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You may be surprised to learn home health agencies receive the most calls around the holidays. Adult children visiting their aging parents come away concerned about their parents’ safety at home.

As a local occupational therapist and certified aging in place specialist, I work to maximize safety and independence in the home for aging adults and to educate and support caregivers in our community.

I most commonly receive calls from families after a hospital visit, a traumatic experience, or an earth-shattering diagnosis. But I wish families were having these conversations much sooner.

Did you know the average length of a hospital stay is three to five days? If you qualify for an inpatient rehab center, the average length of stay is 10-13 days. This leaves a maximum of just over two weeks to deal with often massively life-altering health events. Unwelcome change happens fast.

Awareness and preparation can soften the blow of life-altering events and provide more options in the aftermath. We must normalize conversations around aging within our families and community members.

In my experience, there are five common barriers to older adults being able to live safely and independently in their home as they age in order of significance:

•  Fear of vulnerability
•  Need for support
•  Home safety
•  Personal health
•  Financial considerations

Despite research data and poll results indicating that there is a 100 percent chance we all age and eventually die, individually, we hold onto either the ideal of happy and healthy living or the desperation and fear of change. This is to our detriment.

Fear of Vulnerability — This understandable concern contributes to an individual’s unwillingness to acknowledge their needs and ask for help. This is first on the list because the fear of losing independence is frequently the toughest nut to crack when you are trying to plan ahead on the complex and deeply personal topic of aging. It requires insight and humility to realize you need support and ask for it.

Often I find the aging person wants the security of knowing their desires and concerns will be considered and taken seriously if and when they accept support. These conversations go best when there is empathy and understanding on both sides.

Need for Support — In addition to family members, there are social resources available. If you require assistance with transportation, grocery shopping, medication management, getting dressed, or showering — who’s going to help with that? Sometimes this is a family member. Sometimes it’s a home health aide. Sometimes it’s a mix of several resources.

Home Safety — This refers to how safe and accessible the home is. Identifying the needs and finding the right support within your budget is time consuming and takes intentionality and planning. Having professional support can often save time and money by getting things done right the first time, especially when it comes to small or large home modifications.

If you are an older adult admitted to the hospital, you will be asked questions about the accessibility of your home because this greatly influences your discharge plan. For example, two patients with the same functional ability and diagnosis will require two different discharge plans if one has a no-step entry versus the other who has 12 steps to enter their home. The one may be able to go home from the hospital while the other will require an inpatient rehab stay to build back the strength to safely climb a dozen steps.

Personal Health — You may wonder why personal health is so low on the list of barriers. I’ve seen individuals and families weather some scary and uncertain health situations provided the proper support was available and adequate home preparations were made. You may have heard the nihilistic phrase: eat right, exercise daily, die anyway. There are certainly things we can do and should be doing to maximize our strength and longevity. There are also many factors outside of our control.

Financial Considerations — Ignorance is rarely bliss in this category. In my experience, financial concerns cause the most anxiety because they feel like such an unknown. What does it cost to add a ramp? What does home health care cost in terms of time and money?

Here are a few things that help: (1) knowing your financial standing is a powerful step in your journey of planning your future, and (2) knowing what options are available locally within your budget.

If you are a caregiver, older adult, adult child of an aging parent, or an aware friend reading this, and feeling concerned about the health of yourself or a loved one, know that you are not alone. The next article in this series will continue the challenge of having normal, day-to-day conversations around aging, this time with a look at the role of the family caregiver.

Andrew Myers founded Universal Home Consulting to provide home safety assessments and caregiver support and education.


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