Q: My 81-year-old aunt is moving to the area to live closer to my family. Her plan is to purchase a small condo on one of the golf courses and remain there as she ages. We are trying to look ahead and plan for things she might need to make the home conducive to future needs. She currently uses a cane but is still very independent. Do you have any suggestions?
A: Many people choose to “age in place.” It has become a popular lifestyle choice with the baby boom generation, simply meaning the desire to remain in your own home as you age. The ability to age in place depends on several factors, having a safe, comfortable, and accessible home are a few. It is important to consider environmental adaptations, future care needs, and the financial resources that will be required.
Your aunt is starting with a clean slate, purchasing a home with this intent. It is important that she considers the location and set up her new home. She will want a single floor home on the ground level to avoid stairs, and preferably a sidewalk or pathway that could accommodate a wheelchair or walker if needed. Even surfaces, minimal front or garage steps, and good lighting are key to the outdoor area. A covered walkway or garage option is a plus to accommodate rain or snow. The potential advantage of a condo is that it is likely to be part of a community that offers outdoor maintenance and other support.
As she begins looking at the interior layout, keep in mind that the fewer changes she has to make structurally, the more cost-effective the move will be. This will help preserve funds that may be needed in the future to supplement care. Here are a few universal design essentials that will be important to her age in place plan:
- Zero entry shower – avoid a shower/bath combo or anything that requires her to step over something to enter the shower
- Make sure the shower has enough space to accommodate a shower chair or bench
- No step entry to the home or ability to install a ramp to accommodate a wheelchair if necessary
- Sturdy handrails at any entrance point
- Wide hallways (42”) and doorways (35”)
- Switches and handles at a level that could be reached if seated in a wheelchair (42” – 48” from floor level)
Once she makes her purchase, there are some other preventative safety measures and household features that can be put in place to enhance a safe environment. Do these things from the beginning and avoid waiting for a fall or crisis to prompt a specific need for something. Being proactive is one of the best things you can do.
- Hand-held shower nozzle
- Grab bars in the bathroom near the shower and toilet
- Easy-grip door handles (lever style)
- Easy flip, rocker-style light switches
- Smart home capability to voice activate lights
- Easy-grip cabinet and drawer handles
- Raised level cabinets and appliances that prevent her from having to bend over to open
- Non slip floors with no loose areas or throw rugs
- Emergency alert systems with fall detection
Once her environment is set up for success, you can start to plan for supplemental assistance that will most likely be needed at some point. Make a list of what resources are available to meet those needs, how they will be accessed, and what the ongoing financial cost will be. Here are some things to consider:
- What transportation services are available when it is no longer safe for her to drive?
- What grocery shopping and meal service options are available? Nutrition and hydration are important to maintain her health.
- What options are available to provide personal care assistance, such as bathing and dressing?
- Who can assist with sorting mail, managing money, and paying household bills?
- How will medications be monitored and administered? The pharmacy can often provide options.
- Who can assist with household chores and maintenance?
- What are local resources for social interaction?
- What exercise programs are available to help maintain balance and mobility?
- If pets are involved, who will help take care of the pet?
There may become a point when it is no longer feasible to remain at home: for example, if your aunt required skilled care, 24-hour care, or developed behavioral or cognitive issues that put her safety at risk. The cost to provide these things in the home can reach $20,000 plus per month. Living alone can also become very isolating, especially if she no longer drives and has not established friends in the area. It is important to determine the limitations now so that a plan B can be agreed upon. Placement in an assisted living facility or nursing facility should be identified as a back-up. It is best to visit a few places while she is independent and able to make decisions (versus waiting for a crisis).
Many people age in place successfully, but it requires a plan and some preventative steps. It also requires flexibility and a willingness to recognize and adapt to change. Another move at some point does not mean failure; it simply means a different plan became necessary to meet her changing needs. It is wonderful that your aunt has you to help guide her in navigating this change in her life. Keep in mind that you can only do so much, and she will need to be on board with making decisions that support her desire to remain at home. There are many professionals who can help you both, so remember to preserve the relationship you have with your aunt and ask for assistance along the way.