Community Forum

January 5, 2021 by Julia Weaver of Redfin Now more than ever, we’re seeing more adults choosing to live at home as they age, or what is known as aging in place. Living at home helps aging adults maintain their lifestyle for as long as possible, rather than moving into a nursing home or assisted care center. In fact, three-quarters of adults 50 years and older would prefer to remain in their homes as they age, according to a survey by AARP . Though many of us won’t be able to live independently forever, home modifications will allow your loved ones to continue to live in their home longer by creating a more manageable environment. Whether they’re living in a single-story condo in Dallas, TX or a three-story home in Portland, OR , there are modifications that can be made to every home to help make daily tasks a little easier. Helpful home modifications As we grow older our bodies and capabilities change, and not all homes are designed to support this challenge we’ll face. A lot of times doorways are too narrow, bathrooms too small, floors too slippery, and kitchen cabinets too high to reach. For aging adults, a home designed for optimal accessibility, convenience, and safety is imperative to avoid falls or serious injuries. Optimizing a home for safe and comfortable living while creating a home environment that makes getting around easier is essential for aging in place. That’s why we’ve gathered the most common home modifications, from simple adjustments to larger remodeling projects. General Home modifications to aid in mobilit y Install handrails. For aging in place, add handrails to stairs, hallways, bedrooms, and bathrooms for extra balance. Upgrade the lighting. Replace existing bulbs with LED bulbs to increase visibility. Consider installing touch-activated lamps, and placing night lights in the bedroom, bathroom, and hallways. Install lever door handles . Switch out standard round doorknobs for lever-style handles. These do not require the same level of grip. Install a stairlift. This is a great alternative when walking up stairs becomes more difficult. Install light switches at the top and bottom of the stairs to prevent your loved one from using the stairs in the dark. Install automated blinds. This style of window treatment allows aging adults to adjust their blinds without having to stand up. Create an open floor plan. Make wide passageways throughout the home with little obstruction. Widen doorways and hallways if your loved one uses a walker or wheelchair to navigate their home. Replace hardwood, tile, laminate, or vinyl flooring for carpet. If your loved one doesn’t use a wheelchair, carpet will be most forgiving and provides more floor consistency. For the living room Rearrange furniture and remove clutter. To avoid tripping hazards, be sure furniture placement leaves plenty of space to move about the room safely. Install anti-slip mats. Add strips to the bottom of rugs to increase traction and reduce the chances of tripping. Replace unsteady furniture. Discard furniture that wobbles to prevent falls, and add plastic bumpers to the sharp edges on furniture pieces. For the kitchen Keep daily-use items accessible. Store small appliances, cookware, and tableware between waist and shoulder height to avoid the need to crouch down or use a step stool. Consider purchasing a stovetop with an automatic shut-off feature. Once the sensors fail to detect motion for an extended period of time, the stove will shut off. Install a hands-free faucet and anti-scald device. Easily turn the water on and off with the wave of a hand, and install an anti-scald device to avoid the possibility of burns. Replace kitchen cabinets and adjust counter and sink height. For more convenient storage space, install drawers, open shelving, or pull out shelves. Choose a counter height where it’s easy to prepare meals and wash dishes while sitting. Adjust the location of major appliances. Place the oven, sink, and refrigerator as close to each other as possible. For the bathroom Add adhesive strips to a bath mat in showers and tubs. This can help prevent slipping on wet surfaces. Install non-skid strips in case the flooring becomes slippery. Try to avoid ceramic tile as this can become slick when it’s wet. Install a walk-in bathtub or a shower transfer bench. This can greatly reduce the chances of slipping and falling. Climbing in and out of a traditional bathtub or standing for an extended period of time may become more difficult. Install grab bars or rails in bathtubs and near the toilet. This will improve mobility and help to prevent falls. Install a raised toilet seat. An elevated toilet seat decreases the distance between standing and sitting. For the home’s exterior Create at least one no-step entry into the home. Replace exterior stairs with a removable ramp for a smooth transition into and out of the home. Add exterior lighting and landscape lighting. To avoid falling or tripping, add outdoor lighting to walkways and stairs. Install handrails. Add handrails on both sides of walkways for extra support and balance. Choose low maintenance materials. Opt for vinyl siding, metal roofing, composite decking, and low maintenance landscaping. Install a security system. A home security system can give your loved one a sense of security and protection. How to pay for home modifications While in the end, it’s generally less expensive to age in place as opposed to living in a senior living community, the upfront costs for a remodel can add up. Luckily there are resources and programs available, such as home improvement grants, equipment loans, and low-interest loans. You should also consider researching programs like Medicare Advantage, Non-Medicaid Government assistance and Medicaid HCBS Waivers, Veterans programs, and non-profit organizations for financial help. As you’re crunching the numbers, it’s important to remember that the cost associated with home modifications has two components: the labor cost and the materials cost. Oftentimes, the cost of labor for installing the equipment will not be covered by insurance. Create a support system with senior care and services Forming a support system for your loved one is a big part of aging in place. Besides the support from family members, it’s a good idea to consider senior care and services for your aging parent. There is a network of services available, including meal delivery, nurses, transportation, and house cleaning services. In-home care services are also offered at various levels depending on the situation. On days when you’re unavailable, an elder companion could spend time with your loved one to prevent social isolation. In-home caregivers can provide help with day-to-day activities like cooking, grooming, or shopping, while also making sure your loved one is safe in their home Introduce technology into your loved one’s home Assistive technology solutions, smart home features, and tech gadgets can be used to help simplify everyday tasks, promote independence, and stay safe while aging in place. There are all sorts of devices, like medical alert devices to signal for help, assistive seating devices to lift your loved one into the standing position, and smart bulbs that can be controlled remotely. Individual results may vary. This is not intended as a substitute for the services of a licensed and bonded home services professional. Redfin does not provide medical advice. All of the material provided on Redfin’s blog, such as text, treatments, dosages, outcomes, charts, patient profiles, graphics, photographs, images, advice, messages, forum postings, and any other material provided on Redfin’s blog are for informational purposes only and are not a substitute for professional medical advice or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on Redfin’s blog. If you think you may have a medical emergency, call your doctor or 911 immediately. Redfin does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on Redfin’s blog. Reliance on any information provided by Redfin’s blog, by persons appearing on Redfin’s blog at the invitation of Redfin’s blog, or by other members is solely at your own risk.

“Home care” encompasses a wide array of services provided by aides, therapists, and nurses in home for a loved one or you. You might only briefly need home care to:  Recover from an injury or a hospitalization  Supplement services from assisted living or retirement communities  Remain healthy and independent at home, despite declining capabilities or chronic illness  Depending on the situation, you may need help around-the-clock, once a day, or for just a few hours a week. How should you assess your caregiving needs? It’s best to determine what kind of care you need before learning to be a good caregiver or for finding a qualified home care agency. Would you need on a regular basis skilled care from a nurse or a therapist? How about personal care services, such as help with bathing and dressing? Are there mental health issues that need to be addressed? Does your home need to be made safer and more accessible? How often – and for how long – will you need care? Is your situation likely to change in the near future? When selecting a licensed Home Care Agency for you or loved one's caregiving needs, use these questions in making a selection. 1. Please provide documentation that your agency is registered?  2. Does your agency not have any citations or fines from the State you are licensed to work?  3. Does your agency have literature or a website that describes services, fees, and billing? If yes, please provide?  4. Does your agency work with us/me to develop a written plan of care or service contract? 5. Are your caregivers’ employees of the agency or are they independent contractors? (Use agency employees)  6. Does your agency pay workers’ compensation insurance and payroll taxes for its workers?  7. Does your agency provide written explanations of client and family rights?  8. How do the agency screen workers and assess their competency?  9. Are your agency caregivers and supervisors available 24/7/365?  10. How does the agency investigate complaints and/or resolve conflicts between its staff and clients?  11. Can your agency document that it carries professional & general liability insurance? 12. Regarding payment, does your agency only accept private pay and long-term insurance? 13 Will your agency provide a list of at least three references? Find an Agency Complements of Aging in Place Essential Toolkit aginginplacetoolkit.com

Baylor College of Medicine Homa Shalchi , Baylor College of Medicine People all around the world are encouraged to stay home to contain the spread of coronavirus, and experts have especially urged older adults, who are at a higher risk of complications from the virus, to stay inside to protect themselves.  Dr. Angela Catic , assistant professor in the Huffington Center on Aging at  Baylor College of Medicine , provides insight on how to help older adults in the community during the global pandemic. Stay connected Not all elders will be willing to connect digitally, as it may be a major challenge for them. Some may not have the proper equipment, while others may have hearing and visual difficulties or cognitive impairments. Technology is not a necessity if it will add more stress to an already stressful time. Instead, call your loved ones on the phone or send letters and postcards. Children can send drawings to their grandparents as well. Others may visit their elderly loved ones by waving and speaking through the window. If the older adult wants to use technology, give simple explanations to help them log in. Something like FaceTime on a smartphone, if they have one, may be easier to explain since it has less steps than Zoom or other video conference services on the computer. Help with groceries and errands Family members can offer to run errands or get groceries. If this is not an option, neighbors and peers in the area can drop off groceries to their elderly neighbors. Many community and faith-based organizations also are offering food delivery so people do not need to leave the house. If they have difficulty doing this on the computer, stores may allow them to call to place grocery orders over the phone and can provide more information on senior hours. “If there are alternatives to going to the stores, like neighbors, family or delivery, I would encourage them to do that to further minimize their exposure to others during this time,” Catic said. If older adults chose to go out in to the community, it is important for them to take precautions to minimize their infection risks. All individuals should wear multi-layer cloth face masks in public in addition to maintaining physical distancing. Masks can be made from common household items and can be sewn or folded for effect. To safely remove a mask, be careful to avoid touching your eyes, nose and mouth and wash your hand immediately. As the community continues to reopen, new concerns will arise regarding shopping, eating out, and attending social events. It will continue to be important for older adults to continue physical distancing. If they do decide to go out shopping, curbside pick-up continues to be encouraged. At this time, older adults should continue to avoid restaurants and other public areas where physical distancing is not possible. Food can be delivered or picked-up to enjoy at home. Religious services and many cultural events can be attended virtually. As parks reopen, older adults should feel free to get out to enjoy the fresh air and sunshine as long as they are staying at least six feet from others and using a face covering. Manage Anxiety Worry and stress are common responses in everyone. Even in older adults with cognitive impairments who may not be able to verbalize their concern, there are behaviors that can indicate a high level of anxiety: increased restlessness, inability to sit still, asking the same question repeatedly or asking a lot of “what if” questions. “We can all reduce stress by being prepared, cautious and limiting misinformation or over-information. Don’t sit with the news on all day long. That can be a great cause of anxiety because the news tends to focus heavily on threats to our health and safety,” Catic said. “Understanding and addressing the underlying worry of an older adult around coronavirus can be a very successful strategy to mitigate anxiety. Focusing on what the individual can do and control is another proven success strategy. Feeling useful and productive is another strategy to focus on what you can do.” Empower older adults to stay home Explain that the best way to prevent significant spread of the virus is by keeping distance from one another. Empower them to feel that this is a step they can take to safeguard their own health and that of those they love. Educate them and explain that this is a new virus, so no one is immune, and we are lacking a vaccine. Make them feel empowered by explaining that they are helping the community by staying inside. “Staying home is not inaction, it’s action,” Catic said. “Discourage them from going out if they can stay home.” Try not to use the phrase social distancing. Instead, say ‘physically distant, socially connected.’ Many older adults are feeling isolated, but if they are distancing at home, they can still connect through the phone, letters and postcards. Set a routine Catic encourages people of all ages to follow a routine and think of ways to engage mentally and physically. Exercise at home with walks around the house and gentle stretching. Museums, libraries and other institutions across the world have opened up virtual exhibits to experience at home. If older adults have regularly scheduled doctor’s appointments, contact the doctor’s office ahead of the visit. Many doctors are converting to telephonic and video visits to protect patients from increasing their risk of exposure for non-urgent issues.  “We don’t want older adults to feel abandoned. Their doctors are available to care for them while taking steps to reduce potential exposure to the virus,” Catic said. To make a video or telephone visit more productive, older adults are encouraged to have a caregiver present for the call to write down recommendations and to be sure all is understood correctly. Prepare for the visit by collecting home health visit records, glucose readings, pill bottles or a list of questions for the doctor. Older adults are also encouraged to ask for prescriptions refills proactively, keeping more than 1 month of refills on hand when possible. Multigenerational households Some people live in multigenerational households, which makes distancing difficult. All family members should minimize social contact. This is important for everyone in the home, not just older adults. Catic offers tips for family members to protect their loved ones in the house. It is important for everyone in the family to be diligent about practicing infection prevention measure, including washing hands frequently with warm water and soap for at least 20 seconds and disinfecting high-touch surfaces several times per day. As there is evidence that asymptomatic individuals can spread the virus, members of the household could consider wearing cloth face masks in the home to reduce this risk. Multigenerational families could consider physically distancing at home, staying six feet away from older adults. This may be especially relevant in young children who may not be able to be as vigilant about infection prevention measure. “While multigenerational households may present some additional challenges given that older adults are high-risk for coronavirus, there is the benefit of families being able to assist one another during this challenging time,” Catic said.