While the prospect of aging is a universal one that no one can avoid, the challenges and issues involved with reaching the average overall life expectancy of 79.8 years and beyond can be planned for in advance. For example, the issues of aging in place, living arrangements, transportation, and companionship with individuals of similar age can be investigated and decisions made long before they become necessary considerations. As Natural Awakenings discovered, the result of researching the numerous options available and planning ahead can provide priceless peace of mind for seniors and their family members.

Aging in Place Most adults prefer to age in place. In fact, 90 percent of adults over the age of 65 report that they would prefer to stay in their current residence as they age. Aging in Place—the ability to live in one’s own home and community safely, independently, and comfortably regardless of age, income or ability level— has been growing in popularity. The concept is celebrated October 15 to 21 during National Aging in Place Week and is encouraged by the National Aging in Place Council, which promotes older adults having a choice in their care and living arrangements. With a national housing recovery under way, according to a new report from the Joint Center for Housing Studies at Harvard University, remodeling to age in place has become a trend. Several items to consider for this remodeling purpose include an open floor plan with more clear floor space for easier maneuvering; a master suite on the main floor so that upstairs becomes guest or flex space; fewer wall cabinets and more drawer storage in the kitchen along with appliances at comfortable heights; and no-threshold showers in bathrooms.

In-Home Care “From picking up prescriptions, taking seniors grocery shopping, or just being a friend to sit with on the patio, Homewatch CareGivers is about sustaining and maintaining your loved one’s quality of life in their home,” says Wendy Pester, Homewatch CareGivers community relations liaison. Home care provides the flexibility of professional caregivers, who can be in the home from two hours to 24 hours. Services provided include helping with personal care such as bathing, dressing, oral care, toileting, ambulation and transferring in and out of bed, running errands such as grocery shopping and picking up prescriptions, preparing meals, household chores such as vacuuming or doing laundry as well as providing medication reminders and companionship and meaningful activities so that a loved one is not alone. “We provide services or individuals of all ages—from pediatrics to seniors— but what sets us apart from other homecare services is that we specialize in dementia care, which involves working with individuals who have very challenging behaviors. This is why we provide special ongoing training for our caregivers as well as support,” notes Pester.

Types of Independent Living Facilities and Retirement Homes Independent living is any housing arrangement designed exclusively for seniors age 55 and over. Senior living can vary widely from apartment-style living and apartment complexes for low-income seniors, subsidized by the U.S. Department of Housing and Urban Development, to separate and more luxurious housing as well as freestanding homes. In general, this type of housing is often more compact with easier navigation and no maintenance or yard work to worry about.

The Key Difference The key difference between independent living and other housing options is the level of assistance offered for daily living activities. Individuals who require round-the-clock help with eating, dressing, and using the bathroom, or regular medical assistance, may be better suited to other housing options such as nursing homes with a medical staff.

Independent Living Residents, who live independently, with little or no assistance needed with the activities of daily living, often enjoy access to amenities such as daily meals, basic housekeeping and laundry services as well as amenities such as recreation centers or clubhouses. In such shared spaces, intended to generate a sense of community, residents connect with peers and participate in community activities such as holiday gatherings, arts, crafts, continuing education and movie nights. Independent living facilities may also offer facilities such as a swimming pool, fitness center, tennis courts, as well as a golf course or other clubs and interest groups. Other services offered in independent living may include onsite spas as well as beauty and barber salons. Brandywine Senior Living at Voorhees provides premiere senior living including independent, assisted living, and rehabilitation services. “Often when adult children come to tour our facilities for their parents, they tell me that mom doesn’t do things like play bingo, go to movies or socialize much. Then after mom moves in and the kids come back to visit, they are shocked to find that mom isn’t even in the building; she’s out having fun with her new friends,” quips Nicole Longo, director of community relations. Longo also notes that one of the biggest hurdles for a potential resident is to think beyond the downsizing of their home to move into a smaller personal residence. “Now they have to adjust to having a magnificent, 94,000-square-foot building with weekly housekeeping services, a 24- hour snack bar, all-day dining, therapy pool, movie theatre, common area living rooms and a library for socializing as well as scheduled transportation to shopping, cultural events and other planned activities,” she advises.

Help for Coping With a Move Donna Willmann, who founded Byron Home in 1998, is very familiar with the stress that seniors feel when it’s time to deal with the daunting task of downsizing and moving from the familiar environment of a home that they have lived in for many years. “Even when seniors are looking forward to the increased social opportunities and companionship offered by independent living, they might still be saddened by giving up a home filled with memories or a neighborhood filled with familiar faces,” says the founding member of the National Association of Senior Move Managers (NASMM). “We take much of the anxiety out of downsizing by measuring the pieces of their furniture and creating a layout to scale of their new spaces so that individuals know what fits and what doesn’t. This allows them to prioritize their choices, move the pieces around and imagine themselves there,” says Willmann, whose services supports seniors and their families through ever aspect of the process including coordinating movers, packing, unpacking and meticulously making sure everything is in its right place. Byron Home also provides assistance with disposition of extra contents. An initial consultation is free.

Continuing Care Retirement Communities (CCRCs) Individuals who are relatively healthy now, but anticipate significant health problems in the years to come, may want to consider a CCRC. These facilities offer a spectrum of care from independent living to nursing home care in the same community so that when residents begin to need help with activities of daily living, they can transfer from independent living to an assisted living or skilled nursing facility on the same site. The main benefit of a CCRC is that residents only need to relocate once to a new environment and can maintain their independence for as long as possible.

Hospice Hospice is a family-centered philosophy of care, rather than a place. This philosophy emphasizes humane and compassionate care that comforts rather than seeks a cure for people in the last phases of life-threatening illnesses. Most hospice care, appropriate for individuals of any age (including children), is provided in a patient’s home, assisted living facility or nursing home, but can also be provided in a private hospice facility or inpatient hospice center. The patient’s home-centered care allows families more involvement in their loved one’s care, more opportunities to make decisions, and greater time to spend together in comfortable surroundings. Hospice care is fully covered by Medicare, Medicaid, most commercial insurers and the Veteran’s Administration (VA) so cost of care should not stand as an obstacle to receiving help and support. A hospice team of caring experts provides medical, emotional, and non-sectarian spiritual support for both patient and family. This team includes a physician, nurse, social worker, home health aide, pastoral care counselor, and volunteer. In addition, hospice care includes delivery of medicines and medical equipment related to the hospice diagnosis to the place of care and offers up to 13 months of bereavement support to surviving family members. “Medicare’s eligibility standard for hospice care is that a patient is eligible, if in a doctor’s best judgment, the patient’s prognosis is about six months or less if the disease follows its normal course. Sometimes patients are on the program for a longer length of stay. All too often, however, patients are referred with only seven days or less to live which deprives their families of much-needed support,” advises Carol Paprocki, Samaritan Healthcare & Hospice public relations manager. “Many people believe hospice and palliative care—the managing of pain and symptoms associated with disease or injury—should be reserved only for the last few days of life. This mistaken belief deprives them of the opportunity to live the last six months or more of life to the fullest by taking advantage of the physical, emotional and spiritual comfort that is available,” says Paprocki.

The final segment in this three-part article will focus on caring for the caregivers. Linda Sechrist is the Natural Awakenings senior staff writer. Visit her website, ItsAllAboutWe.com.