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How to Keep Elderly Parents in Their Home
It’s everyone’s wish and desire to live life on their own terms and be secure in the home of their choosing. As we age it’s natural to want to be around what’s most familiar and what reminds us of the past. In many cases, our homes become a chronicle of a life lived, a collection of tokens of memorable events and people, or in some cases, our own “fortress of solitude”.
As children or loved ones with elderly parents/relatives, we want them to be able to stay in their homes as long as possible. But, it can become a challenge trying to figure out how to safely keep the elderly in their home to age in place, so to speak.
How Seniors Can Stay in Their Homes
Although it’s best to consider how to help seniors stay in their homes before an emergency arises, most, unfortunately, put it off. Until an emergency health or otherwise, is the wake up call realized and all are confronted with the challenge they have living alone in their home when assistance is needed.
In most cases these emergencies generally fall into 3 broad categories that are common reasons that force seniors from their homes.
- Mobility – Your loved one may have difficulty climbing stairs, getting out of their recliner, or getting into or out of the tub/shower.
- Cognition – Your loved one’s memory may be slipping a bit and they forget to take their medications, turn off the stove, pay their bills, or simply forget to care for themselves or the home
- Security – Home modifications and Your loved one may not have home security which leaves them vulnerable or they fall prey to financial scams or other predatory behaviors.
When you hear health care professionals speak about “maintaining independence”, more often than not, they are referring to the first 2 areas, mobility and cognition. These are the 2 most important of the 3 areas above because they have a direct effect on how seniors “function” in their homes.
Each person’s situation is different and the problem/solution scenarios would be infinite. However, this guide will touch on these 3 areas with general suggestions to solve minor problems in the above 3 areas. This guide also assumes that there is no physical disability such as hemiplegia or debilitating health condition such as COPD, Parkinson’s disease, or advanced dementia, that is affecting the loved one.
Mobility
One of the most obvious areas that has an impact on whether or not it’s safe for seniors to stay in their home is whether they can mobilize safely in their home. Some elderly have become so sedentary in their daily routine that they suffer from a general deconditioning that makes it hard for them to get around their home.
Falling is a problem with many older folks. While falls could be caused by several different reasons, weakness is one that is generally more easily addressed with a regular physical activity program.
People don’t realize that once a person retires from a more active lifestyle, unless they keep their body moving, their muscles will weaken and shorten. This weakening and shortening will impair their reaction time and limit their ability to move freely and thus prevent them from “catching” themselves if they trip or stumble.
General weakness will also affect the ability to climb stairs, get into and out of the bathtub, and even decrease stamina and endurance that may affect a senior’s ability to “keep house”, allowing clutter to block pathways. All of these could contribute to a fall and so, prevent the elderly from safely staying in their home.
The simple solution to this would be a regular walking program. As I mentioned in another guide, walking is fundamental to independence. It is necessary for all activities of daily living and it’s preservation in the elderly will decrease the need or burden on family caregiving.
If needed, your family doctor can request a home physical therapy evaluation to assess any equipment needs and help develop and establish what’s called a “progressive ambulation program” that will go a long way to helping people age in place in their own homes.
Cognition
We all joke about having a “senior moment” when we forget something that we feel should be easily remembered. But, in the case of our elderly parents and loved ones, it can be more serious and make living in their own home unsafe.
One of the more common issues that people face when it comes to cognition and living alone is remembering to take medication. Poor memory results in under- and over medication and can lead to falls, decline in function and inability to perform daily routines safely, and can also result in hospitalization.
Other areas where impaired cognition may affect a person’s ability to live safely on their own is forgetting to pay bills or maintain the home, make or keep doctor’s appointments or other activities or obligations that are essential to living independently.
There are several strategies that will help elders with these challenges continue to stay in their home. In the case of staying on top of their medications, the solution could be as simple as organizing their pills in a “medi-set” pill box. In the case of making sure bills are paid timely, setting up “automatic bill pay” is a common solution.
Many seniors may not fully realize if they are having memory problems. And, even if they do, they probably would be uncomfortable admitting to it, or talking about it for that matter. But, it’s something that can’t be ignored or swept under the rug, if their plan is to live independently in their home.
But, before the topic is broached by a family caregiver, it may be better received if their family doctor brought the subject up and asked a home speech therapist to visit them and assess their cognitive function.
Some seniors may resent the suggestion that they may be slipping a little. But, it should be made clear by the physician and the healthcare professionals that assessments are necessary in order to find out what’s needed in order for the senior to be able to stay in their homes rather than looking for reasons as to why they cannot live independently.
Security
How to Make Home Safe for the Elderly
In this case, when we mention “security”, it covers a couple of different areas. The first area is the actual living environment. The second area has to do with living securely in the living space.
One thing that prevents the elderly from continuing to live safely in their home is that they are unable to safely navigate what was at one time, easy to do so. Stairs (whether inside to access a bedroom, or outside to enter and exit the home) are frequently a challenge for older folks to safely negotiate.
Having accessible bathrooms is also something that people do not consider as they age. In many cases, medical equipment like commode and shower chairs, grab bars, and step-in showers are better for people when extra support is needed. But, many bathrooms may be too small to accommodate these needed items.
Adequate lighting (especially at night) will also help keep people safe in their homes and may prevent accidental falls or injuries.
AARP has a “Home Fit” guide that seniors and family caregivers can download and use to see how they can make the home environment safer to live in. You may also be able to find Certified Aging in Place Specialists (CAPS) in your area that can help you determine what’s needed to help keep your loved one safely living in their home as long as possible.
Closely linked to whether the physical aspects of the home allows an older person to mobilize safely throughout is whether the home itself is actually secure. When we bring up this topic what typically comes to mind is security from crime from an external source, but “internal” security needs to be considered.
There are a growing number of solutions that can minimize safety concerns from outside the home to help seniors stay safe. The Ring doorbell and it’s family of camera security options is an established and popular brand that many opt for. But there are many other popular options as well (Arlo and Blink come to mind) as well as well established dedicated security systems that young and old use alike.
The aforementioned examples are more concerned with the “external” security for the home. But, internal security is also important. Having a way to monitor seniors as well as give them a solution to reach the outside world in the case of an emergency or fall should be considered essential to helping them stay safe.
The “medical alert” bracelet and/or pendant has been the go to resource for the last 2 decades. There are several companies that offer this service that with a touch of a button seniors can alert emergency medical services that they are having a crisis. These services usually are a monthly subscription and are affordable.
Other solutions to making sure everything is alright in the home are becoming more and more popular and accepted. The move toward home automation or the “smart home” allows users to monitor and have remote control over technology that performs essential functions in the home. The overall goal is to help make the home easier and safer to live in.
Solutions for home automation for seniors are rapidly developing and evolving. Solutions for automatic lighting, smart door locks, and alarms are available. But, there is also technology for fall detection, medication management, and telehealth that are also being developed.
In addition, remote communication with loved ones as well as remote visual monitoring is also something that will help family caregivers keep in touch with loved ones but eliminate the need to physically make the trip just to “check up on them”.
In Summary
How to Help the Elderly Maintain Their Independence
In this guide we discussed the desire for elders to live independently, in the familiar and comfortable surroundings of their own home and the areas that may need to be addressed in order to do so safely.
In unfortunate cases, many seniors may have to move out of their homes and either move in with relatives or move to an assisted living facility because it’s not safe for them to live by themselves for one reason or another.
If you are having concerns about your aging loved one or parents living by themselves and you want to help them live and stay independent in their own homes, it’s a good idea to start assessing the areas of their lives that may become problems in the future.
Keep in mind that there are 3 general issues (apart from a debilitating health condition) that present the biggest challenges for anyone who wants to live on their own terms and in their own homes. 1) limited mobility, 2) limited cognition, and 3) an unsafe physical environment.
Home health care services can assess and address the first 2 issues. For the third, there are ample resources online that can help you understand how to make a loved one’s home safer to live in.
Having a conversation with your loved one is also important. Frequently letting them know that you want them to stay in their home as long and safely as possible will make making changes easier and acceptable to them. All this and more will help seniors age in place.
Bryan Williams
Physical Therapist
is a licensed therapist with near 30 years of professional experience treating a diverse patient population in a multitude of settings. With simple strategies, he educates and empowers his clients with simple strategies to help them move better and with less pain.