by Ben Swenson
If senior citizens weren’t already asking themselves the question before COVID-19 struck, they may be now: Am I prepared to remain in my home for the long haul?
Stay-at-home orders meant to encourage social distancing and slow the spread of the novel coronavirus have presented an opportunity for seniors to evaluate how well their home meets the growing demands of old age. Is the home sufficiently accessible for elder issues, and can the residents themselves accomplish so-called Activities of Daily Living, or ADLs, such as eating and hygiene? Is socialization and communication with those outside the home easy and effective?
The good news for seniors and their loved ones taking a hard look at home is that the concept of aging in place – remaining in one’s preferred residence rather than moving to some sort of institutional setting – has become a clear priority in recent decades.
The number of resources and programs available to help older Americans age in place has grown and it’s easier than ever to remain in one’s home as long as possible. But that doesn’t mean that staying home is effortless. A frank assessment of long-term prospects and priorities is needed, the results of which could determine if they may already be in the best place to spend their golden years.
Most older Americans want to stay put. According to a 2018 study by AARP, 76 percent of Americans aged 50 and older want to live in their current home as long as possible. That’s welcome news for administrators of health care systems and specialized elder-care facilities that are ill-equipped to handle the swelling population. According to the U.S. Census Bureau, by 2034, there are projected to be roughly 77 million Americans aged 65 and older, up from 52 million in 2018.
Aging in place doesn’t necessarily mean remaining in the relatively large home where one may have lived for decades and raised a family, according to Mary Languirand, a clinical psychologist and co-author with her husband Robert Bornstein of How to Age in Place:
Planning for a Happy, Independent, and Financially Secure Retirement. “The real key is flexibility,” she says.
Staying in a lifelong home, making it accessible, and still having access to services will work well for some people, Languirand says. But others may choose to move to a different home, perhaps downsizing to an independent living or age-restricted community where amenities are more-readily available. There are many different arrangements and locations to age in place.
Aging in place can yield significant cost savings for Medicare and Medicaid, which pay for a majority of institutionalized elder care in the United States. And staying in one’s home can also be cheaper for individuals who pay for a large portion of their care out-of-pocket. The average annual cost of sharing a semi-private room in a nursing home in the United States is $90,155, according to 2019’s Cost of Care Survey conducted by the insurance firm Genworth Financial. The cost of aging at home is about half that.
Cost savings aside, staying at home as long as possible is challenging, because it requires long-term vision and planning that seniors themselves often have difficulty tackling on their own. Simply declaring an intention to age in place is not sufficient, according to Heather Schouten, a senior advisor with ChooseHome Riverside, a continuing-care program for seniors. “People want to stay at home, but life happens,” she says, so preparation is key.
Remaining in one’s home requires an ambitious, holistic approach that addresses every area. Charlie Martino, a personal-services coordinator with ChooseHome Riverside, identifies five elements of successful aging, each of which should receive ample deliberation ahead of time: financial preparedness, defining one’s purpose, keeping socially connected, giving back to the community and staying physically and mentally fit.
Even if a retiree or couple has a good handle on their current finances, having a financial plan in place will help prepare for the ballooning costs of old age. There are simply too many unknowns to believe one’s finances at the time of retirement will be enough as time moves on. And it’s always important to make one’s final wishes known before advanced age compromises your ability to think, or communicate. Martino says consulting an elder lawyer and financial planner is a must before aging in place.
A hard look at the finances of retirement might seem like a logical step, but Martino says that the other, less-obvious considerations are equally as important. One must think about individual purpose, for instance, and work toward a life that is meaningful and fulfilling and decide how living at home can help them accomplish that.
Seniors should make a strong effort to maintain social connectedness with family and friends, and have established routines and networks in place to avoid isolation. And one must think about what giving back to the community will look like when they live in their current residence, because so many people place great emphasis in their later years on giving back by sharing the knowledge and abilities that they’ve spent a lifetime acquiring.
Martino says he and his colleagues spend most of their time talking to people about their physical well-being. Maintaining one’s health is paramount to successfully aging in place. Perhaps that can be accomplished at home, or with some sort of regular program off-site.
“If they can stay healthy through physical and mental exercise, when they do have an injury or illness, the resilience that gets them back to their baseline of health…depends on how strong they are to being with,” he says.
Seniors must be adaptable to confront the challenges that aging in place requires. Perhaps that means modifying one’s home to make it more accessible for limited mobility, or becoming familiar with community resources that assist retirees, such as the nearest Area Agency on Aging or senior center.
Adversity sometimes takes people by surprise, Languirand says, especially things they didn’t want to think about – their health, mobility, dwindling resources or the cast of characters that populate their lives, for instance. Some changes are going to occur with near-certainty, she says, while others will come out of left field. You will very likely suffer age-related illness and deterioration, but at the same time, there may be – of all things – a pandemic. “You should have the ability to marshal your resources regardless of what happens,” she says.
How to Age in Place: Planning for a Happy, Independent and Financially Secure Retirement by Mary A. Languirand and Robert F. Bornstein. Ten Speed Press.
Aging In Place – AgingInPlace.org
National Institute on Aging, National Institutes of Health – NIA.NIH.gov/health/topics/aging-place
By The Numbers
Each year since 2004, Genworth Financial, a Henrico County-based insurance firm, has conducted a nationwide Cost of Care Survey to estimate how much senior citizens and their loved ones can expect to pay for elder care. This metric is used nationwide by senior advocacy groups such as AARP and SeniorLiving.org, as well as government agencies, such as the National Institute on Aging, to help constituents make long-term plans. Based on the company’s 2019 Cost of Care Survey, these figures represent what Hampton Roads residents can expect to pay annually for various services, compared to the statewide and national averages for the same level of attention.
Aging in place
Homemaker services, including household chores and errands:
Hampton Roads – $46,904
Virginia – $50,336
United States – $51,480
Home health aide, providing regular, individualized medical attention:
Hampton Roads – $48,002
Virginia – $52,578
United States – $52,624
Adult day health care program or facility:
Hampton Roads – $19,240
Virginia – $19,240
United States – $19,500
Residential assisted living facility:
Hampton Roads – $55,524
Virginia – $57,600
United States – $48,612
Nursing home facility
Hampton Roads – $84,023
Virginia – $88,206
United States – $90,155
Hampton Roads – $93,988
Virginia – $98,550
United States – $102,200
Source: Genworth Cost of Care Survey 2019, available online at www.Genworth.com under the “Annual Cost of Care” link on the homepage.