What to consider when helping an older person to age in place

Q. I am in despair and exhausted regarding my 99-year-old mother. My father, while he lived, did not encourage her to learn anything about electronics or the Internet. She cannot even manage her hearing aids and refuses to use a cellphone. Despite being fairly capable in her 99th year, she is completely cut off from the world. I have to manage everything to keep her at home. Our part-time caregiver speaks little English. Would moving my mother to an assisted living residence increase her chances for social interaction? Your thoughts? N.A.

It’s good to know that your mother is “fairly capable,” yet, unfortunately, not sufficiently capable to live without your ongoing help.

Many of us may have heard the phrase from an older person, such as “I am never leaving my home to go into one of those old-age places,” or an adult child saying, “Mom, I never will put you in an old-age home.” 

These intentions reflect the desire of most (75 percent) older adults age 50 and older, according to AARP.  At the same time, almost half (44 per cent) believe a move is inevitable. Sometimes intentions don’t match reality.

There are many advantages to staying in one’s home. Maintaining independence is a big one. That involves coming and going as you please, being in familiar and comfortable surroundings, and eating what you want when you want it. It means having the option of calling on friends and family when you need some assistance, living among your neighbors and not according to someone else’s schedule. 

At the same time, aging in place can be risky, depending on the circumstances.  

Falls: These are the leading cause of fatal and non-fatal injuries for adults ages 65 and older. More than 14 million, or one in four, adults report falling each year, according to the Centers for Disease Control (CDC). The rate is slightly higher in California, where over 2300 older adults died from falls in 2021. 

Social isolation: Older adults with little or no social contacts are at risk for a variety of physical and mental conditions. These include high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease and even death. According to a 2023 Surgeon General’s report, loneliness has the same impact on health as smoking 15 cigarettes per day. 

Caregiver stress: We cannot ignore the ongoing impact on the caregiver. Being in despair and exhausted, as indicated by N.A., is a red-light warning. Ongoing stress and burnout often lead to both physical and mental health consequences such as depression, anxiety, a weakened immune system and chronic diseases.  

So, what are the advantages of moving to an assisted living residence?

To begin with, there is an opportunity for the individual to have more social connections and feel less isolated.  Assisted living facilities are designed to meet the needs of their residents. That consists of shared spaces to enhance social contact, such as communal dining and recreational activities, programs and classes. There often are clubs, fitness programs, discussion groups and more. One such facility offers a well-attended improv class. And then there is transportation. Other features include assistance with bathing, grooming, and managing medications, often referred to as activities of daily living (ADL).   

When looking for an assisted living residence for a blind person, it is important to inquire about staff training.  Also, on a site visit, observe if there is safe access to cleared pathways. Assistive living facilities usually are equipped to serve the needs of partially sighted or blind residents in compliance with the Americans with Disabilities Act (ASA) and Fair Housing Act (FHA).  

Note that isolation and loneliness are different from one another. Loneliness is a subjective feeling; isolation is being separated from one another, lacking social contact. Studies indicate that older residents can feel lonely in assisted living residences with statistics varying according to the reporting agency.  

Speaking of aging in place, Sara Zeff Geber, an expert on solo aging, reframes the notion of aging in place to “aging in the right place.” The challenge is to find the right place. 

Thank you, N.A., for your important question. You might consider exploring an assisted living residence for your mother. There would be a better opportunity for social interaction, managing day-to-day personal needs and relieving you of ongoing stress and potential burnout.  

Take care, and know even small acts of kindness count. 

Helen Dennis is a nationally recognized leader on issues of aging and the new retirement with academic, corporate and nonprofit experience. Contact Helen with your questions and comments at Helendenn@gmail.com.  Visit Helen at HelenMdennis.com and follow her on facebook.com/SuccessfulAgingCommunity