One of the biggest decisions as you age is where you will age. Three-quarters of adults in a 2018 AARP survey said they wanted to remain in their homes, but only 59% thought they would be able to do so. If remaining at home is your preference, here are nine steps you can take:
1. Prevent falls
Falls are the most common cause of nonfatal, trauma-related hospital admissions for older adults. According to the Centers for Disease Control and Prevention, one-quarter of Americans 65 and older fall every year.
A fall can trigger a decline in functioning “which may affect your ability to remain independent,” explains Liz Barlowe, aging life care manager with Barlowe & Associates in Seminole, Fla.
Falls result from muscle weakness, vision problems, medication side effects, poor nutrition, chronic health conditions and unsafe home environments. The National Council on Aging has a quiz to determine whether you are at risk. To prevent falls :
Talk to your doctor about weakness, dizziness or vision problems, management of chronic health conditions and medication side effects . The physician may have some helpful ideas.
Have your home evaluated by an occupational therapist for issues with lighting, tripping hazards, stairs and bathroom safety . This pro might offer practical safety suggestions.
Keep moving. “Do regular strength and balance exercises like Tai-chi,” suggests Dr. Nirmala Gopalan, medical director of the geriatrics clinic at Santa Clara Valley Medical Center in San Jose, Calif. Continued mobility is essential in preventing falls. Once you fall, it’s common to be fearful, but reducing your activity just makes you more prone to falls. Instead, learn how to modify your movements and environment to make activity safe.
2. Work with experts
Switching to a geriatrician for primary care, for instance, helps preserve independence.
Geriatricians are trained to manage the complexity of multiple complicated health concerns “and know the difference between normal aging and more serious illness,” says Gopalan.
“An older person’s body metabolizes medications differently. Geriatricians are trained to recognize side effects and drug interactions in seniors and manage polypharmacy [the simultaneous use of multiple drugs by a single patient] safely,” Gopalan says.
Move to a geriatrician “when your health is starting to impair your mental or physical well-being and the activities of daily life,” advises Dr. Alicia Arbaje, associate professor of medicine at Johns Hopkins University School of Medicine in Baltimore.
“Some reasons might be: (you’re) in and out of the hospital a lot, on many medications, or (having) difficulty with mobility, memory or medication,” adds Arbaje, who is also chair of the American Geriatrics Society’s public education committee.
Geriatric care managers are also key. They identify what you need help with and assist in finding appropriate services.
Kizzy Chambers, a professional care manager and licensed clinical social worker with RR Care Management, in Orlando, Fla., recommends “consulting with a care manager as soon as there is a concern or when a family member is feeling overwhelmed with caring for their loved ones.”
For referrals, “call your local Area Agency on Aging,” says Emily Greenfield, associate professor of social work at Rutgers University in New Brunswick, N.J. You can also use the federal government’s Eldercare Locator .
3. Stay mentally active
Maintaining brain health is key and helps you remain at home.
A study in the journal Brain Imaging and Behavior showed that mentally stimulating games and activities preserved cognitive functioning in older adults. And a Harvard Medical School study showed that thinking skills, which decrease with age, can be sharpened with brain games.
“Think of your brain like a muscle. You need to alter your exercise programs to ensure you are utilizing different muscles to develop your body,” says Barlowe.
To keep your brain in peak condition, Arbaje recommends a healthy diet including fruits and vegetables.
Gopalan says daily physical activity, fresh air and sunlight “are very stimulating to the brain” and that the key is always to “focus on enjoyment and not achievement.”
4. Access support services
To remain at home, “it is important for people to feel independent and self-sufficient,” says Arbaje. To do that, “be open to the idea of outsourcing services,” recommends Barlowe.
Getting groceries delivered can help. If you feel intimidated by apps and online platforms, Instacart offers dedicated “ senior support specialists ” who help customers order by phone. Caregivers can arrange delivery of restaurant meals via DoorDash or Uber /zigman2/quotes/211348248/composite UBER +3.27% Eats, or frozen premade meals through services such as Freshly. Meals on Wheels is also an option.
Amazon /zigman2/quotes/210331248/composite AMZN +0.14% has an automatic shipping option where family members can place needed items for their loved ones on a monthly auto-ship schedule. “Many of the managed care Medicare insurance plans [Medicare Advantage] allow insured individuals to order medical and nonmedical supplies, such as gloves, over-the-counter medications and adult briefs,” says Chambers. Most drugstores also deliver.
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