctor also may recommend you take medications to preserve your bone strength. As to preventing falls, at a minimum it’s advisable to remove tripping hazards from your home (these include throw rugs, awkwardly positioned furniture, and power cords in high-traffic areas), and ensure that your home is well lit at night. Installing useful items such as grab bars and stair rails can also help. If you don’t have these and don’t feel confident when it comes to using power tools to install them yourself, ask a family member to do it for you, or ask friends if they can recommend a handyperson.
Something else you might want to consider is attending a community fall prevention program. These typically are delivered in local senior centers and can educate you in how to mitigate fall risk factors as well as show you how to fall “correctly” to help prevent injuries. You can find out if there is a fall prevention program in your community through your local Area Agency on Aging or through the national Eldercare Locator (www.eldercare.acl.gov).
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