Whether 102, 80 or 55, many vintage adults are evaluating their current and future home alternatives. Most Americans desire to live out their life in a familiar home environment. While aging in place is often a goal, it takes thoughtful planning to achieve. In any case, a nursing home is seldom the preferred choice, but often ends up the place of last residence. The decision to move to a different type of residence is generally difficult and based on a number of factors. Far too often such decisions are made at a time of crisis and later may have to be reconsidered.
* Population Factors. It is estimated that 7.1 million vintage adults are currently in need of some level of assistance or ongoing care. It is expected that this number will escalate tremendously in the next few years. Of those who need some level of assistance, almost 80 percent are able to live in their own homes or in community-based settings. Because more and more elderly are choosing independent living over institutionalized care, the need and available options for home and community-based services continue to grow. Such supportive services help maintain physical, social and spiritual independence in the least restrictive environment.
About 30 percent (9.4 million) of all non-institutionalized vintage adults in 1993 lived alone, while 55 percent lived with their spouses. The remaining 15 percent lived with other people, both relatives and non-relatives. The percentage, of adults living alone, increases steadily with age. Whereas, just 23.6 percent of people age 65 to 74 live alone, among those 75 to 84, 38 percent live alone, and close to half (48 percent) of those 85 and over live alone. About 28 percent of those over age 70 who live alone have no living children. Many of those with children do not live near them and, therefore, have to look to other sources for home and community- based services. Over 60 percent of all elderly disabled men, living in the community, are cared for by a wife, while only 24 percent of elderly disabled women are cared for by a husband. No matter where vintage adults live, independent living is fostered by readily available assistance whether provided through the community, friends or family.
* Remaining at the Homestead. Living out their life in the family homestead is an aspiration of many. It is the reality of only a few. A nuclear family in close proximity certainly can support vintage adults' desire to remain in their homestead. There are a number of services that can assist family caregivers to allow individuals in declining health to stay at home.
Hospice care provides nursing care and a variety of other supportive services, such as counseling and homemaker services, to terminally ill persons and their families. Hospice care may be provided in the individual's home which by regulation includes an assisted living center or a nursing facility.
Adult day-care services provide a variety of health, social and related support services, which usually includes a nutritious meal in a protective setting during the day. Some day-care programs are designed especially for those with Alzheimer's disease or other advanced illnesses.
Home health services are provided in a person's own home and can include part-time nursing services, personal care and homemaker/ chore services, medical supplies/equipment and physical, occupational and speech therapies.
Transportation services help older people get to and from shopping centers, keep appointments and, generally, access a variety of community services and resources.
Respite care provides families temporary relief from the responsibility of caring for older persons who are unable to care for themselves. Respite care is provided in a variety of settings, including the older person's home, the caregiver's home or a nursing facility.
Care coordination/case management helps older people and their families gain access to needed services. …