Kathy Black, PhD, MSW, MPH, MSG. is a Hartford Geriatric Social Work Faculty Scholar and Associate Professor at the School of Social Work, University of South Florida Sarasota-Manatee campus. Dr. Black’s areas of expertise include advance care planning throughout the end-of-life, advance directives, healthcare professional communication, and aging-in-place.
Q: What is Aging-in-Place?
A: Aging-in-place refers to people getting older in their “home,” or the place where they live and wish to continue to reside. The majority of older adults wish to remain in the homes they have lived most of their lives and many do; in fact most people age 65 years and older live in non-institutional settings and own their own homes.
Q: How can I Age-in-Place?
A: The ability to remain at home generally depends on several factors. Ask yourself the following questions to see if you are prepared to age-in-place:
- Personal health status and needs: Do physical or mental limitations affect your ability to manage at home? Are you able to get your health needs met at home?
- Family and other informal supports (such as friends, church, etc.): Who will provide care for you if and when needed? Is the caregiver capable of providing the care you need?
- Economic circumstances (including finances and insurance): Do you have enough money for care that you may need to stay at home? Home care services can be expensive and are generally not covered by insurance. Know that Medicare provides limited short term home health care at home under specific circumstances and that Long Term Care Insurance may not meet your home care needs.
- Physical home environment: Are you able to get around in your home? Stairs and the lack of bathrooms may impact your ability to stay at home. Although available, home modifications to add a ramp or bathroom can be costly. Also important to consider: Can you maintain your home? Home repairs can be costly, difficult, or unsafe. Have you considered where you might move to if unable to stay at home? Many assisted living facilities and other care settings have waiting lists.
- Broader community of services: What services does your community offer to help people age-in-place? Communities vary in available services; some services may be free or low cost or covered by insurances such as Medicaid, while others are not; many have waiting lists. Your state and local government may provide some services, while others are private or for-profit. Eligibility for services also vary.
Q: What services are available to help me age-in-place?
A: There are a wide range of services to support aging-in-place; however, the availability of services will depend on where you live. Generally, examples of services to help remain at home include:
- Basic homecare: having someone in to make a meal or clean the kitchen;
- Home healthcare: having someone come in to provide personal care or specialized medical care;
- Home maintenance: hiring someone to take care of the lawn;
- Transportation: accessing a ride to and from a doctor’s visit;
- Home-Delivered Meals: free or low cost meals delivered at home.
Needing a variety of services is not uncommon, however it is often difficult to learn about, access, and manage the range of services you might need. Geriatric case managers are professionals employed in public and private settings to assist you in accessing and managing the care you might need. You can access public case managers through many of the governmental programs offered in your area.
Private geriatric case managers can be reached through such organizations as the National Association of Professional Geriatric Care Managers, 1604 N. Country Club Road, Tucson, Arizona 85716, 8:00 a.m. to 4:30 p.m., Mountain Standard Time (all year round; Arizona does not observe Daylight Savings Time), Monday through Friday, except holidays. Telephone number is (520) 881-8008; fax number is (520) 325-7925. Voice mail allows you to leave messages 24 hours a day, seven days a week, or via the Web site at: http://www.caremanager.org/
To learn more about services in your community, please contact the Administration on Aging’s Eldercare Locator to begin your search for services to help you remain independent in your community. You can reach an Eldercare Locator information specialist by calling toll-free at 1-800-677-1116 weekdays, 9:00 a.m. to 8:00 p.m. (ET). Spanish-speaking Information Specialists are on duty. You may also access the service via the Internet using the following link, http://www.eldercare.gov/Eldercare/Public/Home.asp.