Aging In Place A Challenge For Senior Citizens

By Nancy K. Crevier

(Because the seniors interviewed for this article live alone, and to protect their privacy, real names have not been used.)

Financial well-being, good health, a car, and a social network are vital for the elderly to remain independent and in their own homes. So say four women, all between the ages of 75 and 90, as they discuss the pros and cons of living in their own homes at an advanced age. Words like “independence,” “pride,” “socializing,” and “privacy” crop up more than once in the conversation. The words “burden” and “imposition” rear their heads, as well, as does “loneliness,” as they gather at one of the tables at the Newtown Senior Center.

They have lived in their homes in Newtown for 30 years or more, and for the last several years, on their own. Mrs Smith is 88 years old and when her husband died 13 years ago, it never crossed her mind to leave the home she had lived in for 38 years. “I had enough of a network of neighbors, and my son, to get the names of outside people like plumbers or someone for repairs if I needed.”

Admittedly, it does get harder to remain on her own as she ages, said Mrs Smith, but she likes her sense of independence and privacy. “Some of the chores, I can’t do anymore,” said Mrs Smith. “Things like doing the windows, vacuuming, even cooking and changing the beds is harder now.” Her son and his wife live nearby and she relies on him to take her shopping, mow the lawn, and take care of other things around the house that she no longer feels able to handle. He would welcome her, she said, but she worries that moving in with him would be a burden. “And I would miss my home.”

Mrs Smith is the only one of the four women who no longer drives, but she uses the SweetHART bus each day to come to the senior center. “If I didn’t get out, I would go crazy,” she said.

 Mrs Green only learned to drive nine years ago, and without her car and the independence it gives her, she would “go bonkers,” she said. Transportation is a concern as people age, she said, and the SweetHART bus does not operate 24/7. Mrs Brown and Mrs Jones agree that having their vehicles allows them a greater sense of freedom, allowing them to remain spontaneous, more a part of the community, and less of a burden on their children.

“Children should have their own lives,” said Mrs Jones, who at 90 years of age still drives weekly to visit family in New Jersey. “We only want to move in with our children if we have no other choice.”

For Mrs Brown, it is less expensive to remain in her home of 30 years than to go to assisted living or move in with family, she said. Her home is much too large for just one person, really, but with the help of family and neighbors, she is able to maintain it. “It is three levels, but I live only on the main level now,” she said. “What I would really like to see, though, is builders building small, one-level homes around the community for seniors. Then we could get rid of our big homes and still live on our own and have privacy.”

The four women agree that having a network of friends and neighbors is also an important aspect to remaining in their own homes. “The Senior Center is a great place for fun activities and to form friendships,” said Mrs Brown. “Everyone here looks out for each other. If someone doesn’t come in for a couple of days, they get a phone call. People care.”

The four women are part of a growing number of aging adults who choose to remain in their homes. With the help of family, friends, and some outside help, they are able to do so. Their network is loose and often hit or miss, but across the country the elderly are banding together to formalize groups that provide peer assistance. The movement, known as Aging in Place, is blossoming into organized groups of the elderly that offer practical means and support to allow each other to stay in their homes as long as they want.

Seniors Helping Each Other

There is no such organization currently in Newtown, but in New Canaan, Tom Towers, president of Staying Put in New Canaan, is certain that the Aging in Place phenomenon will only spread as baby boomers age.

“We will help one another to maintain our vitality and health and to stay connected to one another and to the many established institutions in New Canaan that offer a wide range of services to residents,” reads one part of the Goals Statement for Staying Put. “We are active seniors helping one another. Our organization will be an insurance policy for ourselves — if we need it, it will be there.”

Staying Put in New Canaan is modeled after another Aging in Place group in Beacon Hill, near Boston. There is a yearly fee of a few hundred dollars to belong, but belonging offers peace of mind and quality of life, said Mr Towers. There are professionals on the board who can offer support and services, he said, and the older people who join find comfort that they have been part of the process that selects and screens service providers. Being part of a peer group helping each other provides dignity and a sense of belonging, as well, said Mr Towers.

“Elderly people do not want to feel that they are needy,” Mr Towers said. “The notion of seniors helping themselves [through Aging in Place groups] resonates with them. The notion of helping ourselves sticks.”

Peers can empathize when help is needed with light housekeeping, yard work, pet care, transportation, technology assistance, legal advice, and for social opportunities, he added. There are certainly outside organizations that offer home care, personal care, and companionship, Mr Towers said, but elderly people are hesitant to take part in community services.

This is true, said Newtown Senior Center Director Marilyn Place, who is also co-chairperson for the Retired Seniors Volunteer Program and a member of the Newtown Commission for Aging. “A lot of seniors stay in their homes without assistance until there is some kind of emergency. They have so much pride.”

The elderly often not only do not want to ask for help, but may not even be aware of services available to them. The Senior Center, said Ms Place, is one service that offers not only friendship and social activities, but also information and referrals, health screenings, transportation, recreation, and educational programs. Noontime meals are also offered nearly every day. “Many of the seniors no longer want to prepare meals at home, and they worry about nutrition. This is one place they can be assured of getting one good meal,” said Ms Place. While not an Aging in Place organization, at the center seniors can make connections. “Once they make a connection, the peers do take care of each other,” she said.

She sees where a “self-help” organization would have much appeal to the seniors. “I think Aging in Place is an up and coming thing. The ‘younger’ aging demographic are accepting aging and looking at how to adapt their lifestyles and thinking about what changes they may need to make in order to stay in their homes.”

Getting Involved

One of the most important things for the elderly is volunteering, Ms Place went on to say. “The retired seniors have time to volunteer and they meet other wonderful people in the community, too, who also help. It is so easy for the elderly to become reclusive due to lack of socialization. Keeping the mind active is necessary so that they can remain at home, too,” she said.

Having an involved family or family member can be the difference between a senior’s ability to stay in his or her home or not, said Ms Place. “They don’t necessarily need to live nearby. But in my 19 years here, I am seeing more family supporting the elderly in their desire to remain at home and they try to do what they can to help. What it really comes down to, though, is money. They have to be able to afford to stay in their homes, and understand when that is not possible any longer,” Ms Place said.

Several companies exist in the Newtown area that offer nonmedical home care, light housekeeping services, meal preparation, transportation, assistance with personal care, and even companionship.

“I like to help seniors,” said certified senior advisor Sharon Massafra of Home Instead in Sandy Hook. “But it is 50/50 getting the elderly to ask for help. Some that are so independent they will deny help until something critical happens.”

She understands that seniors may be suspicious of outside help, but said that Home Instead caregivers undergo vigorous interviews, a criminal background check, a nationwide DMV check, and require six referrals. Mandatory education on safety and basic caregiving are required of all caregivers for Home Instead, as well, said Mrs Massafra.

The typical Home Instead client is in his or her mid-to late 80s, said Mrs Massafra. “About three-quarters of them have family support, but not always locally. Many are truly alone.”

The care and companionship offered by Home Instead makes it possible for seniors to stay in their homes, said Mrs Massafra. “I have no doubt in my mind that we help people stay where they want to be.”

Visiting Angels is based in Brookfield and is owned by Patti Werlau, a licensed social worker and member of the Brookfield Commission on Aging.

A survey in Brookfield, said Mrs Werlau, found that staying at home and transportation are two of the area’s biggest concerns for the aging population. Visiting Angels can help with care and light chores that enable the elderly to remain at home, and can provide companionship, as well. “We provide an initial assessment, see which of our caregivers is best suited on the care level, and in personality. Then the client and potential care giver meet. Care can range from a few hours a week, to live-in care,” she said.

One of the major hurdles for the elderly is asking for help, said Mrs Werlau. “Sometimes their children call, worried. Many of seniors our would rather go without than ask for help. It is pretty rare that an elderly person will call and say, ‘I need help,’” Mrs Werlau said.

Visiting Angels tries to empower the client, said Mrs Werlau. “We promote maintaining the quality of life and then independence. They are left with the time to enjoy life.”

Daily Living

In Danbury, Almost Family tries to reach out to the aging population with many of the same nonmedical services offered by Home Instead and Visiting Angels.

“What is most difficult for the elderly are the activities of daily living: the housekeeping, the laundry, medical transport, or preparing meals,” said Paul Lacovara, the in-home program director. “It is hard to get the elderly to ask for help,” said Mr Lacovara. “It’s a dignity issue.”

Transportation is a problem for the elderly, and volunteer driving services have been adversely affected by the high cost of gasoline, he said, and that means that many elderly do not get out to socialize or get to medical appointments.

“A big part of our business at Almost Family is companionship. Our caregivers monitor safety and do activities with the clients,” he said. The carefully screened employees also provide personal care, some chore help, and light yard work, he said, and the company works to match personalities as best they can.

By accepting outside help, or the help of peers, though, Mr Lacovara said it is possible for many aging people to remain independent. “You lose your self-worth when you can’t stay in your own house. Almost Family definitely helps people remain in their homes much longer than they would be able to without help,” he said.

But along with the indignity of asking strangers for help, the cost is a big issue for those on fixed incomes. Home services range between $15 and $20 an hour, and some outside care services require a minimum three-hour visit. Live-in care runs around $200 a day and a private sleeping area for the caregiver is required. In some instances, the state can subsidize the cost of in-home care, and agencies like United Way will sometimes assist with cost, said Mr Lacovara. Still, it adds up quickly.

There are plenty of people “aging in place” in Newtown, said director of social services in Newtown, Ann Piccini, “but they should not be.” The clients she sees are often not physically or mentally able to care for themselves. “They live in bad conditions, personally and environmentally. The clutter is often overwhelming,” said Mrs Piccini.

Her clients often cannot afford the help of outside services. “Honestly, I don’t know if mentally they would allow someone to come in and help them. I have found that it can take several visits, myself, before I can convince them to let someone help them. They don’t even know or understand that aid programs such as fuel aid, Meals on Wheels, or the Salvation Army are available. They don’t know about the Western Connecticut Area Agency on Aging and what they can do for the elderly.”

Dementia, Alzheimer’s, and isolation plague many of her clients who have opted to remain at home long past the time when they are able to do so, said Mrs Piccini. “In these cases, clients are very low-income, family is usually nonsupportive, and the home has been let go so badly, for so long, that getting professional services in to do repairs and such can be difficult because of unsanitary conditions,” explained Mrs Piccini. “I suspect that the Aging in Place programs work for those seniors who have always been active in the community, have friends and family, and who have money,” she said.

At the Senior Center, Mrs Smith, Mrs Brown, Mrs Jones, and Mrs Green can see the fine line that separates getting outside help from help arranged by a peer-run Aging in Place organization. It is a program that they think could one day catch on here in town.

In the meantime, they praise the network of friends, family, and neighbors that enable them to stay in their homes for now. “Not everyone is as lucky as us,” said Mrs Brown. “Without their support, we couldn’t do it.”