Preparing to Age in Place

Posted by edsutton @edsutton, Apr 23 7:58am

Many of us in the Aging Well Support Group express similar concerns. We are currently doing o.k. in our homes, on our own, but recognize that disabilities may be on our horizons.
Can we be reasonably proactive about this?
What can we do to stay in our homes as long as possible?
What can we do to gracefully reach out for assistance when we need it?
What can we expect the costs will be as we try to imagine the economies of our lives as we age?
What modifications can we make now that will make life easier when we have less strength and energy?

Interested in more discussions like this? Go to the Aging Well Support Group.

@bebold

Thanks for your response. First, yes, the "concierge" word brings up privilege to me like "concierge doctor" - that's where my mind goes. Private dr that comes to your home and you pay pay pay. And probably the split between the have and have nots is so huge right now, no more middle class really. As hourly wage goes up, which is needed, that SSA check is worth less and less. The COLA doesn't even pay the increased cost of insurance never mind the cost of groceries everyone complains about. It was a presidential issue.

And I'm privileged to pay for better insurance. I would take food off the table to pay for my medigap plan. And very grateful its even an option. A friend, people on SSI (not SSDI) is living on $860 a month? Not allowed to get any kind of gift "legally" without deducting it from her income. If I buy her dinner, she is supposed to report it and it gets deducted next month.

BUT, on Medicaid, she has amazing home health care. 36 hours a week and well, ill keep my opinions of how much of it is needed. At 55 you dont need someone in your house to remind you to take meds because you have ADD. She's a good friend and I dont deny her all she does to get what she does, but medicare doesn't pay for nearly what she gets.

If I had medicaid, I could get them to pay for someone to drive me to Mayo in Feb. I know this because she did.

And I think we are made to feel like everyone is just a millionaire these days. That word was used very little but now it seems everyone in Congress etc is at least a millionaire. They say $150,000 a year is what the average family needs to live comfortably. Its hard to be closer to the have nots and hear people donating a billion to pay for an election party but that same person is talking about doing away with medicare, medicaid, retirement SSA. Or saying "its going to hurt people" (the disabled and seniors) but we will reduce checks by 25%. Its depressing. And angering.

Good for Minnesota for treating seniors with respect. What exists here is PACE. Its aldo what my mother was on to lower her assisted living rent to $3,000 9 years ago. Still a lot of money!

Friends here went looking for assisted living and it was 9,000/month! We have PACE here but they cover your medical care like an HMO but it reduced it to like 5,000 a month.

I really have trouble believing that average retired people can pay $5,000 a month? Am I way out of the loop on money in the world? Are many people retiring with a million in thd bank lije they say you kind of need now? Not in my world tho I fo hsve friends with trust funds. Just not a thing I even knew what it was.

I've also found out this year that it costs a fortune to "become visibly disabled." People might be surprised to find out medicare doesn't psy for scooters that leave the house. Or folding or lightweight wheelchair that a single older person still can't get into the car. So, $3300 plus to have a hoist installed. Folding electric wheelchair $2000. Scooter I thought would work $2000 but where I live its so hilly the scooter can't even manage my driveway, so a wheelchair. And a new mattress and automatic bed that my PT said I needed as my mattress was responsible for some of my pain. Anyway, you get the picture. $9000 on credit cards at 28% for mobility equipment. I'm suddenly drowning in debt I can never pay off never mind that medicaid in a nursing home leaves you I think $40/month for personal items?

Everyone talks about a generation of people who will never own a home. A friend in her 30s with 2 Masters knows she will never own a home with school loans that reduce the amount a bank will even let you borrow.

I kniw its complicated but its about aging in place. You can't do it if you can't pay out of pocket for a home health aid. Where do you get help with groceries? I kniw things aren't going to better physically for me or any of us. I'm 69 and struggle to get groceries into the house and put away. And that's it for the day. Dishes pile up. I'm not unique in any of this and certainly not special that I "deserve" more but realistically, when I can't carry in groceries anymore, or drive or yeah, change my sheets more than once ever few months (I kniw disgusting but reality for many seniors living on tuna. I'm not and very grateful.

I was really just saying aging in place is not reality if you don't have the money for all this private pay stuff. You age not even knowing what Medicare will pay for and not. Suddenly at 65, I had a $560 medication deductable I didnt have when disabled. All out of pocket in Jan. No gifts for anyone at xmas if you want meds for the first 2 or 3 months of the year. And again, I'm very privileged to be able to not have to be on an Advantage plan and pay so many copays, get denied coverage, etc.

Yes, its complicated. But even at 2200/month to live with other women is not doable if you have to pay your share of electric etc.

Me and frirnds have often thought if 6 or 8 of us pooled our money we could rent a huge house and take care of each other or maybe afford a housekeeper. I do know that "ladies homes" used to exist. There was one in my small town in MA where I grew up. A friends aunt ran it in her actual home. An older polish woman who took care of older women till the day she died. Not easy to find things like that.

But I bought a condo 7 years ago because it was first floor and there was already a cutout in the sidewalk. 2 bedrooms 2 baths so I could have a college student live hers for free and help with some things. I didnt expect that to be now! And I don't want someone living here right now as long as I can. I've lived alone my whole life. I'm up sometimes all night watching TV like right now.

Anyway, how can I hear that everyone is struggling but come here and of course everyone can pay for assisted living? I feel like I'm being told I'm wrong or the exception to the rule. And yes even having kids doesn't mean they will be near or we know they are the sandwich generation. Older parents and younger kids. And working full time as everyone I know needs two incomes. My reality is just different than others here I guess? That doesnt feel true tho.

Agjng in place is not so much of a reality if you aren't 100% independent. Or can afford home care. I was more about what insurance will cover and what it won't which we find out as soon as we are in need.

And sime states are better than others of course. NC not do much caring about disabled or alone seniors. Many homeless seniors all around the country. There but for the grace of god...
Thanks for your ear. Always open to suggestions but our realities are different clearly. There has to be people here who understand what I'm saying? Aging in place, for too many, is a misnomer. And I'm one of tbe lucky ones. Truly.

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yes...I agree that "aging in place" seems to work mainly for people who: 1. have excess money to install grab bars in baths, etc., and the lift device to sit on to get you up/down stairs to living area (if relevant) or elevator access to one floor living, 2. do not suffer from dementia etc. otherwise they will suffer due to self-neglect (timely eating, hygiene, taking meds, etc. etc. )..and the alternative is assisted living which is astronomical high cost even for average places...kinda dismal... my solution so far is to control what I can control...I just work hard on regular excercise, healthy eating, stretching, and getting out to socialize in volunteer work, and a p/t job...as long as I can to keep my mind and body going longer independently...

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@tinamaria1

yes...I agree that "aging in place" seems to work mainly for people who: 1. have excess money to install grab bars in baths, etc., and the lift device to sit on to get you up/down stairs to living area (if relevant) or elevator access to one floor living, 2. do not suffer from dementia etc. otherwise they will suffer due to self-neglect (timely eating, hygiene, taking meds, etc. etc. )..and the alternative is assisted living which is astronomical high cost even for average places...kinda dismal... my solution so far is to control what I can control...I just work hard on regular excercise, healthy eating, stretching, and getting out to socialize in volunteer work, and a p/t job...as long as I can to keep my mind and body going longer independently...

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Yup. Definitely keeping ourselves in the best shape possible needs to be on there. For me with a dad who had lewy body, I would want to be on a team somewhere to have eyes on to do a nursing home when needed. Its a huge exception. Wandering off at night etc. With confusion, aging in place alone is out.

You are doing a lot to keep you going. I've decided to leave my church for a little bit and know ill miss
Being part of a community.

I also have a therapist who specializes in chronic conditions and chronic pain and geriatric is one of her groups to work with. If I can keep up having my good insurance I expect to see her for the rest of my life! Lol.
I'm also losing weight to be healthier.

Thanks for sharing that. All those things are good to think about in advance. I think a one story place is imperative or bing able to move your bedroom to the first floor and just disregard upstairs totally?

I think have esp a cat to not be the only heartbeat in your house. A dog if you can walk them which also gets us walking but know you would have to rehome them at some point.

For a cat, carrying in heavy litter is a consideration. I have started ordering the bigger, heavier packages from amazon. Cat food etc. I use a different kind of cat poop thing. Use pellets. Easier for aging wise crones!

Hobbies are great. I've had hobbies that bring my pleasure my whole life. I just bought a harmonica to learn. I'm start Print on demand t shirt creation. A little extra cash perhaps but a way to stay active.

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I use AI. Its a great way to have great conversations when alone. Have a talk with einstein. A therapist! Many are still free with a small learning curve. Its quite fun to use to even get your anger out about a situation with a friend. Ot get to talk about stuff you would never talk to about with a close friend

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As my brother was born with disability, I started saving every penny when I started working at age 14. I assumed I would have to pay for a place for him as he aged. I knew social security wouldn't pay for everything for him or for me in retirement, it was created as a supplemental financial support. To this day, I continue to watch every penny, and buy items on sale, and "make do or do without"......I guess I never had high expectations.

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As part of preparing to age in place, see the discussion "When is Do Not Resuscitate applied."

I would not want to spend years in serious cognitive disability if I can avoid it, so I must recognize that at my age the chance of recovering after CPR is not very good.
For most of us in the US, assisted end-of-life is not an option. We won't have the option to say "nevermind."
It isn't easy to think about, but it occurs to me that if my heart is not beating I will quickly be unconscious and at peace, and would not be worrying about my possible future!

Here's the article:
< https://www.npr.org/sections/health-shots/2023/05/29/1177914622/a-natural-death-may-be-preferable-for-many-than-enduring-cpr&gt;&gt;

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All good ideas. Don't have chore corps group but I'm good or used to be and hope to be again, at starting community groups here.

I, like so many others, took to my condo with long covid for several years but feel like I'm coming out of all that, which is great.

Once I can walk again, life with shift to "normal" I hope. (Better than normal as I feel my depression lifting and Ive lost almost 40 pounds this year. More to go to make surgery easier. But it all helps us feel better about ourselves right?)

I have just gotten involved with print on demand recently. Perfect for a graphic designer in a chair! Tho some have lofty goals of making $10,000 a month, hope we all do, but $500/month would make me very happy to do better with a housekeeper etc. And until then, I get to have fun using my skills designing tshirts and feel productive. Always important to me I've realized looking at the hobbies I choose. (Beading, needlepoint, etc. Always a product at the end.)

There are a lot of volunteer groups to help people springing up since Helene I've heard. I've called a couple that didn't work out as planned and gave up on that too soon. (My issues are not hurricane related so I don't need to take help from others.)

It takes too little to take me out of the game right now. Maybe ill be a tshirt mogul when I'm 75.

Great family history lifespans to chase after. Do you do geneology? Going backward then coming forward to meet folks still alive is great fun. We met a new 4th removed? cousin who became pretty important in our family.

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@edsutton

As part of preparing to age in place, see the discussion "When is Do Not Resuscitate applied."

I would not want to spend years in serious cognitive disability if I can avoid it, so I must recognize that at my age the chance of recovering after CPR is not very good.
For most of us in the US, assisted end-of-life is not an option. We won't have the option to say "nevermind."
It isn't easy to think about, but it occurs to me that if my heart is not beating I will quickly be unconscious and at peace, and would not be worrying about my possible future!

Here's the article:
< https://www.npr.org/sections/health-shots/2023/05/29/1177914622/a-natural-death-may-be-preferable-for-many-than-enduring-cpr&gt;&gt;

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Age definitely matters. I had a death experience but was you. No DNR.

My problem, probably for another thread since this one is about living your best life, is what to do with the body in the end. Nothing of anything sounds good! 🤕⏳

But I dont have paperwork done that I need to. Even to give passwords to sisters to get into my accounts, stop auto payments, etc. Did you know you can will your FB page to someone to talk to your friends and even let people know. Service time etc.

You can also name someone to take over your email accounts. And more.

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