According to the AARP, at least 90 percent of people in a recent survey say they want to age in their own home. But sometimes health and mobility issues can make that hope a challenge.
Lynda Shrager has committed most of her professional life to helping people and families navigate this phase of life. Shrager has more than 37 years of experience working in the field of geriatrics, with over a decade of that spent in direct home care. Her book, “Age In Place: A Guide to Modifying, Organizing, and Decluttering Mom and Dad’s Home,” suggests guidelines and offers tools for readers to help make good choices and arrive at a living situation that works well for seniors – and their caregivers.
Shrager says the discussion between older parents and adult children can be a constructive one, and ideally is had before a health crisis occurs.
"It shouldn’t, in the end, be a stressful conversation," she notes. "Because it’s not like we’re saying, 'You’re on your way to assisted living, mom and dad,' what we’re saying is, 'We want to keep you home. We want to help you.'"
There are often signs that aging parents may need help, according to Shrager. Issues like getting lost while driving home, not recognizing objects or physical accidents such as falls. But, she says it’s important to address these situations and have the conversation of “what should we do?” in a respectful manner.
"Kids feel like they're parenting their parents now, and I try to tell the people that I work with that that's really not true and it never should be true," says Shrager.
If someone feels that their parent or loved one may need some extra assistance or physical changes to their home, they should first gather enough research and support before presenting the idea to the them, she says.
Some red flags may be difficulties in completing "activities of daily living" (ADLs) and "instrumental activities of daily living" (IADLs).
"ADLs are the kinds of things that all of us do every single day. We toilet ourselves, wash ourselves, complete our grooming and hygiene, feed ourselves, and get from one surface to another safely," Shrager explains. "The IADLs take a little bit more cognitive functioning and physical functioning. Making a meal, doing the laundry, cleaning the house, managing medication, that type of thing."
As an occupational therapist, Shrager pays close attention to the physical environment people are in by walking through a client's house to observe any potential problems and solutions. She recommends people do this with their parents to see the house through a new perspective before presenting any changes to the home or their lifestyle.
Home modifications and common remodeling projects such as adding railings, relocating living quarters to the first floor, or moving furniture can often make a big difference in home navigation. Shrager says it is best to make these changes and have the discussion of what a parent's wishes are before a major event forces these changes out of necessity.
"Don't wait for the crisis to occur," she notes. "Don't wait till dad breaks his hip, or mom has a heart attack and they're in the hospital and now they're going to come home and the house is on two levels, and it's difficult for them to manage and there's no help and there's no plan in place."
Shrager adds, "It might not be comfortable to start the conversation, but it's worse not to have it."