Aging-in-place is a term which has emerged in the past ten years to describe the desire by people to stay in their home as they age.
No surprise that if given the choice between going to a nursing home and staying at home, our parents would choose the latter. Wouldn't you? But it might be a surprise to know that the kids of those seniors are wanting them to stay at home just as much as the parents. In a recent survey done by Senior Helpers, 85% of the children of seniors said that they would prefer to have their parents age at home, as opposed to moving to a senior care community. Home care can ease the economic burden of institutional care on family, state, and federal budgets. Now what we need are more aging-in-place programs to enable the burgeoning elderly population to stay in their homes as they grow older. An innovative program, CAPABLE, combines medical care with the classic approach of programs like Aging True, which respects elderly people's autonomy.
The Centers for Medicaid and Medicare (CMS) recently funded a study of CAPABLE, which was launched in Baltimore, Maryland. The acronym stands for Community Aging in Place, Advancing Better Living for Elders. CAPABLE not only saves money for the federal budget (some $10,000 per participant per annum). It also enhances seniors' sense of autonomy and enables their independence effectively.
Over a five-month period, participants in the study were visited ten times. Half the visits came from registered nurses, and half were from physical therapists. Nurses monitored health conditions. Physical therapists introduced exercises to increase strength, stamina, and balance. Some monies-about $1300 per participant-were available at no cost to the elderly person for home adjustments and equipment that would support safe aging in place.
There were almost 300 participants in the study. Most of them had trouble with four Activities of Daily Living at the start of the program. However, by the time the program ended, they needed assistance with just two ADLs. Depression abated, according to the study, and the elderly people became more capable of managing their lives. What was more, fewer seniors in the program moved into nursing homes compared to those in a control group.
The CAPABLE program was developed by Sarah Szanton of John Hopkins University School of Nursing. It deliberately empowers seniors by allowing them to set and strive for their own goals. While the overall goal is to increase the time seniors can safely age in place, these smaller goals are important in increasing the quality of seniors' lives according to their own wishes.
The program has been so successful that it is being launched in multiple places. CAPABLE may very well become the national norm for supporting senior independence.
Aging True saw the value of seniors aging-i-place before it became fashionable. They have been in operation for 55 years, attesting to their successful approach to enabling senior independence. Church-initiated, the program embraces partnerships with other churches, other faith traditions, and social and state agencies to provide meals for the elderly, light housekeeping, personal care, and safety services such as reducing clutter in seniors' homes to prevent falls.
Aging True rose from a fledgling grassroots effort of church members to becoming the largest non-profit senior care provider in northeast Florida. The organization sees the senior years as a time that should be filled with gracious dignity, respecting the independence, wishes, and autonomy of the elderly. Aging True's classic approach to senior care-relying on volunteers, charitable donations, and collaboration with state and federal programs-has proven to be of enduring value.
A Canadian study showed that dependence and independence are more fluid than one might think. For example, some seniors regain independence after losing it. The study showed that in a period of a year, some 14% of elderly individuals studied did indeed become dependent, needing help with several ADLs. However, during the same period of the study, 32% of dependent seniors became independent.
However, the study found a strong correlation between age and dependence, even when controlling for factors like chronic conditions, smoking, alcohol use, income, the level of education, and physical activity levels. Age is a stand-alone factor in limiting independence. For example, almost 50% of independent seniors 85 or older became dependent within two years. Only 7% of people between the ages of 65 and 69 did so. In addition, men younger than 75 regained independence once it was lost at greater frequency than women of the same age. However, by age 75, the differences disappeared. Aging itself is the factor most predictive of losing one's independence.
Thus, we know that dependence is almost inevitable as an elderly person ages. However, the goal is to put off dependence as long as possible and programs such as CAPABLE and Aging True can help support senior independence and autonomy.
Aging True Community Senior Services. (2016). Annual Report. Available online at http://agingtrue.org/wp-content/uploads/2016/08/AgingTrue_AR2015_SINGLES_PRINT.pdf. Accessed May 3, 2017.
Baker, B. (April 26, 2017). A Novel Program Helps Older Adults with Aging in Place. NextAvenue.org. Available online at http://www.nextavenue.org/capable-aging-in-place/. Accessed May 3, 2017.
Martel, L., Belanger, A., Berthelot, J-M. (July 2002). Loss and recovery of independence among seniors. Health Reports, 13(4). Statistics Canada. Catalogue 82-003. Available online at http://odesi1.scholarsportal.info/documentation/PHIRN/NSAI/6316-eng.pdf. Accessed May 3, 2017.