Elder Care: Aging in Place

By Neal, Andrea | The Saturday Evening Post, July/August 2007 | Go to article overview

Elder Care: Aging in Place


Neal, Andrea, The Saturday Evening Post


Boomers are opting to age in place with the help of family, hired help, and smart technology.

Five years ago, semiretired teacher and musician Mercedes Russow got an offer from her daughters that she couldn't refuse. "They said, 'Mom, we want you to sell everything and move up here and let us take care of you,'" Russow recalls.

The generous invitation convinced her to put her 40-acre Indiana farm up for sale, pack up decades of memories and memorabilia, and move to a six-room house in Hamburg, New York. Now she lives within 10 minutes of her two New York daughters, who take turns driving her on errands and outings. She gardens, plays piano, makes jelly, and visits with friends. She's mobile and in robust health, but at her daughters' request she threw away the car keys. "I think I must have frightened them," she reports. "That's the one thing they wouldn't let me do."

At age 87, Russow is a trendsetter at "aging in place," the new term for growing old at home amid familiar things and surroundings. Blessed by a large family (she has another daughter in Oklahoma, 12 grandchildren and nine great-grandchildren), Russow still calls the shots of daily life. But helping hands are only minutes away. After most of a lifetime spent around New Palestine, Indiana, she realized that if she wanted to age in her own place, on her own terms, she would have to relocate near a support network. Assuming all goes well, her Hamburg house will be her final home.

If the term "final home" makes you squeamish, it's time to face facts. About 35 million U.S. residents are 65 or older, a number that will spike dramatically in coining years. The first wave of baby boomers turns 65 in 2011. By 2030, there will be 71 million older adults, roughly 20 percent of the U.S. population. Where, how, and with whom will they spend their final decades? Their choices will come from a menu of possibilities: in-home care, retirement communities, assisted-living facilities, adult family homes, and nursing homes. In a 2000 AARP nationwide telephone survey of Americans aged 45 and older, 71 percent said they "strongly agree" that they want to stay in their homes. As long as health and finances permit, they will choose the road of maximum independence.

They won't enter a nursing home unless the severest disability dictates. "Old does not mean institutionalized," says Joseph F. Coughlin, founder and director of the AgeLab at Massachusetts Institute of Technology. Baby boomers, after all, are the folks who've defied the aging process so far, joining fitness clubs in record numbers and using plastic surgery and Botox to lift their lids, tuck their tummies, and remove the lines of aging. If there's a way to age gracefully in the comfort of their own homes, that's what graying boomers say they want to do.

But it won't happen automatically. It will require strategic planning that takes into account an individual's physical, emotional, and financial needs. "Start thinking yesterday," Coughlin advises. Nearly 85 percent of long-term care decisions are made after an older person has already reached a medical crisis. That's too late to create a plan to age in place.

Preventive healthcare, starting before middle age, is the place to start. "Wellness is going to become the next lifestyle," Coughlin predicts. Russow, a widow since 1992, is a testimony to the benefits of healthy living. Although she credits good genes with her longevity, she points to a lifetime of nutritious eating habits and staying physically and mentally active.

The 2007 State of Aging and Health in America report, published by the Centers for Disease Control and the Merck Company Foundation, recommended a variety of behavioral changes that would reduce all aging Americans' risk of developing chronic diseases, such as heart disease, cancer, arthritis, and diabetes. Chief among these changes are: increased physical activity, eating five or more fruits and vegetables a day, maintaining a healthy body weight, and not smoking.

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