4 tips for helping your parents age at home

If you are reading this you have either found yourself in a caregiving situation or anticipating being in one in the future. Chances are your aging loved one wishes to "age in place" so what does that mean?

According to AARP, nearly 90 percent of seniors want to stay in their own homes as they age, often referred to as "aging in place." You have suddenly found yourself as the air traffic controller responsible for your loved one's safety and well-being.

Here are some tips to help your loved one maintain independence for as long as possible.

1. Know Your Limits: Evaluate the difference between your parent's needs and your ability to assist. One of the biggest challenges that face caregivers is the literal juggling of all aspects of life. If you have too many balls in the air they will all start tumbling down. It is very common for caregivers to feel like they've got it all handled and continue to add more and more balls. Often caregivers find themselves sandwiched between care for an elder and care for children, grandchildren, and/or a spouse as well as managing responsibilities at work. As demands grow in any particular area, other areas suffer and eventually the caregiver breaks down and everyone suffers. Knowing your limits means trying to anticipate future care needs of the one you are assisting as well as the needs of your other family members. Couple those with the expectations of work and dare I suggest your social life. Part of this evaluation needs to include being prepared to expect the unexpected and reevaluate as the balance begins to feel off. When you enter into a primary caregiving role it is important to make it clear that you are going to try this but if it becomes too much, an alternative will need to be considered. Many people have found themselves in situations promising family members that they would never put them in a "home." Steer clear of these types of commitments because it is not possible to completely anticipate the future care needs nor what may impact your future ability to provide such heavy assistance.

2. Evaluate Finances: No matter how you slice it, care as we age gets expensive and much to the wonderment and even dismay of many people, private insurance and Medicare do not cover all of it. As a matter of fact, most of the care needs that a loved one will need whether it is aging in place care or residential care will need to come privately out of pocket! It is so important to evaluate the finances of your loved one and determine what their monthly expenses are and how much "extra" there is to pay for additional assistance. Helping a loved one age in place also means that family members need to come together and see if they have any funds that they can put toward the effort as well.

3. Determine Care Needs: Certain chronic illnesses have "projected trajectories" meaning they typically follow a certain path of decline. If your loved one has been diagnosed with a chronic condition such as congestive heart failure, kidney failure, dementia, or even Parkinson's Disease (to name just a few), it is important to get the big picture from their family care physician about what to expect. With that being said, you must know that not everyone falls neatly on a particular statistical graph so there will be variances with every situation. When you understand what the care needs are for now and the future you can determine what you should do to help your loved one age in place. You can also have a candid conversation with your aging parent/spouse about how long you feel you can take this on and at what point you may need to transition into a different living arrangement. Knowing what the future holds also gives you and your family member a sense of control. Being able to plan ahead will help allay panic when there is a future health crisis.

4. Enlist Support from Professionals: We are incredibly resource rich when it comes to long-term-care organizations in this area. A great place to start is with Transitions GuidingLights Caregiver Support Center. This nonprofit charity provides free information, referral, education, and support to family caregivers. They are just a phone call away and can help you unravel the tangled web of resources available to you in our community. There are so many home and community-based organizations available in this area to support you in your efforts to help your loved one age in place. Below you will find the most commonly accessed types of community-based care and a few hidden gems!

Private Duty Home Care Agencies: Private Duty Home care agencies are able to place a professional nursing assistant in the home to assist with personal care tasks such as help with bathing, grooming, dressing, medication reminders, and walking. Oftentimes, these agencies can aid with transportation, meal preparation, companionship, and light housekeeping in conjunction with helping with other care needs. This service is typically paid for with private funds but there some limited services available for individuals on Medicaid. Some people have purchased long-term-care insurance policies to assist in paying for these services.

Home Modifications: Among the greatest threats to one's ability to age in place is falling. According to the Centers for Disease Control and Prevention (CDC, September 2016), falls are the leading cause of injurious death among older adults. Therefore, engagement in fall prevention is crucial to one's ability to age in place. Our homes are filled with hazards that place falling as a huge risk. We can find danger spots in the bathroom, on the floor (throw rugs), and in almost every living space (clutter and blocked passageways). There are many low-cost modifications that can be made to an older person's home that can greatly decrease the risk of falling, as well as decrease the risk of other forms of injury. Some examples of home modifications include:

• Increased lighting,
• Accessible switches at both ends of the stairs,
• Additional railings,
• Grab bars,
• Nonskid floor in no step shower areas,
• The removal of throw rugs and clutter

In most cases, home modifications can be simple and cost-effective, while simultaneously offering substantial benefits to the individual. Most of these modifications are paid for privately and it is important to find a contractor you can trust. Universal Design Specialists offers specific training in how to make homes accessible for older adults and their experts go through extensive training to be able to offer this necessary guidance.

Aging Life Care Managers: Aging life care managers are a wonderful resource to assist very busy and overwhelmed caregivers with tasks such as care coordination. According to the Aging Life Care Association, aging life care managers are also known as geriatric care managers and provide "a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. Working with families, the expertise of Aging Life Care Professionals provides the answers at a time of uncertainty. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off work for the family caregiver." This service is typically paid for privately or with long-term-care insurance. Aging life care managers also provide an extra pair of eyes which can be very beneficial to the long-distance caregiver.

Home Health Organizations: According to Medicare.gov, "Home health care is a wide range of health care services that can be given in your home for an illness or injury. Examples of skilled home health services include: Wound care for pressure sores or a surgical wound, patient and caregiver education, injections, monitoring serious illness and unstable health status." One of the most wonderful things that home health care provides is rehabilitation therapy, meaning helping your loved one regain lost ability. The goal of home health care is to treat an illness or injury. Home health care helps you get better, regain your independence, and become as self-sufficient as possible. Home health care is typically paid for by Medicare and/or private insurance but it is not a long-term option. Once your loved one has progressed as far as they can according to Medicare guidelines the service ends. This type of service is not a long-term solution but is imperative to help your loved one get stronger!

Adult Day Care Centers: Adult daycare organizations are one of the best-kept secrets in long-term care. They offer services for seniors so family members who work full or part-time or have additional obligations like child-rearing can take time for self-care. The National Adult Day Service Association defines it as "coordinated programs of professional and compassionate services for adults in a community-based group setting. They provide social and some health services to adults who need supervised care in a safe place outside the home during the day. Adult day care centers allow seniors to enjoy safe and productive days in a caring environment while returning to the comfort and familiarity of home at night." Adult day care centers are typically very affordable, and we are very fortunate to have both medically-based and socially-based centers in this area. This benefit is typically paid for privately or with long-term-care insurance.

Transportation Companies: According to ncdhhs.gov, "North Carolina offers transportation services. Adults 60 and older may be eligible for transportation assistance to destinations such as senior lunch programs and grocery stores. Some counties also have funding for senior transportation to medical appointments. These rides are sponsored by a combination of county, state, and federal Older Americans Act funds." There are also several private transportation companies that specialize in transporting seniors in the area. The benefits of these agencies are that they free you up as a caregiver from having to run errands or even transporting to and from appointments.

Area Agencies on Aging: Area Agencies on Aging (AAAs) are offices established through the Older Americans Act that facilitate and support programs addressing the needs of older adults in a defined geographic region. In North Carolina, AAAs are located within regional Councils of Government. These agencies offer a huge variety of services in our community specific to the county in which your loved one resides. Locally, you may wish to contact the following organizations for support:

Chatham County: Chatham Council on Aging

Durham County: Durham Center for Senior Life

Harnett County: Harnett County Department on Aging

Johnston County: Community Senior Services of Johnston County

Orange County: Orange County Department on Aging

Wake County: Resources for Seniors

Technology: Aging in place technology can help people stay safe, comfortable and secure in their homes for longer. The number of products available to older people that help meet their specific needs is growing fast. From personal growth to health to making communication with family easier, this area of support is exploding. There are many options to make the home more automated, connect your loved one to family members more frequently on a social basis, monitor health from a distance including blood pressure and weight changes, remind your loved one to take medicine, and even help you keep track of your family member with GPS tracking devices!

Respite: Respite care often refers to short-term stays in assisted living communities. Respite care is a helpful option for family caregivers who need a short break from their caregiving duties, or for seniors who need a higher level of care as they recover from an illness or surgery. Short-term stays are also used by many seniors to try an assisted living community before moving in long-term.

If you find yourself in a caregiving situation we invite you to join the Caregivers Corner an online space to get support from each other and share resources. Aging in place is going to become a bigger and bigger topic facing aging Americans. According to the U.S. Census Bureau, by 2030 there will be approximately 71.5 million Americans over the age of 65. That number is more than twice what it was in 2000 and represents nearly 20% of the entire projected U.S. population in 2030. The challenge this number of older Americans will bring to the country is unprecedented. We lack much of the financial resources and familial support to help older Americans age in place successfully. Planning and having open discussions about these issues will help you face this head on in partnership with the senior for whom you are providing care.

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