Seniors Want to Age in Place—Are We Ready for the Challenge?


90 percent of older adults have expressed a preference for receiving care at home.


 

As we saw in the previous issue of Hand in Hand, U.S. Census figures show that fewer older adults are choosing to receive care in a nursing home. Yet the projections also shows major growth in the number of seniors who are living with chronic illness. It is clear that our population is aging, and providing quality care for our nation's older adults is already beginning to challenge our healthcare resources.

This Census information comes as little surprise to the 65 million Americans who are already serving as family caregivers for older loved ones who need help managing health conditions and the activities of daily living. Many of these caregivers are members of the baby boom generation, who are reaching the age when they themselves might be expected to need care! From the local to the federal level, government agencies, too, are taking notice of the financial impact resulting from this population shift. The discussion about how to best (and most cost-effectively) care for our seniors is taking center stage.

The Census study showed that 90 percent of seniors would wish to receive care in their own homes. Is this realistic? Can they be safe and well-cared for even if they are living with age-related illnesses such as heart disease, diabetes, arthritis, or memory loss? Several demographic changes in our society make this more of a challenge than it was in the past:

  • A University of Michigan study showed that almost 40% of chronically ill older adults in the U.S. live alone, and the majority of those who are married have spouses who are themselves facing health challenges.
  • Our lower birthrate equals fewer adult children to help out as parents’ care needs increase.
  • Adult children are more likely to live at a distance, having moved to find employment.
  • A higher divorce rate means more seniors live alone, and family caregivers’ financial and time resources are stretched when parents live in different households, or even in different parts of the country.

The cost of institutional care continues to grow. For some seniors with medically complex health challenges, nursing homes and other residential health facilities may be the best choice. But for many other seniors, home care is the most desirable and cost-effective arrangement.

Dr. Soeren Mattke of the RAND Corporation noted, "The aging of the world’s population and the fact that more diseases are treatable will create serious financial and manpower challenges for the world’s healthcare systems." He added, "Moving more healthcare into the home setting where patients or family members can manage care could be one important solution to these challenges."

A wide variety of care services can be provided right in a patient’s home:

Skilled healthcare services can be provided at home and are cost-effective. Visiting nurses and rehabilitation professionals provide skilled medical services in the home. Registered nurses (RNs) and licensed practical nurses (LPNs) perform hands-on procedures such as wound care and IV therapy. Rehabilitation professionals include physical, occupational and speech/language therapists.

Non-medical home care provides companionship and homemaking services that support the senior's independence, at a much lower cost than nursing care. Caregivers provide supervision, assistance with dressing, grooming and other personal care, laundry and housekeeping, meal preparation, transportation, socialization, and respite for family caregivers.

Dementia support is also available. Even when adult children live close to home, dementia complicates the caregiving dynamic. Trained in-home caregivers who understand the challenges of Alzheimer’s disease and similar conditions can help patients remain at home longer, even as the need for assistance and supervision grows.

"The growing number of older adults with chronic illnesses poses a serious challenge to the U.S. healthcare system," says Dr. Steven H. Landers of the Cleveland Clinic. "But this challenge is also an opportunity. We may be able to improve the care of these vulnerable patients—and control costs—by taking their primary care to their own homes."

Source: Assisting Hands Home Care in association with IlluminAge. Copyright © IlluminAge, 2014