Wednesday, April 2, 2014
The AARP reports that nearly 80 percent of adults age 65 and older want to remain in their current homes as long as possible. That population is growing. According to the Department of Health and Human Services’ Administration on Aging, the population 65 years or older numbered 39.6 million in 2009. By 2030, that number will grow to about 72.1 million.
While people are living longer and healthier lives, there are still barriers to aging in place, including medication management, self-care, socialization and transportation. But there are innovative strategies and initiatives to help combat these roadblocks.
"We’re showing people how to modify their home so that it is accessible," said said Robert C. Eiffert, the Long Term Care Program manager for the Fairfax County Health Department. Fairfax and other local counties are conducting workshops on how to make a home safe for a senior who wants to live alone. "We’re talking about things like adding a ramp to your front door, changing your door knobs and cabinet handles for people who have arthritis in their hands."
"There are wonderful emerging technologies that allow adult children to monitor their parents who live alone," he said. "It is not intrusive. There are not cameras involved, but there are motion sensors. For example, if there is no movement in the morning, an adult child might think, ‘Hmmm, I need to check.’"
Andrew J. Carle, director of the Senior Housing Administration at George Mason University, recommends First Street for Boomers and Beyond (www.firststreetonline.com) which offers products for seniors and their caregivers. "Products like a nice walk in bathtub for seniors or an alarm that reminds you when to take your medicine are things you can do to change your home and make it safe."
A LACK OF SOCIAL interaction and mental stimulation can contribute to depression and mental deterioration, Carle said. Organizations like the Osher Lifelong Learning Institute (OLLI) at George Mason University, offer opportunities for intellectual stimulation and cultural experiences for retirees in Northern Virginia.
"OLLI, as we call it, is for people who don’t want to sit around and watch television all day," said Carle. "Professors volunteer their time to give lectures on art, history, science and other topics. Listening to professors speak about stimulating topics helps keep their brains sharp."
Jennifer Disano, OLLI’s executive director, says the group has 1,200 members, and is funded by an endowment from the Bernard Osher Foundation. The group’s main campus is in Fairfax, but other campuses are in Reston and Sterling. It serves the needs of those who might not feel comfortable in traditional college classrooms and don’t want the pressure of writing papers and taking tests, but are still interested in learning.
"We have people here who were economists and worked with finance, but in their retired life they want to explore areas … like art classes or history classes," she said.
One of those members is 76-year-old John Woods. He has attended three to four OLLI events a week for 10 years. "We have a wide variety of professionals and a wide variety of groups that meet," he said. "We have a group that meets to talk about financial investments. Another group meets every Monday morning at 9 a.m. and looks at the past week’s headlines from the Washington Post, New York Times and Wall Street Journal. They have insights that are important. The stimulating thing is sharing ideas among ourselves."
VILLAGES ARE community_based organizations designed to help members help each other remain independent and in the communities of their choice. "Back in 2000, villages started with a group in Boston, and in 2007 there was a big boom," said Barbara Sullivan, executive director of Mount Vernon at Home in Mount Vernon. "It is community-based. Every village is different, but they’re there for people who want to age in place."
Eiffert, of George Mason, says village members define the type and scope of services. "A good starting point when creating a village is to survey the community members to determine their needs," he said. "We provide technical assistance to community groups that are interested in putting together a village and encouragement on what models work best for their community. Fairfax County is working with Montgomery County to rewrite the manual on how to start a village."
There are a few different models, including the "Concierge Village," which is a non-profit model that coordinates access to an array of services through vetted providers, including transportation, home repairs, care coordination and computer technicians. Most also include social and educational activities. Members arrange for services by calling a central phone number, and pay annual dues that can range from $500 to $800 for an individual and $700 to $1,200 for a couple.
The "All Volunteer" model organizes community volunteers to provide services and support to others. There are no paid staff. In some cases, hours donated by volunteers are "banked" and can be used in the future if the volunteer needs services or assistance. The "Neighborhood Network" is also informal. Groups meet on a regular basis to hear speakers on topics of interest selected by members.
ANOTHER BIG GAP is medication management, Eiffert said. "If someone can’t manage their own medication and can’t afford to pay someone to come in to do it for them, that is a service gap that forces people into assisted living facilities."
Carle agrees that the decision to age in place is complicated. "The first knee-jerk reaction is that when asked, seniors want to stay in their own homes," he said, adding that those surveys can be misleading: "The surveys are not always credible if you’re surveying people who are 50-plus. I’m 54 and of course I want to stay in my house, but ask me again in 20 years. I think they should be surveying people who are 75-plus."
In addition, "people don’t always understand the economic, social and safety aspects of it," he added. "You can create all kinds of technology and universal designs to create a house for aging in place, but a senior might not be able to afford it. It could end up costing far more than the best assisted living facility in town."
Granny Pods, small prefabricated homes that allow families to house their relatives in small backyard cottages, are another alternative. "These small living units allow you to put an elderly relative in your backyard and hook up to your electricity," said Carle.