​Helping a Loved One Live Independently at Home​

​Helping a Loved One Live Independently at Home​
CATHERINE FALLS/GETTY IMAGES

According to AARP's "Home and Community Preferences" survey, 3 in 4 adults age 50 and older say they want to stay in their homes and communities as they age. And many do: Nearly 9 out of 10 care recipients live in their own home, someone else's home, or their caregiver's home. Some homes are suitable for aging and caregiving, but many require modifications.

When my parents needed 24-hour care and moved in with me, we didn't have the budget to build an addition or completely renovate the house. But with some research and advice, I found easier and more affordable ways to make the house safe and navigable. And I continued to adapt as their needs changed. Eventually, I was able to completely remodel a bathroom for Dad's safety, as well as get doorway ramps.

The goal is to help loved ones be as independent as possible at home, for as long as possible. To adapt your residence or that of your loved ones for home care, you can start with an in-home evaluation by an occupational therapist, physical therapist, geriatric care manager (aging life care specialist) , a Certified Aging-in-Place Specialist (CAPS), or a qualified professional through the area agency on aging or the Department of Veterans Affairs.

Some tips to get you started:

1. Do basic home modifications.

Use universal design principles to ensure the home is comfortable and safe for people of all ages and abilities. Make any changes easily adaptable, as needs and skills change over time. A safe home doesn't have to be unattractive – modifications can be beautiful and stylish. If you hire a contractor, look for one that has proven experience in this field. You can look for a contractor with the CAPS designation in the National Association of Home Builders Directory. Also, consider AARP's HomeFit Guide and the HomeFit AR app to tour your home and determine what changes are needed.

Consider the following improvements:

  • Stepless entry. This makes it easier to enter the house for those using wheelchairs and walkers and makes it easier to transport medical equipment, groceries and suitcases inside. If this is not possible, consider a threshold, full ramp, or lift.
  • Bedroom and bathroom on the first floor or elevator. Stairs can become difficult and unsafe. If you can't create a bedroom/bathroom on the first floor, you might consider an elevator in the home.
  • Grab bars in bathroom and raised toilet seat. Making the bathroom safe and accessible is a priority. A shower chair can also be helpful, and if possible, a shower with no curves is best.
  • Laundry room on the same floor as the bedroom/bathroom. If the laundry room is in the basement, it might be time to create one upstairs.
  • Wide portals and corridors. I had offset hinges installed on the doors, which left enough extra room for a walker or wheelchair to pass through.
  • Accessible outlets, controls, knobs and switches. Light switches, thermostats, faucets, cabinets and doorknobs can be lowered and outlets can be raised for easy reach from a sitting or standing position.
  • Variable worktop heights. In the kitchen and bathroom, counter height may be more comfortable for some people to stand up or use a stool without bending over and straining their back, but others may need to sit in a chair or wheelchair.
  • Easy to use handles and latches. Lever handles are easier on arthritic hands..
  • Increase lighting. Dim areas can cause falls.

2. Keep safety top priority.

Each year, 1 in 4 Americans over the age of 65 falls, so fall prevention is paramount. Many of the modifications mentioned above help prevent these types of accidents. And sometimes a very simple adjustment can help. For example, I took the wheels off my dad's chair so it wouldn't move when he stood up. We have a sunken living room, and a friend who was visiting once fell over the edge and broke her ribs. To prevent this from happening again, I lined the furniture up along the edges so Mom and Dad couldn't slip.

Preventing a loved one from getting lost is also essential. Monitors and alerts can be very helpful when someone has dementia. I put a motion sensor in the hallway, so it would alert me if Dad, who had Alzheimer's disease, walked by. Also, I placed an alarm mat next to his bed. For mom, she had alarm pads for the bed and the seat of the chair. Even a simple door alarm, found at her local hardware store, can give her peace of mind. These alarms can also help prevent falls if your loved one is unsafe walking around the house alone.

Medical equipment and mobility aids, including canes, walkers, wheelchairs, and shower chairs, are often key to preventing falls. Stair lifts, entrance ramps, and wheelchair lifts can also be helpful.

3. Personal care devices and apps are rapidly changing home care.

Try using technology these ways:

  • Medical alert systems (or personal emergency response systems). A wide variety of options are available, including GPS tracking and automatic fall detection.
  • Monitors, alerts and alarms. Alerts include motion sensors, video cameras and audio monitors, rug and bumper alarms, door alarms, stove burner alerts, and smart medication organizers/dispensers. Integrated systems are available that combine all of these options. A smart home and security system can be synced so you can lock and unlock doors, check and change the temperature in a loved one's home, control who comes and goes, and even raise or lower window shades remotely. .
  • Health monitoring tools. Apps and devices that monitor blood pressure, blood sugar, weight, nutrition, and other health issues are readily available, and some can send reports to your loved one's doctors.
  • Apps can help communication between members of your care team, create medication lists, and provide care tips or resources. There are also apps for setting up transportation and finding paid caregivers.
  • connections. Technology that helps combat home isolation makes it easier for your loved one to visit friends and family through video calls and smart speakers.

4. Look for home based services.

Find out what assistance may be available through your local agency on aging, the Department of Veterans Affairs, or other community organizations. Physical, occupational, speech, and music therapy can be provided in the home. Cleaning, housework services, and meal delivery are often the first supports people need as they age. Other helpful services for home care include mobile physicians, X-rays and lab tests, and dialysis; Home health aides can help with activities like bathing, dressing, and using the bathroom. If your loved one is a veteran, ask about VA primary home and home health services.

5. Do your homework when hiring paid caregivers.

Help is wonderful to have, and there are many dedicated and caring people willing to provide it. But of course there are others that are not so reliable. Mom had several falls due to untrained paid caregivers, and one stole her jewelry. When hiring caregivers, make sure to check her background and get references, and carefully monitor her work. Stop by, preferably at unexpected times, to check for professionals or volunteers coming to the house.

As your loved one's needs change, you can creatively increase support at home. Dad lived with me for six years; he died, aged 94, in his own bed, surrounded by his daughters, supported by hospice care, provided through the VA. I am so grateful that I was able to adhere to his wishes and take care of him at home. Looking back, while it was challenging, I have no regrets and overall an extremely rewarding experience.


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