Just about everyone would tell you that they want to remain in their own homes, that their preference would always be to remain as independent as possible and to stay in their familiar surroundings. Let’s face it, who wouldn’t want that? We like that which is ours, where we have our history, where we find and have found comfort. The issue that we face, however, is that our changing needs as we age may not be compatible with the environment in which we live.
There are some interesting efforts underway to try and help people age in place safely. One study that was done in Baltimore, through the Johns Hopkins School of Nursing using an intervention called CAPABLE, which stands for Community Aging in Place, Advancing Better Living for Elders. Through CAPABLE, home visits were conducted with older adults. These visits included professionals you might expect—an occupational therapist and a nurse—as well as one you might not expect—a handyman. This team worked with the older adult to understand not only their health needs but also their ability to care for themselves in their homes and any mobility issues they faced. They made small adjustments, everything from installing handrails to lowering shelves for easier access. They added systems to help clients remember to take their medication and rearranged beds and lighting to ensure that navigating to the bathroom in the middle of the night was easier.
What did they find? Over the course of five months, 79% of the clients in their study improved their ability to care for themselves. More than 50% of clients found self-care tasks easier to achieve and participants overall experienced a decrease in depression symptoms, with an improvement similar to that which would be achieved by taking an anti-depressant medication.
On the other hand, the 2011 National Health and Aging Trends study reported that there were 7.7 million elderly receiving help with self-care activities and that 73% of them, 5.63 million people, live at home in the community. While that statistic may not be either surprising or concerning, the follow up statistic tells a different story. Of those people living in the community with difficulty or receiving paid help, 60% of them report an adverse consequence associated with unmet need. What does that mean? It could mean that someone falls because they don’t have assistance in and out of the shower or in and out of bed; it could mean that someone does not receive proper medications or have them administered at the proper time; it could mean that physician appointments and other necessary health services don’t take place.
There is much to consider when we talk about aging in community and helping people to continue to live independently for as long as they are able. As our demographics shift and the older population continues to grow at a rapid rate, these issues have implications for all of us—from our own families to our organizations to our society as a whole. No simple answers to these complicated issues but lots of creative solutions already in the works.