Independence Day is a natural time to reflect on our national and personal freedoms. For many older adults, this includes the freedom to live independently and age in place.
There are four key areas in which you can encourage safe senior independence, lower fall risk, and help seniors maintain their abilities to remain in their own homes.
1. Assess the Costs of Care
Help seniors understand the true costs of aging in place versus assisted living or nursing home care. Coverage provided by Medicare and long-term care insurance is limited, and depends on the service and amount of time it’s needed. One advantage to receiving services at home even when paid out of pocket is often far less expensive than moving to a long-term care facility.
The daily cost for a semi-private nursing home bed in 2016 was $6,844 per month, according to
Genworth 2016 Annual Cost of Care Study: Costs Continue to Rise, Particularly for Services in Home. Assisted living facilities cost roughly $3,628. By contrast, the cost hiring a homemaker or in-home health aide for 44 hours weekly was $3,813 and $3,861, respectively.
Home health nurses and therapists are typically more expensive, but for seniors who only need part-time assistance, this option could be less costly in the long run. These potential savings free up more money to spend on other aspects of independent senior living.
2. Support Physical Health
The greatest challenge to maintaining senior independence is declining physical health. Healthcare providers can have a direct and significant impact on preserving older Americans’ wellbeing, by:
- Identifying physical issues that interfere with independent living.
- Focusing specifically on prevention and management of the most common chronic diseases, keeping in mind that seniors frequently live with comorbidities.
- Helping seniors be safer at home and on the go by exploring technological options such as home monitoring, medical alert systems and automated medication dispensing.
The leading cause of death in the US, heart disease takes the lives of 614,348 Americans every year, according to the U.S. Centers for Disease Control and Prevention (CDC).
Inform recovering cardiac patients that a slow change in lifestyle choices has a higher chance for success. Eating a healthy diet, quitting smoking, finding a safe and enjoyable place to walk, learning to control stress, and properly managing medications are all important. In most cases, these goals are realistic, especially if instituted gradually. Also be sure patients are aware of medication side effects such as dizziness, which may increase their risk for falls.
Organizations such as the American Heart Association offer a wealth of useful information to reduce the impact of heart disease on senior independence, including diet plans, recipes, and exercise instructions. Government agencies such as the CDC and the National Heart, Lung, and Blood Institute also offer useful insights.
Cancer and its side effects may negatively impact your senior patient’s comfort, safety, and independence. Fatigue is the most common and persistent side effect of cancer treatment. It’s experienced by about a third of survivors, especially those who receiving chemotherapy. The American Cancer Society’s 2016-2017 Cancer and Survivorship Facts & Figures explains the impact: “Compared with fatigue experienced by healthy individuals, cancer-related fatigue is more severe, more distressing, and less likely to be relieved with rest.”
Other side effects of chemotherapy, such as poor balance, visual changes, confusion, and trouble walking, may increase the risk for falls and fall-related injuries.
Help cancer patients with medications and/or activity recommendations to reduce these impacts. The American Cancer Society’s Stay Healthy section features information on how to live better with the effects of the disease.
Lower Respiratory Diseases
Chronic obstructive pulmonary disease (COPD) can become severe enough to make walking and other movement a major challenge. When the lungs are unable to provide the brain and organs with an adequate oxygen supply, the result can be weakness, dizziness, and confusion – all things that increase a senior’s fall risk. Tubes and tanks for oxygen support may also become tripping hazards. These factors may adversely impact seniors’ ability to age in place.
Introduce your patients to resources from the American Lung Association for advice on living safely with COPD. Your patient’s local United Way or Department on Aging also provides assistance and referral network resources. Through these and other organizations, your patients can find help with such needs as transportation, food assistance, senior companions, and much more so that they can continue living as independently as possible.
Because a stroke significantly effects balance and gait, it has a huge impact on senior independent living. Once a stroke survivor is home, how well s/he manages depends on the residual damage and the patient’s motivation, environmental conditions, and social support.
The United Way is an excellent resource, while the American Stroke Association, National Stroke Association, and the National Institute of Neurological Disorders and Stroke are the go-to resources for stroke patients, caregivers, and healthcare professionals alike.
Diabetes influences senior independence in many ways, including:
- Poor eyesight that increases fall risk.
- Neuropathy from damaged vessels that leaves the feet oversensitive or with minimal sensation and makes safe walking difficult.
- Sore gums and loss of appetite that can cause unsafe weight loss and increased fatigue.
Diabetes symptoms are manageable but require self-discipline and significant lifestyle changes. The American Diabetes Association recommends that patients eat a healthy diet as advised by their primary healthcare provider, stay as active as possible, maintain strict blood glucose monitoring, keep up with good oral healthcare and routine trips to the dentist, and exercise good foot care.
3. Focus on Mental & Cognitive Health
Mental health concerns — primarily mood disorders, anxiety, and cognitive impairment — affect approximately 20% of the 55+ population, according to the CDC. These conditions can reduce a senior’s ability to age in place for many reasons, including the increased risk of falls.
The CDC estimates that most older adults are in good mental health – only about 15% report any mental health illness. The incidence of depression, however, rises with age and loss of independence: 11.5% of older hospital patients and 13.5% of people needing home healthcare are depressed. The National Alliance on Mental Illness and CDC offer useful resources for patients and professionals.
Sometimes overlooked, substance abuse among older adults is a real and growing problem. According to the Center for Behavioral Health Statistics and Quality, more than 1 million 65+ people had a substance abuse disorder in 2014, the most recent year available. That includes 978,000 abusing alcohol and 161,000 abusing illicit drugs. And those numbers are on the rise, expected to reach 5.7 million by 2020. Consult the Substance Abuse and Mental Health Services Administration for education materials and links to support groups in your area.
Cognitive issues related to Alzheimer’s disease and dementia make senior independent living difficult. These patients are prone falling and to becoming disoriented, lost and confused – so they require assistance and supervision. Home monitoring and medical alert systems with fall detection can help patients age in place safely. The Alzheimer’s Association is a valuable resource for patients and caregivers.
4. Address Fall Risk and Prevention
Any patients you believe may be at risk for falls can benefit from tips to prevent slips, trips and falls at home and on the go, including:
· Removing loose rugs, electrical cords, and clutter.
· Maintaining adequate lighting.
· Installing grab bars, ramps, and other safety equipment.
· Wearing shoes with sturdy soles.
· Understanding how medications and conditions can make falls more likely.
· Using a personal emergency alert device.
Developing creative ways to help your patients age in place safely benefits their health and wellbeing, and makes you a valuable partner for them and their caregivers. That’s the best way to honor and ensure senior independent living.
Updated June 2017