Older adults who need more help with activities of daily living for safety have options in the community
By Deborah Jeanne Sergeant
When an older adult needs more help with activities of daily living for safety, health and comfort, several options are available before considering full-time skilled care in a nursing home: aging in place with support, independent living and assisted living.
Many people prefer to age in place at home or the home of a loved one. For many people, this would require home modifications such as installing grab bars, building an addition to add a bedroom and full, first-floor bathroom and other changes.
As the need for assistance increases, older adults may need help at home. Home care services are not covered by Medicare typical health insurance plans and most people do not have long-term care insurance.
“Elder One can provide a great deal of support but you need family or friends if an aide calls off or you need some other assistance,” said Sarah Bateman, administrator at Rochester Regional Health’s Edna Tina Wilson Long Term Care in Greece.
Intergenerational living can provide considerable support, as merging households can prove mutually beneficial in many ways. Homes with in-law suites and first-floor bedrooms can help make it possible for older adults to stay at home longer. Some families choose to move to a new home to provide space for themselves and their seniors.
Using technology such as cameras, fall alert pendants and smartwatches can help the family better protect their older loved ones. It’s also helpful to have Meals on Wheels stop by for older adults living by themselves or who are home alone while their family members are at work.
“Resources like Lifespan are incredible,” Bateman said. “They will support living in the community and helping them navigate. Caregivers of elders are usually working and in their 50s and 60s and don’t know where to start.”
The county’s office for the aging may also recommend local resources.
Some older adults don’t want help, which is where caregiving family members may need to get creative. Instead of arranging for a family friend to stop by and check on your loved one, “maybe you’re ‘helping’ someone not be bored who stops by to visit,” Bateman said. “There are friends, neighbors, there are often a lot of folks who could do some work on the side.”
Arranging for someone to drop by to play a few card games two days a week can really be a gentle way to check in with a senior’s wellbeing. Scheduling a visit per week from a handful of friends can provide socialization and safety.
“Loneliness plagues elders,” Bateman said. “They need people to talk with and people checking on them.”
Some older adults do not want to have the responsibility of yard work and household maintenance and feel unsettled in their large, now-empty home since their children moved out and their spouse passed away.
Others may not need to downsize right now but want to do so before it becomes an emergency. Independent living may be a good next step, as it “is centered around convenience, enhancing socialization and connection and a maintenance-free lifestyle and assisted living provides that added layer of hands-on support,” said Meghan Gravino, executive director of Thompson Health’s independent and assisted living communities, Ferris Hills at West Lake and Clark Meadows at Ferris Hills.
Residents manage their own cooking, medication and personal care and benefits include a safe neighborhood, similarly aged neighbors and secure shared spaces such as sometimes a community center or green space.
“When those daily tasks start to feel overwhelming or there’s a need for more consistent support with things like bathing, dressing, meals or medication management, assisted living becomes the better option,” Gravino said. “It is not about losing independence. It’s about gaining the right level of support to continue living safely. They say you thrive in the right level of care.”
Many times, assisted living residences include services a la carte, such as laundry, care management, transportation, and recreational activities.
This ensures “residents have consistent support while maintaining as much independence as possible,” Gravino said.
Some independent living residences, such as Ferris Hills at West Lake, are connected to assisted living residences, such as Clark Meadows and share staff. Since residents at Ferris Hills are already in the system, transitioning to a higher level of care is seamless.
“I feel that the need for assisted living often reveals itself gradually, through missed medications, needing assistance with activities of daily living, meal management and so on,” Gravino said. “Ideally, you don’t want to miss that window. Assisted living is regulated by the New York State Department of Health and residents need to meet specific criteria to be appropriate for that level of care. When the transition happens at the right time, individuals are far more likely to flourish, rather than risk declining beyond what that setting can safely support.”
That’s why she encourages beginning conversations about care early. Making the move to independent living can also provide residents with more social interaction and buffer against isolation.