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  • Writer's pictureDr. Heikens

Aging in Place

Updated: Nov 6, 2023

Aging in place is the ability to live independently in your preferred location for as long as possible. It's a common goal for many seniors, and with good reason.


Benefits

There are a number of benefits to aging in place. When done well:

  • Seniors who age in place are more likely to be happy and satisfied with their lives

  • Those who are able to successfully age in place seem to have a better quality of life and are less likely to be institutionalized

  • You know your area and your home. This familiarity can make your living situation safer.

  • Your friends and family may be closer, and you may have local ties to your community

  • It may be less cost to maintain your home when you already own it and have been there for a number of years

Challenges

Of course, aging in place can also be challenging. As we age, our bodies and minds change. We may become more frail, and we may have more health problems. We may even develop a little difficulty with memory.

  • If you are no longer able to drive, living in a remote area can be problematic

  • Isolation may be an issue if you are not actively engaged with your community, and this isolation can lead to depression or loneliness

  • Your home may need significant (read: costly) modifications, especially if some maintenance items have slipped through the cracks

  • If your loved ones are far away, there may be significant cost and burden associated with providing needed care

  • Household clutter can go from being an annoyance to a trip or fall hazard

  • The things we own can become a burden: more maintenance requirements like cleaning and organizing which can increase in difficulty as we get older

When we speak about aging in place, it is important to understand how we can be unsuccessful. We cannot just be stubborn, so that by the time we need more help, we REALLY need it, and our family feels unprepared, rushed and guilty about needing to get the help we require. It is imperative that we plan ahead to determine how to successfully navigate changes in health and independence, and discuss with our family or friends as to when it might be time to seek further help.


Aging in Community

The term “aging in community” may be more appropriate overall than “aging in place.” This adds choosing to live among others to obtain and maintain a sense of social belonging. This can reduce isolation which can have a significant positive impact on emotional and physical health. Because like-minded people are living near each other, they are more likely to engage in activities and maintain their physical and mental health.

  • Consider retirement communities of people who are 55 and older. These frequently provide homes that are already built with seniors in mind and a number of recreational activities/amenities. These can also take the form of senior villages, RV communities, “tiny home” communities, etc. depending on your taste. Each has its own benefits and struggles.

  • “Granny pods.” Some seniors choose, with their families, to live in a small home separate from their adult children but on the same property (or very nearby) to provide a decent amount of privacy while having assistance more closely located.

Strategies for Success

There are a number of things you can do to age in place successfully. Here are a few tips:

  • Practice self-compassion. We can all agree that just about everyone deserves to be treated with respect and kindness, but it can be difficult to apply this to ourselves. If we need to leave our home due to physical or other medical reasons, this does not represent failure. It may simply be a natural progression of aging and our health problems.

  • Realize you are NOT a burden. What would you do if your family member came to you in need, and you could help them, perhaps if they just graduated college and were having difficulty making ends meet until they got a job? Maybe they need a place to stay for awhile? Assistance from your friends and family is provided out of love and respect. Try to accept it from that standpoint, and realize that you are NOT a burden.

  • Participate in activities that provide you with a sense of purpose. These are different for each individual, however some like to volunteer, others like to learn a new method of art, and yet others like to learn a musical instrument. These activities, and the people you interact with to pursue them, can provide a sense of purpose and even community.

  • Make your home safe and accessible. There are a lot of possible interventions that might be helpful to keep your home safe. There are even local services that can evaluate your home and make recommendations: look for a “Certified Aging in Place Specialist” to learn more.

    • Downsize. Reducing the number of things you own and maybe even the square footage of your home can be helpful to reduce the need for cleaning or maintenance. Many times our “stuff” is only kept because of the memories it evokes - NOT because of the actual function it serves. See if you can find a meaningful home for your stuff, rather than holding onto it, if possible.

    • Pay attention to safety. You might benefit from:

      • Removing trip hazards like rugs and extension cords

      • Converting to a walk-in shower instead of a tub

      • Grab bars in the bathroom (around the toilet or in the shower/tub)

      • Widened doorways

      • Adding ramps to the home

      • You may even wish to consider moving to a single-story home or to an apartment with an elevator

  • Stay healthy. This is not always easy but it is something we should all be working on. It is much easier to maintain your physical fitness than to try and recover it after you are starting to have difficulty getting around. Eat a healthy diet and exercise regularly. This should really be a discussion between you and your physician, but it is amazing how so many concerns in life respond to these simple (but not easy!) recommendations.

  • Do not neglect sleep. Poor sleep can lead to irritability, memory problems, increased falls or accidents, and even depression. Aim for 7-9 hours of sleep per night. Try to AVOID afternoon or evening naps that can disrupt your usual sleep, and have a bedtime routine that can include a bath, reading, or even just softer lights and calm music. If you are having difficulty with sleep, discuss sleep aides with your physician before you try them, as many of these are not recommended in patients over the age of 65.

  • Have your hearing checked. Reduced hearing leads to isolation which can increase loneliness and even increases risk of dementia. So have your hearing checked and treated to prevent these unfortunate outcomes.

  • Have a physician you trust. Get regular checkups from your doctor and take any medications that are prescribed to you - and be open and honest if there is a concern with taking a medication, whether it is a side effect you are experiencing or if it is difficult to remember taking it as frequently as instructed (like if you have a two- or even three-times daily medication). It is super important to have a doctor you know, who also knows you, and can help you navigate your health decisions.

  • Have a plan for transportation. Make sure you have a way to get to and from doctor's appointments, the grocery store, and other important places. You may want to consider using public transportation, ride-sharing services, or a senior transportation service.

  • Build a support system. Having friends and family members who can help you out is important, especially as you get older. Consider joining a senior center or other social groups. You may also want to consider hiring a caregiver to help you with tasks such as cooking, cleaning, and bathing, if or as these are becoming more difficult. Staying connected with others can prevent isolation and helps with physical and mental health..

  • Discuss possibilities with your family ahead of time. As previously mentioned, have a plan in place for when you feel it would be appropriate for friends or family to bring up an alternative living situation, and commit to being able to have an open, honest conversation with your family if you or they feel the time is right for this.

  • Plan for what-ifs. The above conversations should include planning ahead for unforeseen circumstances - discussion of advance directives and what we call “code status” should definitely be a part of this. You might be surprised to hear how often family members do not seem to agree on a course of action for their loved one simply because it has not been discussed before. Again, this should be done in consultation with your physician.

Resources

There are a number of resources available to help you age in place successfully. Here are a few examples (there are a number of organizations in each of these categories in San Diego):

  • Senior centers: Senior centers offer a variety of programs and services for seniors, including social activities, transportation, and meals.

  • Area Agencies on Aging: Area Agencies on Aging provides links to a variety of services for seniors, including counseling, information and referral, and financial assistance. Visit www.usaging.org for more information and to look for local services.

  • In-home care agencies: In-home care agencies provide a variety of services for seniors, including personal care, companionship, and home health care.

  • Assisted living facilities: Though this may not seem like aging in place, assisted living facilities (ALFs) can provide a range of services to assist you in maintaining independence. These services can include social activities, help with cleaning or laundry, provided meals, help with bathing or personal care, assistance with medications, and sometimes even medical services.

  • National Institute on Aging: For more information on related topics, visit https://www.nia.nih.gov/health/topics

Conclusion

The goal of all of this is to maintain independence and dignity, while also receiving as much assistance needed. This combination is an attainable goal for many, with proper planning between you, your family, and your physician.


If you do not have a personal physician, we would be happy to discuss how we can help.

We are a direct primary care office in San Diego. Direct primary care is a relatively new, membership-based model of providing traditional primary care services outside of the typical insurance-driven model. By eliminating insurance from the equation, we can take more time with you and focus on what matters most: you and your health. We provide longer appointments, easier and earlier access, and reduced barriers to care.


If this sounds like something you would be interested in, you can find more information on our main website, www.healthmattersdpc.com, where you can schedule a free 15 minute meet-and-greet appointment to discuss our services further. If you would rather call, our phone number is 619-949-3479.

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