Aging With Dignity And Safety at Home
Home care should be the cornerstone of eldercare – growing old in the comfort of our own home brings us joy, dignity and supports good health.
“At the National Institute on Ageing (NIA), we have conducted surveys showing that nearly 100% of older Canadians want to age in their own homes for as long as possible. Given that this is what people want, I think trying to achieve this becomes quite integral to people’s happiness and wellbeing,” said Dr. Samir Sinha, leading geriatrician in Canada and director of Health Policy Research at NIA.
To live safe, healthy and socially-connected lives as we age, support is needed – unfortunately, insufficient home care and community services make aging at home an overwhelming challenge for many. It’s costly and complicated.
“For too many of my patients, their ability to age in place is often undermined by a system that is not adequately resourced to support them to adapt their homes and receive the care they need or further support their family and friends serving as caregivers,” said Dr. Sinha, director of geriatrics at Mount Sinai and the University Health Network.
Home Care is Cost Effective
People end up becoming prematurely institutionalized in long-term care (LTC) homes, or living in overburdened hospitals waiting to go to a long-term care home, which are both more costly than providing more care in people’s homes, he said.
The National Institute on Aging reports it costs an average of $103 per day for an LTC-eligible person in their own home compared to $201 in long-term care. It’s $703 a day for older adults admitted to hospital while awaiting a permanent place.
Enabling more people to receive additional care in their own homes would greatly benefit seniors and society, said Dr. Sinha. “Other countries that have developed more robust home and community care systems are benefiting significantly from this approach.” There’s growing recognition of the increased health and happiness outcomes.
The future for our rapidly aging population isn’t pretty, said Dr. Sinha. We’re not prepared and have so much catching up to do. There are record numbers on Ontario’s LTC home waitlists and the majority of the people waiting in hospitals as ALC (alternate level of care) patients are there because of the insufficient home care to allow them to return to their own homes. “While 15% of hospital patients are ALC patients in Ontario, in Denmark this rate is around 1% as they are providing much more home care to their citizens.”
Home Modifications Needed
Adding to the problem of limited, underfunded care access is a shortage of underpaid care providers to deliver home care. Also additional private care beyond what the government and their families and friends can provide them can be unaffordable. And healthy aging in place needs to enable social connection rather than inhibit it.
The home also needs supports, including age-friendly modifications. There are some grants and support to help people make home adaptions or buy equipment to enhance home accessibility, said Dr. Sinha, “but these are rather piecemeal supports and need to be more comprehensively considered to ensure that we can really enable aging in place whenever possible.”
Sadly, as things stand and with lack of sufficient supports, people relent and put their name on a LTC home waitlist and enter a home. Currently there are more than 40,000 people in Ontario alone who are on LTC home waitlists, he said. “Some jurisdictions have simply offered to provide clients the home care they need up to the cost of having to care for them in a LTC home. After this, a person is invited to purchase additional care to stay in their own homes or go to a LTC home. This is one method that creates a greater level of transparency and accountability and doesn’t cast anyone as a failure when aging in place is no longer possible.”
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Far too many people blame themselves for the failure to be able to age in their own homes, he said, for example, not having saved up enough privately to fill in unanticipated care gaps. Families can also feel like failures for not being able to do more to keep their loved ones at home. “This as a result likely affects the personal happiness and wellbeing of older persons and their caregivers.”
Home is Our Happy Place
Home sweet home is our happy place so plan for it. “I always say that the best defense is a good offence,” said Dr. Sinha, adding that practically working through what might need to be done in advance to make aging in place happen can help better ensure you can better age with dignity and respect.
Read also, How To Prepare An Aging Brain To Re-enter The Workforce
And with health and happiness too. Plan ahead for you and your elderly loved ones to be able to grow old in the place of your choosing: Take into account location, accessibility, available support and services, medical conditions, isolation, finances, and family in order to make the best informed decision.
Don’t assume publicly-funded programs will keep you at home in the future. Don’t let a health emergency catch you unprepared and leave you scrambling for living options. Develop a contingency plan that considers other options in case aging in place is no longer possible.
Being able to access home maintenance, modifications and repairs make aging in place easier and safer. Custodia can help take the hassles and headaches out of home maintenance and tasks, and greatly reduce the barriers to aging in place.