Not the only.    Not for everyone.     Just the best. We have been promoting Aging in Place as a thing unto itself, when it is really the most scalable, desirable and economical Long Term Care (LTC) strategy. We have also been looking for a better way to say it then “aging in place”. I propose Long Term Care at Home. News accounts lament the lack of planning and saving among adults. No one plans to move into assisted living or a nursing home. Those are the only LTC strategies most people know about.* Financial planners and long term care sales people don’t even talk about where you are going to live. I don’t know if it is because they don’t know, don’t care or do know that talking about assisted living and nursing homes takes the discussion where no one wants to go, ruining the sale. Smart people don’t buy something they don’t want, so what may look like burying heads in the sand is really a wise consumer decision. “I don’t see anything I want. I am not going to buy.” One benefit of planning is increasing the odds of things going well. The flip side is reducing odds of things going poorly.  You plan a vacation or a party so it is pleasant and limit the chance things will go astray. Retirement/ Financial/ Long Term Care Planning should be the same. Not just the money to travel but real strategies to avoid nursing homes. Health has a role. So does your home.
- Â Updating your home make it more pleasant, a better match for your current taste and activities.
- Long Term care at Home means the ability to get the care you need in the residence you choose. You own the venue. You control what happens there. The folks who own assisted living make the rules. Plan to live at your house. You make the rules. You maintain control.
- A well prepared home helps avoid injury, one reason people are forced to move to traditional LTC.
- A well prepared home is the most pleasant and most economical place to recover from accident or illness.
- A well prepared home makes it easier for family and informal support-Â the most important source of care – to contribute.
- Long Term Care at Home allows paid care to be used selectively. Various services can be ramped up or withdrawn to match changing needs, rather than ‘in the package’ of assisted living or nursing homes. Custom, ‘Just in Time’, more economical use of resources
- An energy efficient home shields fixed income homeowners from rising energy costs.
Long Term care at Home requires being aware and making plans. That is not a hard sell if it is presented in the right context…Long Term Care at Home is a desirable long term care strategy. All retirement, financial and long term care planning should include the at Home living strategy. Long Term Care at Home is something to look forward to. Let the planning begin! * or can afford…some find Continuing Care Retirement Communities (CCRC) desirable but they are very expensive.
Louis Tenenbaum, one of the nation's leading authorities on aging in place, is the founder of HomesRenewed, a coalition of business, consumers and nonprofits, driving policy and investment to increase the number of age-friendly homes.
{ 13 comments… read them below or add one }
These are great points. There’s a lot of dignity in staying in your own space.
Nicely put Louis – always eloquent… thank you!
Louis, we met at ASA last March. Would love to reconnect and see if there is a way we can be mutual referrals.
Bonnie
But don’t expect your loved ones to be your constant care givers at home without that added workload taking its toll on them to the detriment of their own health. Off-loading the financial cost of professional home care onto the shoulders of a long term care insurance company allows your loved ones to be care monitors and not your primary care givers. There are consequences to all your actions: consider them carefully and plan ahead to preserve your family’s integrity.
Louis, a good article, except you generalize that no one is talking about aging in-place. Not true. Many of the LTC Financial Partners agents across the country promote LTC insurance (of some type) as a means to afford to stay at home! Getting skilled care at home can be more expensive than being in a nursing home.
This is not a situation where generalizations can be made like FACT. I bring value to people by showing them options that may apply to their unique situation. It involves discussion of some topics they would rather not think about, but are important, none-the-less.
I like your article and hope you will continue to promote the concept.
I am all for “aging in place” and hope to be able to do so. I have actually taken all of the steps recommended and then some. However, I recognize that there may be circumstances that make my wishes less than ideal for me and my family. An example: The women who wanted to live at home and by all estimates should have been able to do so. However, she developed dementia and after having help in the home for a fair amount of time, she began to believe that she was actually living in someone else’s home. She kept asking to “go Home” – a not uncommon request for people with dementia. It turned out that she actually could return to an area where more family would be close and available for care and visits. It wasn’t until her anxiety heighted to the point of becoming disruptive that it was decided to try a move to a dementia specific care facility near another relative (which parenthetically was closer to her prior “home”). After a brief adjustment, this individual did think that she had gone home. In her mind, she identified other residents who she designated as her “mother” and “father”. She believed that some of the men were the “boys” of an earlier time. With the move, there were other fortuitous outcomes…additional members of the family took on caregiving responsibilities, which was a blessing for all. Additionally, the elder was able to achieve better health for a time until her dementia began to shut down bodily functions. By having hospice care, she was able to “age in place” in the facility until the day of her death.
I hope that in our wishes to age in place that we are also respectful of the unknown and the needs and wishes of those who are charged with our care. Having said that…I hope to live in my own place to the end.
I agree that living at home is the best option, when it is available. Unfortunately, there is not sufficient recognition and acknowledgement that at some point, it is better for the individual along with their friends and relatives, etc., that the individual move into a caring and competent assisted living or nursing facility, particularly when comprehensive and significant skilled care is necessary. It’s important to make the right decision for the individual’s health and safety.
I strongly agree with you Louis. Aging in place is the most popular choice nowadays because it allows older adults to maintain their independence and receive care at the comfort of their own homes. In my opinion, promoting aging in place is not even necessary because everyone desires this long term care setting. But just because you’ll receive care at home you no longer need to plan ahead. The strategies you’ve posted can help people make aging in place comfortable, can fully satisfy their care needs and make it more economical for you to receive care.
Jack here gives a sound suggestion of off-loading the cost of care through long term care insurance companies. That’s actually a good option but make sure to consider their financial ratings first. For your guidance, http://www.ltcoptions.com/long-term-care-insurance/long-term-care-insurance-companies shows the the different financial ratings from A.M Best Ratings, Standard and Poor’s Ratings and Moody’s Ratings that can help consumers choose a company that is stable, pays for claims and provides high quality services.
By having long-term care insurance, you can spare your family members from caregiving duties. Instead of being primary caregivers, they can become a good source of informal support.
I would agree that aging in place is most desirable for the aging person. If the person is experiencing physical issues, then there are many ways to make the home accessible and safe to address physical disabilities from aging. As others have said, there may be a point where family support and occasional home health care will be insufficient. I waited too long to put my loved one in a residential care home. It took a huge toll on my health trying to take care of her night and day while working full time. Only the caregiver can know when it is too much.
As a professional interior designer with CAPS certification, my career is focused on preparing the 50+ for what is ahead and it can be very good if one prepares. My book, Boomer Smarts Boomer Power, addresses home and also health preparations. America is changing rapidly but most 50+ ers I witness are either not aware or are in denial that they will ever need what we are advocating. Those that do however, will be the ones rewarded for their wisdom of doing something.
I prefer “Aging In Place” to “Long Term Care @ Home” – that sounds more institutional to me. However, maybe a term for consideration might be “Comfortable Living @ Home” or “Living Safely @ Home”.
Sounds more accepting yet descriptive to me.
Louis- totally agree as few people have the interest or finances to leave their home. Home mod businesses and home service providers are growing briskly as you would expect. I have taken the innovative heavy duty assistive product route with my “Friendly Beds”. There are many struggling people that need all the help they can get to cope with mobility issues of age/disability.
I LOVE how passionate and definitive this article is about staying in your home for the long term as a GREAT choice. So nice to hear even though yes there are hurdles and planning is necessary. But there are ways to afford it.
We got a reverse mortgage to make it possible here http://www.thereversemortgageconsultant.com/
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