In-Home Care: Helping Loved Ones Age in Place
5 steps for keeping older family members comfortable and safe, in their home or yours
En español | Two-thirds of U.S. adults, and more than three-quarters of those age 50-plus, want to stay in their home as they get older, according to AARP's November 2021 "Home and Community Preferences" survey.
Family caregiving is a key component to making that wish a reality. The 2020 Caregiving in the U.S. report from AARP and the National Alliance for Caregiving found that 43 percent of family caregivers are looking after people who live in their own home, and 40 percent share a residence with the care recipient.
Helping a loved one age in place may mean anything from stopping by a parent's home to check in every few days to assisting a spouse or partner with tasks such as bathing and meal prep, as well as activities including medication management and administering injections. Whatever level of care you provide, these tips can help you help your loved one remain at home for as long, and as comfortably, as possible.
Develop a plan
Planning for both the short and long term is important. You need to stay on top of the daily stuff, the doctor appointments and prescription refills while thinking through the what-ifs of your relative's age and condition.
You can't anticipate every scenario, but being forward-thinking now will help you respond more quickly and effectively in an emergency. And don't go it alone. Reach out to form a larger team of family, friends and others who can help you.
- Determine tasks and find consensus. Ask team members what they're willing to do to contribute to the individual's care. Even if they live far away, they can handle jobs such as paying bills, ordering prescriptions and scheduling medical appointments. Work with them on a plan.
- Be honest with yourself. What are you prepared to do? If you are uncomfortable with hands-on caregiving tasks, such as helping a family member bathe, ask if another team member can step in, or discuss whether money is available to hire a professional.
- Summarize the plan in writing. A written record will ensure that everyone on your team, including your loved one, is on the same page, thus avoiding misunderstandings. Remember, of course, that the plan will likely evolve; update it as time passes.
Make adaptations for safety's sake
If the person you're caring for has difficulty getting around or has compromised vision or hearing, you'll need to consider ways to make the home less hazardous.
Consider consulting a professional, such as an occupational therapist, geriatric care manager or aging-in-place specialist, who can assess the home and make recommendations. Be alert to changing needs over time.
- Make simple fixes for fall prevention. Some basic, low-cost changes include removing trip hazards like throw rugs, making sure the home is well lit (use automatic night-lights) and installing items such as adjustable shower seats, grab bars and handrails.
- Fine-tune the plan to account for dementia. Dementia brings with it particular worries about wandering and self-injury, but there are many ways to reduce risks. Examples include installing remote door locks, disabling the stove when it's not in use and keeping the water heater temperature to 120 degrees Fahrenheit or less.
- Modify more extensively if necessary. When physical limitations are more severe, you may need to hire a contractor to make structural changes, such as installing wheelchair ramps, creating adjustable countertops and widening doorways.
Manage health care needs
Caring for an aging or chronically ill relative can mean performing some basic medical tasks and keeping track of a confusing mix of medications for a range of ailments. The key is to stay organized and know how to get the help you need.
- Stay on top of meds. Create and maintain an updated medication list with the name, dosage, prescribing doctor and other relevant information — a handy document to bring to medical appointments.
- Be ready to handle medical tasks. In the aftermath of a loved one's hospitalization, many family caregivers find themselves performing challenging tasks at home, such as injecting medicines and inserting catheters. Get detailed instructions and even a demonstration of how to do necessary procedures before you leave the hospital.
- Set up home health services. Medicare will cover certain in-home services deemed medically necessary, including part-time or intermittent skilled nursing care, or physical, occupational or speech therapy. A patient who is considered homebound, or who is unable to make an office visit, may qualify for these services on an ongoing basis.
Maintain a healthy lifestyle
Caregiving can become all-consuming, especially if you are sharing a home with the person you're caring for. You may find yourself playing nurse, life coach, nutritionist and social director.
All of these roles are important for maintaining your loved one's mental and physical health. Just don't neglect your own.
- Address social needs. Isolation and loneliness are associated with poorer health; helping your family member and yourself avoid them is a key part of caregiving. You could find a community arts program for seniors, invite friends and relatives to visit, or go out to eat together.
- Manage nutrition. Be conscious of any dietary restrictions, and encourage your loved one to maintain a balanced diet and avoid processed foods. Look into home-delivered meal programs, and be sure the person drinks plenty of fluids, as dehydration can cause fainting, headaches and more conditions.
- Encourage exercise. Staying mobile can help older people maintain strength, balance, energy and brain health, among other things. Your loved one's abilities will vary, and you should check any exercise regimen with a doctor, but the routine might include activities like walking, seated yoga, swimming or lifting small weights.
- Establish boundaries. Everyone needs a level of privacy, especially if the person you're tending to lives with you and your spouse or partner. Ideally, you should have some separation between living areas and be able to schedule time together as a couple.
Depending on the severity of your loved one's problems, you may need a bit of assistance — or a whole lot of it.
Rely on your team for help with some caregiving tasks and to fill in so you can take breaks. Don't feel guilty: Your own health — and the quality of your caregiving — will suffer if you try to do everything and don't take time for yourself.
- Ask friends and family members for help. Plenty of people in your life will be happy, or at least willing, to lend a hand if you ask. Maybe someone could pick up a prescription for you on the next trip to a nearby shopping center, or a neighbor could stop by with dinner once a week.
- Farm out some household jobs. Consider paying for relatively small services that will relieve your burden, such as a weekly housecleaning, yard care or grocery delivery. If you live apart from your loved one, you could do the same for your home.
- Hire in-home care. You can go through an agency or hire a caregiver directly, but either way, be sure to check references and background, and monitor performance carefully. Cautionary tales abound. It's smart to rely on word of mouth. Ask fellow caregivers for recommendations.
- Watch your mental health. As a caregiver, you are at a higher risk for stress and depression. If either grows serious, seek help from a mental health professional. And consider reaching out to other caregivers for support and advice.
Americans want to age in place
A 2021 survey of U.S. adults by the Associated Press-NORC Center for Public Affairs Research found that a large majority want to receive care in their own home if they need it. The desire is particularly acute among middle-aged and older adults.
- Respondents ages 18 to 29: 63 percent
- 30-44: 79 percent
- 45-59: 81 percent
- 60+: 80 percent
Source: “Long-Term Care in America: Americans Want to Age at Home," AP-NORC