Where Will You Age? Planning to Live Independently

Jonas became a widower a couple of years ago. Before his wife died, they lived in their Springfield home for 40 years. Jonas considered downsizing, but decided to stay for as long as possible. There are too many memories there to just pick up and leave. To Jonas, no other place will ever feel like home.

In another situation, Linda quit work to take care of her husband, Charles, in their Fredericksburg home. His dementia seems to be getting worse every day and is starting to affect his mobility. When he was first diagnosed with dementia, Linda promised Charles she’d keep him at home and take care of him. Seven years later, she remembers that promise clearly, and still wants to keep him at home, but is not sure how she can manage for much longer.

Similar to Jonas and Linda and Charles and many others in their situations, one of the biggest decisions as you age is where you will age. In fact, in a recent AARP survey, 75% of adults said they wanted to remain in their homes, but only 59% thought they would be able to do so. If remaining at home is your preference, there are some steps you can take to plan ahead to make your desire to age in place more realistic. There are also reasons why aging in place may not be the best option for all of us.

How to Plan Ahead to Age in Place

Planning ahead to age in place is often difficult because you never know how your needs might change. These are some of the concerns that seniors who age in place often have when trying to plan ahead:

What kind of help will you need? The first step is to think about the kinds of help you might need in the near future. Maybe you live alone, so there is no one living in your home who is available to help you. Maybe you don’t need help right now, but you live with someone who does. Everyone has a different situation.
Are you prepared for a medical emergency? If you were to suddenly become sick and unable to speak for yourself, you probably would want someone who knows you well to decide on your medical care. To make sure this happens, think about giving someone you trust permission to discuss your health care with your doctor and make necessary decisions. To do so, be sure to have your incapacity planning documents, such as Advance Medical Directives and Health Insurance Portability and Accountability Act (HIPAA) authorization, in place, and be sure these documents are prepared by an experienced Virginia estate planning attorney, Maryland estate planning attorney, or DC estate planning attorney. Also, be sure to talk with your doctor about whether you should get a medical alert ID bracelet or necklace.
Safety concerns: Are you worried about crime in your neighborhood, physical abuse, or losing money as a result of a scam? If you live alone, are you afraid of becoming sick with no one around to help? Consider a Ring doorbell and/or an emergency alert system. You just push a special button that you wear, and emergency medical personnel are called. There is typically a monthly fee for this service.
Accessibility concerns: Concerned about falls and accessibility?  Have your home evaluated by an occupational therapist for issues with lighting, tripping hazards, stairs, and bathroom safety. This professional might offer practical safety suggestions. If a few changes would make your home easier and safer to live in, think about things including a ramp at the front door, grab bars in the tub or shower, nonskid floors, more comfortable handles on doors or faucets, and better insulation. Talk to your doctor if you’re experiencing weakness, dizziness or vision problems, management of chronic health conditions and medication side effects.
Getting help during the day: Do you need care but live with someone who can’t stay with you during the day? Adult day care outside the home is sometimes available for seniors who need help caring for themselves. If your caregiver needs to get away for a day or even sometimes overnight, there are places that provide temporary respite care.
The costs of aging in place: An important part of planning to age in place is thinking about how you are going to pay for the help you need. Rates for home health care aides (also called personal care aides) for things such as helping you with dressing, going to the bathroom, showering, light housework, and meal preparation) range from $20 to $30 per hour depending on where you live. Home modifications can also range from inexpensive changes, such as railings, to major expenses, such as stair lifts. Medicare does not cover home modifications.

Accessing Helpful Services at Home

To remain at home, it is important for people to feel independent and self-sufficient. Outsourcing services may be necessary. For example, getting groceries delivered can help. Caregivers can arrange delivery of restaurant meals via DoorDash or Uber Eats, or frozen premade meals through services such as Freshly. Meals on Wheels is also an option. And of course, Amazon Fresh and Whole Foods and other local grocery stores offer home delivery in most parts of the country.

For medical needs, many of the managed care Medicare insurance plans [Medicare Advantage] also allow insured individuals to order medical and nonmedical supplies, such as gloves, over-the-counter medications and adult briefs. Most drugstores also deliver.

State Area Agencies on Aging can connect older residents with in-home services such as chore assistance and meal delivery.  Geriatric care managers can also be very helpful. They identify what you need help with and assist in finding appropriate services. Check out our web page Trusted Referrals of Other Senior-Serving Professionals for recommendations of people in our area who can help!

Disadvantages of Aging in Place

Next Avenue recently published an article about the disadvantages of aging in place. These are some of the points that they made for you to consider when deciding whether aging in place is the best option for you and/or your loved one(s):

You may have to move again if you can’t be adequately cared for in your home, and it’ll be much harder when you are older and in worse health;
You can become isolated, especially if you can no longer drive;
Caregiving help can get expensive and hard to find if you need it;
If you have mobility problems, it’s easy to be mostly confined to your home;
Your home may become a burden, with its continual needs for maintenance and upkeep.

If your situation, including your health and family health history, indicates you have a decent chance of needing assistance in that period, it would be a wise idea to explore other senior living options in the area where you’d like to live.

When Aging-in-Place is No Longer an Option

What happens when you or a loved one can no longer age-in-place? Nursing homes in Northern Virginia and the rest of the Washington, D.C. Metro area cost $12,000 – $14,000 per month, which can be catastrophic even for fairly wealthy families. By being proactive and helping your loves ones plan for long term care in advance with an experienced Virginia elder law attorney, Maryland elder law attorney, or DC elder law attorney, you can help make sure your loved ones always receive the care they need without worry or financial struggle. You’ll further avoid many costly legal headaches that often result when people are not prepared for incapacity or ongoing care needs. It’s never too early or too late to get started. Reach out to us to make an appointment for a consultation:

Elder Care Fairfax: 703-691-1888
Elder Care Fredericksburg: 540-479-1435
Elder Care Rockville: 301-519-8041
Elder Care DC: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.