November/December 2024

November/December 2024 Issue

Aging in Place: No Place Like Home
By Michelle Rankine, PhD
Today’s Geriatric Medicine
Vol. 17 No. 6 P. 30

Aging in Place in a Post-COVID-19 Era

The public health emergency may have ended years ago, but COVID-19’s lasting impact has significantly altered the life decisions and daily routines of today’s aging Americans. In a period of lockdowns during the pandemic, the business of telehealth and other contact-free health prevention measures rose to high demand, leading many to the realization that health care needs could be serviced from home.

For a vulnerable population that’s often stricken with ailments requiring frequent medical attention, the boost in accessibility to telemedicine and direct-to-patient, personalized care has only further substantiated their desire to remain in their homes as they age.

Aging in place will remain a topic of discussion for years to come. In fact, data from an AARP survey concluded that more than 75% of adults aged 50 and older prefer to remain in their homes for the long term—a number that’s been consistent for more than a decade.

As the cost of living continues to rise due to post-COVID inflation, researchers anticipate more older adults will opt to age in place as a more cost-effective alternative to moving into long term care facilities.

And as new health care innovations, trends, and challenges emerge, aging service providers will need to stay ahead of the curve to ensure that older adults—especially those with physical and/or cognitive disabilities—have the assistance and accommodations they need to maintain their independence and live a fulfilling life at home.

Supporting Aging in Place With In-Home Care
The in-home care market has seen tremendous growth as older adults opt out of nursing facilities and senior living communities to instead age in the comforts of the homes they’ve lived in for most of their lives.

In-home care organizations have specifically catered to this demand by offering a more specialized caretaking approach that includes preliminary intake assessment and home modification recommendations that aid in fall prevention, technology assistance, and transitional care needs for older adults adjusting to being home after spending long periods of time in the hospital.

These home care companies can be a pivotal resource for aging adults, oftentimes serving as a middleman in helping tailor and personalize aging in place services and care based on the specific lifestyle or health conditions of the client.

There’s no one-size-fits all approach to aging in place. A number of contingencies can determine the type of service an in-home care organization may need to provide. Community-dwelling older adults who are coping with Alzheimer’s disease will require more specialized assistance, beyond what they’d receive from the typical personal care provider. A client with a hip injury or those who are wheelchair-bound may need help from a professional caregiver with basic day-to-day needs such as getting dressed for doctor’s visits, bathing, and navigating their way to use the toilet. Other aging in place resources such as companion care can help reduce loneliness for older adults who may be widowed or without children.

All of the previously mentioned services can support older adults and their ability to maintain their independence and well-being, but these resources alone may not be sufficient in keeping elderly adults safe at home by themselves. Geriatricians should be aware of, and educating patients about, the following considerations that are essential in addressing the many needs and challenges older adults face when choosing to age in place.

Overcoming Nutrition Barriers With Strategic Meal Planning and Delivery Programs
While many older adults wish to age in place, planning and preparing meals can be a challenge, especially for those at home with cognitive decline who aren’t physically able to shop for their own groceries or operate a stove. Those individuals still need a balanced intake of protein, calcium, and other nutrients to remain healthy—sometimes even more as they age. Instead of them relying on the convenience of processed foods or habitual take-out, which can later cause even bigger health issues such as heart problems, diabetes, and even malnourishment, programs like Meals on Wheels can alleviate the burden of day-to-day meal prep and bridge the nutrition gap by delivering precooked meals to their front doors.

For aging adults with mobility challenges, reachers and grabbers are tools they can use to keep them from climbing to reach cooking utensils. Modifying the layout within the kitchen is also critical to help them avoid accidents and falls. For example, moving the client’s most-used pantry items and pans to a lower cabinet that’s easiest to reach and doesn’t require a stair step is key. Other appliances, like the coffee maker or air fryer, can remain on the countertop where they’re accessible and less taxing for adults who may not be able to physically move around as much as they once could.

Transportation and Errand Support for Older Adults With Chronic Health Conditions
Poor eyesight and more chronic health conditions like arthritis and hypoglycemia can make it difficult—and even dangerous—for older adults to operate a vehicle or perform routine errands. They may find aging in place impossible without the help of an in-home caretaker, health aide, or loved one who can step in to help them get around to pick up medical prescriptions or mail from the post office. Some home care businesses go as far as offering errand support services that will assign personnel to accompany older patients to their doctor appointments, hair salon visits, and other recreational activities. Many local governments also offer low-cost transportation services and errand assistance, giving older adults an easy way to age in place despite restricted mobility, lack of reliable transportation, and other concerns that make essential errands challenging.

Companion Care and Volunteer Support to Alleviate Isolation and Loneliness
Companion care providers can significantly improve the quality of life for older adults aging in place alone and can help them cope with change and isolation. This is especially the case for older patients who may be grieving a spouse or are without loved ones nearby. Studies show that the physical health consequences of social isolation or insufficient connection include an increased risk of heart disease, stroke, and dementia for older adults.1 Additionally, research shows that having a lack of social connection increases risk of premature death by more than 60%.2 Companion care service providers can be helpful in avoiding these risks by not only alleviating the burden of housekeeping tasks and other day-to-day activities for older adults who choose to age in place but also providing emotional support and positive interactions for those who are likely to suffer from today’s loneliness epidemic.

Technology to Aid in Fall Detection and Monitor Health Concerns
The COVID-19 crisis brought more older patients online in an effort to stay connected with others and limit exposure to the virus. According to U.S. News & World Report’s 2024 Aging in Place With Assistive Tech Survey,3 more than one-third of respondents reported that they’ve increased their use of assistive or health-related technologies due to the pandemic and have found it beneficial while aging in place. Innovations in technology have supported older adults and their ability to virtually obtain face-time and medical attention from their doctors, and other tools such as remote sensors or emergency alert wristlets and necklaces have also been used as preventative measures to help assist with fall detection.

Meeting the In-Home Care Needs of an Aging Population
For the first time ever, the US Census Bureau estimates there will be more older adults in the US population than children in the coming decades. By 2034, the bureau projects that there will be 77 million people aged 65 and older, compared with 76.5 million younger than the age of 18.4

With our nation gradually aging in a world permanently affected by the pandemic, these considerations highlight the critical role aging care providers play in helping older adults make the modifications needed in order to comfortably age in place. Whether personal in-home care or other service offerings, there are a plethora of aging in place resources available for older adults who choose to maintain their independence and spend their later years in a safe, comfortable, and familiar environment.

— Michelle Rankine is a three-times Right at Home franchise owner.

References
1. National Academies of Sciences, Engineering, and Medicine. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press; 2020.

2. New Surgeon General Advisory raises alarm about the devastating impact of the epidemic of loneliness and isolation in the United States. US Department of Health and Human Services website. https://www.hhs.gov/about/news/2023/05/03/new-surgeon-general-advisory-raises-alarm-about-
devastating-impact-epidemic-loneliness-isolation-united-states.html#:~:text=The%20physical%20health
%20consequences%20of,death%20by%20more%20than%2060%25. Published May 3, 2023.

3. Naru L, Beimesche E. U.S. News & World Report aging in place with assistive tech survey. US News & World Report. https://www.usnews.com/360-reviews/services/senior-tech-aging-in-place-survey. Published May 22, 2024.

4. Older people projected to outnumber children for first time in U.S. history. United States Census Bureau website. https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html. Updated October 8, 2021.