If you’d like to stay in your own house, apartment or condo as you grow older, you’re not alone. The desire to age at home is one that most older adults have.
However, aging in place does not mean you have to grow old alone or stay entirely independent throughout.
Successful aging in place requires planning for a time when your abilities will change and identifying the support systems and people you can call on to help.
That was the message delivered by Christine Ritchie, MD, MSPH, director of the Center for Aging and Serious Illness Research within the Mongan Institute at Massachusetts General Hospital (MGH), during a recent MGH Geriatric Medicine Town Hall on “Navigating Independence and Aging.”
Learn more in this Q&A with Dr. Ritchie, whose is working to train the next generation of researchers in geriatric medicine and palliative care.
What do you mean when you talk about “aging in place”?
Aging in place means living safely and comfortably in our homes and communities with the support we need as our health and abilities change. It is about planning to make sure we can stay safe, independent and connected for as long as possible.
What resources are needed for successful aging in place?
Christine Ritchie, MD
There are three areas to consider—human resources, tools and technology, and financial resources.
Human Resources:
When it comes to human resources, it’s important to know that aging is not a solo sport.
It’s a team sport, which means soliciting and accepting help from individuals who you identify in advance.
We are living longer than ever before, which means that we are less likely to die suddenly and more likely to experience some level of functional decline before we die. By and large, that means that at some point we will likely need support with walking, bathing, cooking, shopping or managing medications.
So it is important to identify your support team in advance. Who can help you if you get sick? Who is available close by if you fall inside your house and can’t get up? Who could drive you to a doctor’s appointment if you can’t do it yourself?
These human resources don’t have to be family members. I think we often get stuck on that idea. They can be friends, neighbors, members of faith communities, home health aides or members of community programs.
Tools and Technology:
Tools and technology can help us stay connected to our care and support teams while aging at home. These resources can include fall detection devices, motion-activated smart lights, automated medication reminders, and remote monitoring services, just to name a few.
These tools can provide you and your care team with peace of mind, buy you more time at home, and reduce the risk of illness and injuries.
Financial Resources:
Financial resources are the third important area, and the one where I find that most Americans struggle. We undergo financial planning for colleges, retirement and vacations, but we don’t plan for aging in place and the costs associated with that.
Planning ahead gives us a broader menu of choices in how we handle the challenges that emerge with aging, such as hiring a home health aide to help with tasks around the house or paying to retrofit a tub or shower to make bathing safer. Waiting for a crisis to occur without planning in advance can often take those choices away.
What are the five pillars of aging in place?
Home Safety and Design: Most falls happen in the home while doing regular stuff, such as tripping while taking the laundry up and down the stairs or missing a step when you get up off the toilet.
Making small changes such as putting grab bars in the bathroom, installing walk-in, step-free showers, and avoiding loose rugs and slippery floors can significantly improve home safety.
And if you have one, be sure to close the dishwasher door after you’re done loading and unloading it!
Health and Mobility: Movement is medicine, anything you can do to stay physically active and improve your balance and strength will help in aging successfully at home.
It is never too late to work on your strength and increase your activity levels. Wrapping your bones in strong muscles is the best way to support them.
Social Connection: One of the sad things as we age is that we tend to lose many of our old friends. But we can also make new friendships at any point in life, including in old age.
Think of ways to stay connected with friends, family, or faith communities, and look for ways to create new connections through volunteering, working, going to senior centers or taking part in other community events.
Do your part to make friends with people younger and older than you. Multigenerational friendships and connections can also reduce ageism.
Transportation and Access: Most of us will drive less as we age or eventually stop driving someday. That does not automatically you will lose your independence, but it helps to be aware of and seek out alternate forms of transportation such as ride services, public transportation, and community vans.
You can also take advantage of delivery services for simple errands and may be able to use telehealth for some medical appointments to reduce the need to drive to and from your doctor's office.
Support System and Backup Plans: All of us need a backup plan or a plan B. Plan A is what we would want our lives to be under ideal conditions as we age, and plan B is how we might have to pivot if plan A is no longer possible.
If that means we need to accept help from others, know that this is not admitting a weakness. It’s actually a sign of strength and often how we can preserve or maximize our independence.
When is it time to consider other options?
Look out for the warning signs that your home is no longer serving you well.
If you’re falling a lot, having trouble getting to the bathroom safely, missing doses of your medication, not eating well or feeling uncomfortably isolated, it may be time to consider other options.
Remember that your well-being is not ultimately about your address—it’s really about your safety, dignity and your quality of life.
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