"The stairs are getting to hard to climb."

"Since my wife died, I only eat toast or soup for dinner."

“I can’t imagine moving after all these years. This is my home.”

These are just a few of the common concerns we hear. Sometimes we hear them from our older clients, and other times these concerns are voiced through our younger clients trying to help their parents with difficult decisions.

Given the choice, most seniors want to continue living in their own home rather than moving in with a relative, or going to an assisted living facility or nursing home. Unfortunately, that choice is not always available. But when it is a choice, it is usually because there are local resources available to provide certain critical services.

When thinking about whether “staying at home” is feasible, start with these issues:

• Medical

  The first time the question arises about staying at home is usually after some sort of medical problem or scare. It could be a stroke or heart attack, or possibly the onset of dementia. Or it could be as simple as Mom or Dad forgetting to take their medicine.

  The first question to ask is whether the medical problems are serious enough that they present a safety issue. Start by talking to a doctor about how the specific illness or behavior might affect the ability to stay at home.

• Current Needs

  If you determine that it is possible to stay at home from a medical point of view, the next thing to do is to analyze your current needs. Think about the services or personal care you require, and who might be available to provide. Areas to consider include:

• Personal care including bathing, hair care, and dressing.
• Homemaking including housecleaning, yard work, grocery shopping, and laundry.
• Meal preparation and cleanup.
• Money management including bill payment, check balancing, and filing medical claims forms.
• Medical care and medication management.
• Mobility both at home and in town. Is driving still possible? If not, is public transportation or ride-sharing an option?

No solution is ideal. But for those who want to stay in their home, the reality is that outside service providers are often needed to take care of the critical issues.Some of the best places to look for these service providers include:

• Friends and people you know. It may be that a neighbor is experiencing similar issues and may have found a good source for assistance. You should start with someone you know who is satisfied with the care and service they are receiving.
• Community and local government resources. Most communities have a variety of services available to residents, and local healthcare providers and social workers may have suggestions. Often your community will have an Agency on Aging or similar government agencies who maintain a list of service providers. If you belong to a religious group, check with their local office to see if they can provide you with relevant information.

More and more you will find people known as “geriatric care managers” who can help you identify and engage local service providers. They can also work with you to form a long-term care plan. They charge for this service, and it probably won't be covered by any insurance plan, but they can be very helpful. They also can check with you from time to time to make sure your needs haven't changed.

Unfortunately, even if you are able to assemble a team of service providers, there is almost always a limit to the funds you have available to pay for these services.

Some services are more expensive than others. Some services are provided for free. Some services are covered by Medicare, private "Medigap" policies or other private health insurance, Medicaid, or long-term care insurance. Others are not. Determining the costs and how you are going to pay for the help you need, is an important part of planning.

Keep in mind that paying for just a few services out of pocket could cost less in the long run than moving into an independent living, assisted living, or long-term care facility. And you will have your wish of being able to stay at home.

If you have questions,  click here to have our office call to set up a time to discuss this with you.

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