Is it realistically possible for our parents to "age in place" in their home? How many of you have had success with this?

This is a question that has many, many answers that start "it depends". I don't think it's a question that can necessarily be answered in generalities.

My mom lived with me in my home, which is a 2 family, since 1999. Until late 2018, even at 84 years old, she was still able to live independently. The only thing I "did" for her was make dinner, and that was just more a matter of her coming down every night to eat with us. She was ready, willing and able to shop/cook her own meals, run her own errands, take herself to her doctor appointments, pay her own bills, etc. She was seeing a cardiologist for well over 10 years for beginning stages of heart failure that was very, very well controlled with medication. Then around Thanksgiving of 2018, she got a nasty respiratory infection, and so began her decline. Her doctor thought the infection did damage permanent damage to her heart. And even after, she was still able to do many things for herself - she gave up her car, but she was able to putter around her house and do her own bills, laundry, bathing, etc. until about 4 months ago, when she just became so weak that any sort of exertion wiped her out. 2 months ago, when she decided she had had enough of the revolving hospital visits, she requested hospice at home, and was here, under their care, until she passed last week. So in her case, she did successfully age in place, with our help.

However - I would never had been willing to take care of her if she had had a dementia-like illness. It would have been too much for any of us to manage, and she was very much against us having to take on that sort of responsibility. She had set up a long term care policy in case the day came that we were unable to provide her with care in our home. She never - never!! - made me make promises to keep her here - in fact, just the opposite. She fully expected if the burden became too much that we would look to place her in a facility that could meet her needs. I am grateful that I always had that option.

She also had the financial means for me to be able to get whatever I needed to make the job easier, and she had no qualms whatsoever about my using her money for that purpose. Now that I can look back with a somewhat clearer head, I realize just how more difficult things would have been if I hadn't had that financial security for her these past few months.

So I think in answer to your question - it is possible for some of our parents to "age in place" in their home. But whether or not it's a realistic expectation depends entirely on individual circumstances. I hope you can find an answer that will be agreeable to both you and your parents.

Interesting discussion, and yes aging in place is possible. I wrote a book about end of life "Dying Well Prepared: Conversations and Choices" which was a finalist this year for an Eric Hoffer book award. I'm currently writing a companion to it on Aging in Place which I hope will come out next year. I retired from healthcare, hospice and palliative care a few years ago but am still a long term care ombudsman. We have a local group that meets monthly of retired folks and we discuss how we can help each other and how we can work with our local council to improve the city to usefully accommodate the aging population.

My answer is yes, you can age in place, it is what my wife and I are planning to do and we have set up a plan to follow. This has meant we have made some updates to our home, to our way of life and to our expectations and see a point where we may need to transfer to a facility, but we plan to leave that till way downstream and not enter into either independent or assisted living facilities. Living in your own home and aging in place means you have the security and warmth of a place that is you. But you need develop a plan.

Both of my parents are 'aging in place' at their home. The family must assist and corporate caregivers and medicare allowances help to make that happen. My parents were adamantly opposed to Nursing Home or AL for end of life. Takes an effort but 'aging in place' is entirely possible, at least in my experience.

It depends on what type of house they live in, their resources (financially & physically), their relationship (stable or strained), their insurance, & willingness to receive help from family, friends, & help from outside. If they are able to live on one level that has a full bath & a room that can be used as a bedroom, then it's very possible. Are they able to move from room to room with the use of walkers if needed or can accommodations be made? Would they accept help from family, friends, etc., to help them with grocery shopping, housework, yardwork, repairs & upkeep of the home? Are they a fall risk? If groceries were ordered for them, could they bring them in & put them away or is someone available to bring them in & put them away? Do they have access to emergency help (Medic Alert, Security System, cell phone, a neighbor with key to home) if one of them falls, fire breaks out, sudden illness, etc.)? When the time comes, can they afford to hire someone to help with personal care, or whatever needs to be done? Are they able to prepare or fix meals or come to the door for Meals On Wheels? Would they be able to afford live in help If needed? My mom lived at home with the help of my brother living there, me there while he was working & an aide for when I could no longer provide the heavy physical care. I was releived by my sister when she came in town. I stayed at mom's house when my brother had to go out of town for work. These are some of the questions that your parents need to consider in order to make a decision about their future living conditions. Good luck!

It can certainly be done, if there are realistic plans, reliable people and plenty of funds in place. However, in my parent’s area (East Texas), 24 hour, in home care averages 18,000.00 month... yes! I would also explore additional concerns that could occur, such as developing serious health issues or dementia. Each family is unique, with different dynamics, expendable time/energy, needs and economic resources.

I think the question is more like “is it realistic” rather than “is it possible”. It’s always “possible” but not always realistic. If that makes sense. For many elders, aging at home requires a village and money. A lot of elders have neither of those.

I think it's entirely possible as long as the parents know that in order for them to do that, things will need to be adapted and done differently as time goes on. Safety measures need to be put in place and someone needs to be involved, preferably a family member, who will be able to take notice of changes and be able to get the help and advice needed for each stage. I work in Home Health and have a degree in Human Services with an emphasis on gerontology. My stepfather has Alzheimers and ended up falling at home and then it was one thing after another and ended up in a facility and we were told without 24 hour care he couldn't go home. Taking my mom up to see him everyday and then picking her up and seeing then hug and kiss each other good bye and saying I love you to each other was hard. Especially when he would ask why he isn't going and where she was going. After a few months I decided I would move in with them to bring him home. My sister and stepsister were supportive and I got him set for Adult Day Care 3 times a week to give me a break. Stepsister was to come once a month for 4 days to give me a bigger break. Well 2 weeks after we brought him home the coronavirus hit and everything shutdown. It's been a difficult time without any breaks but I would do it again. I got him a hospital bed which was paid for by Medicare with the Doctors diagnosis. Got safety bars which I installed myself. I have a monitor that has a camera in the bedroom and one in the living room. I have alarms on the patio door and door going out to the garage. I keep him on a strict schedule as it helps with Alzheimers patients. He knows when its time for dinner, time for pjs and time for bed and he is ready and cooperative. He doesn't wander other than wanting to go out onto the patio which he needs help doing because of a couple of steps. Adult Day Care has started again and their housekeeper now comes and while she is here I go to my place and do things. Still no get away time but every night they tell each other goodnight and give each other a kiss and say they love each other smiling....So it may take some doing, but if at all possible to keep them at home I would do that over anything else...The hospital bed was free with the Doctors diagnosis Medicare paid for it. I got the safety bars and installed them myself and got the high rise toilet seats....there are many things and resources to help make it happen. Once tried, if it doesn't work then decide next option. It does help to have a plan for all stages right up to the end. There are many agencies, private and county and federal, that can help. Social workers can help implement plans. It is worth it if at all possible. Being at home with their familiar things and place, makes it much more easier and pleasant for all.

With the help of hospice nurse, aid, social worker and volunteers, plus self pay aids four hours a day, cameras both inside and outside I was able to manage 2 parents, both with dementia to age in place and die at home 4 months apart. I managed Everything for them from finances, home, healthcare, shopping, laundry and also provided care to them 2 shifts a day, every morning and every evening Including weekends. For two of the seven years I managed, my mother was totally bedridden and Incontinent and was in the last stages of dimentia. I could never leave my mother alone so I relied on hospice volunteers to stay with her while taking my father to doctor appointments. Fortunately my father’s dimentia has not progressed as quickly as my mother’s but he still needed help with showering and dressing. I was able to qualify him for hospice for cancer so for about 1 year they were both on hospice together. To undertake aging at home is a major commitment requiring much sacrifice. With the exception of my husband, family members did not share in the responsibilities. Looking back, Caring for both my parents so the could remain at home was difficult, challenging, exacerbating, but an experience that taught me so much about myself and others. I would do it again for them.

This question will be answered in a million different ways because everyone has their own circumstances.

There is no right or wrong way. It is whatever works for the individuals involved.

I think Cali wrote an excellent answer to this thought provoking posting. Great answer, Cali.

I have been my mother's 24/7 primary care giver for over 20 years, but that's because I live with her. It is virtually impossible to do it remotely. She gets up every night to use the bathroom, and she tends to fall. So, someone needs to be there at night. Of course, the family still thinks that I should pay rent - even the ones who never show up to care for her. They are waiting for her to die to collect their share from the sale of the house. I will be displaced, and I will not have the money for a house again. I have given my mother the care that she would have had to pay for. Instead of the money going to the nursing home, the sale of the house will benefit all 8 siblings and grandchildren. But I am still not recognized or appreciated for this. I lost my home due to the downsizing of the defense industry over 20 years ago, and then I aged out of the next two industries I entered.

My mom lives with me but she requires and has 24/7 care through Medicaid. It is possible if you have the financial means, or can be approved for the CDPASS program through Medicaid, which provides reimbursement for in-home care. We went through a lawyer to do this. My neighbor’s dad lives with them but he was able to be home alone for hours at a time. Every situation is different. You have to be very patient and flexible.

They can age in place in their own home if they are competent. My 96 year old mother lives alone in her own house. She told me she is going to die in that house. She said the only way she will go into a nursing home is if she gets Alzheimer’s.

I think all of us want to age in place. I don’t think anyone wakes up and says “I can’t wait to go to a nursing home.”

Imho, while the thought is that a lot of elders want to age in place, the reality is that some cannot.

Great topic.

"I want to stay in my home as long as possible". I asked a question (? last year) about what does "as long as possible" actually mean"?

For some it may be a sudden crises, but for others a very slow progression in declining ability.

What happens when 'aging in place' turns from thriving, into coping, into struggling, into self-neglect/danger?

Wow, I just went looking & found this link to the 5 Stages of Aging by Mark Frankel.

This really makes sense to me: the phrase Aging in Place (place = position/point ie static). While Aging Process (process = series of steps ie movement).

https://www.iris.xyz/viewpoints/understanding-the-5-stages-of-aging-from-self-sufficiency-to-end-of-life/

Reading all your different comments and experiences has helped me immensely! It is comforting to know that I'm not alone and so many of you are going through or have gone through similar situations. Thank you so much for all your support and advice!

My mom passed away in March, she was 87. She passed at home surrounded by my brother, me, and a couple of friends. She was able to stay at home independently until about 15 months before her death.

Starting in the summer of 2018, I could see that she was having some trouble with bills. I put everything on autopay and hoped for the best.

In fall of 18, she was having some pain and we had a part time caregiver that helped her occasionally and drove her where she needed to go.She could still drive locally.

By March of 2019, I was staying full time and she was diagnosed with chf and afib. Hospice was called in and she had a good summer with part-time help every day. By the end of December, we had hired full-time help at home.

My mom fortunately had some money and some pensions that could pay for care. I was driving the 750 mile trip between my mom’s and my house. It was a killer. My brother was 2 1/2 hours away and came as often as possible.

We were very fortunate to find great caregivers locally, I also had a person that was willing to manage scheduling caregivers when I couldn’t be there. It allowed me and my brother to be her children instead of her caregivers.

It wasn’t easy due to the long distance, and wouldn’t have worked without mom’s savings, but it can be done. I’m very grateful that she was healthy and independent until the last 1 1/2 year of her life. A longer illness would have been much more difficult to deal with.

I had no success in aging in place with my parents. After reading and participating in this forum for years and talking with friends my age with elderly parents I think aging in place for most elders is not feasible .

The immediate issue is cooperation from our elders. My folks, like most of their generation, would not accept any help, not even meals on wheels. They were just fine. Didn’t want strangers in the house. I could only do as much as they would allow which was me driving 12 hours each way and running myself ragged. They were fine with that.

And even if your folks are cooperative it takes some big money to keep elders in their home until the end. You basically have to fund your own mini nursing home.

And there’s the issue of the home. Is it a wreck? Need to spend major bucks fixing it up? Priced a new senior friendly bathroom lately? I see people spend thousands on upgrades that are used for a couple months or in some cases not at all.

How about the kin folk? Everybody on the same page? No sibling feuds?

My folks are gone now. I’m going through the probate process for my dads estate. My folks were sweet people but it’s been a tough few years.

My Dad is 96 and livinf in his own home tho now he dies have Caregivers 24 7 that come to his home.

he never wanted to go anywhere else and I promised him he wouldn't have to.

He would be miserably unhappy wouldn't last a few months in a Senior Home.

It really, really depends on their health. My 91 y/o next door reclusive neighbor on the left died about a year ago. She'd been a widow for 11 years. Her house was immaculate, she drove and got her hair done every week (in the most unnatural shade of brown!) until two weeks before her relatively peaceful death. She was diagnosed with cancer about 2.5 months before she died, but just went quickly.

On the right side, my 97 y/o male neighbor was spritely and still managing his own one-acre yard up until about 3 months before he died. He was a dynamo! He had been a widower for 16 years! He was still chasing "girls" (in their 80s) when I met him when he was just 94. He was strong, lean, active, vibrant and had his mind intact. He went from having swelling in his hands to his grave in about 20 days. He spent only the day before he died in hospital, but then went home with his son and died in his house. He was astonishing! I miss him often.

So yeah, aging in place is certainly possible. It depends on the people and the place. Both neighbors had only 1-2 steps into their homes and had family close by just in case.

I want to be like granny on The Beverly Hillbillies when I get old! She had spunk! LOL

I’m convinced it is fear behind our elderly parents behaviours. Who would you trust?

Is it possible, yes. But is it the norm? I’m not sure. It all depends upon the health and functioning of the parent, the ability for them to manage their home on their own and safely navigate the house. Their finances, their cognitive functioning, the ability to feed and dress themselves and so on. At 63 we just built a new home that would allow us to age in place for as long as we can. We have finances to cover in home care. And we have also planned for institutional care if that is our reality. We have discussed our wishes with our families. And we do not plan to be a burden. We did this because of my experience with my own mother who made no plans for her care and is not realistic about her needs. It has been very stressful. I would say that aging in place takes a lot of planning. Expect the best but plan for the worst!?

My mom was in great shape till about 98, then we moved her in with me.   If you wait till they are in moderate to severe dementia, I think they will not remember where they are, and you have better luck if you move them earlier.  Just my two cents

My 86 year old mother is currently "aging in place" in her home, although I don't know how much longer this will last. She enjoys the meal prep, grocery, personal item shopping, mail & newspaper fetching, housekeeping, doctor appointment navigating, medication change pick up service, butler, companion, night sitter, and other AL in home services for free (by me, mostly; my brother and SIL help some - yard work every third week, home repairs now and then, and have been mom-sitting on weekends). Soon I suspect she will have to sell her house to pay for assisted living. She does not want to do this. She says that AL is for old people "waiting to die." So for me, it's successful (for her) inasmuch as my brother and I put up with it. She's had PT multiple times and does not do the exercises independently to help make her stronger and more self-sufficient. That's the goal, right?

When an older adult relies so heavily on others, that's not aging in place and certainly not independent living. She can do some things for herself, like make her own breakfast, but she does not like to. So much easier if I do it! I stopped just to see what she would do - and lo and behold - she managed. I am fortunate enough to still have my job (working remotely) so I have a full plate. I'm widowed and the only daughter so of course it is expected that I do the bulk of the work.

I've told my own kids that under no circumstances are they required to babysit me when I am old. I've taken care of it. Why intrude on them? They do not owe it to me to take on this enormous burden. My two cents.

As notgoodenough and NobodyGetsIt say, "it depends" and "no one-size fits all". Clearly there are examples posted of those who managed to do it. I've known/read of others, but these days it isn't likely the "norm", partly due to the tsunami of dementia. So many factors need to be considered. For starters:

What are the physical and mental conditions of the elders?
What is the layout and condition of the home?
What assets are there available for help and care-givers?
What family is available AND willing to help and care-give?
What other resources are available?
Is there a friend network and/or socialization activities available?

If the home is "safe" and the condition of the elders isn't compromised, it's a start. With some minimal help, they can likely stay. If there are many stairs or other hazards and physical or cognitive issues, then one has to consider these in the "plan." If there are not enough assets to hire help and care-givers, how can they stay in their own home if they need help and/or care? Then again, how can they afford a facility? Despite what some think, 24/7 care in home is (most of the time) MUCH more expensive than a facility (and you need to factor in cost of the home, utils, food, etc with the cost of care.)

Although many families often want to help their parents age at home, there are constraints - logistics (where each lives), ages (are they in work/childrearing ages), capabilities (personally I could not support my mother's weight, so that was a gate), knowledge (some aging issues require more than just helping care for the home and making meals!)

Some seniors are quite capable of staying safely in their home and combining taking care of it and themselves with minimal help. Others are not.

My mother lived alone in her condo to just over 90. Shortly after/around that time dementia crept in, so we had to make plans. The first was to bring in help, but 1 hr/day didn't last 2 months and she refused to let them in. So, she was probably 93 when we moved her. I had already taken over finances, and helped with transport for groceries, appts, etc when we had to take the car away, but she wasn't capable of being alone for long. It was also draining for me, as it was 1.5 hr each way plus whatever task was at hand.

Days before the move to MC she managed to injure her leg and develop cellulitis. She didn't have enough sense to understand how bad the injury was or to seek help - she only mentioned bruising her leg to a neighbor, who told me. If it weren't for the planned move, this could have quickly killed her!

My place would not have worked. Repairs are half done and still on hold. Full stairs to get in/out, which she couldn't do. No way to handicap the bathrooms (too small.) As noted, I can't support her weight. So, staying in her own place was not an option, nor was moving to my place. Bros? One is abusive and not local, wouldn't want her there! The other is still working and doesn't really fully comprehend what care is needed and also tends to be a bit scatter-brained.

So, I would think a person would need to be mostly self-reliant and relatively healthy in order to accomplish aging in place. There really isn't any way to say how "realistic" it would be without knowing all the factors. Understand all the current and potential future needs and work from there. If it can be done, great. If not, there should be a plan B. However for most these days it is not ideal, esp when dementia is involved (but in some cases, with lack of finances, there are no other options.)

Move them in with you, have them go to a adult day center in the daytime, I wouldnt put my dog in a nursing home if at all possible.

Please define:

realistically
possible
(and most of all)
success

What IS a successful final outcome of a decision to "age in place"?

Thinking about these definitions has a serious point, which is discussed in detail in Atul Gawande's essential-reading book "Being Mortal."

Whose wellbeing and welfare is the concern? If you consider aging in place unrealistic because your parent's frailty is making your hair stand on end and your nails are bitten to the quick, it's your nerves at risk, not your parent.

We have a lovely client (I think he's just managed to get rid of us, actually). He is 93. He served in submarines as a younger man. He lives alone. His house is *immaculate.* He deals with all personal care, domestic tasks and meal preparation independently, apart from occasional help with heavier tasks such as changing his bedlinen (large double bed) and mowing his lawn. I spent four or five morning calls with him, and two or three evenings, monitoring and supporting his routines. My heart was in my mouth, observing this frail elderly man stepping into his bath, showering head to foot (he got shampoo in his eyes, that was the only moment I had to assist by passing him a flannel), stepping out and drying himself... as I say, my heart was in my mouth. But he didn't put a foot wrong, not once. The only reason we were there is that he had had a fall one night (not injured, just stuck) and because he doesn't - and won't, grrr! - wear a falls alarm he wasn't found till late the next morning when his family member visited. His children duly tore their hair out and insisted that he allow home visits. Our short-term reablement service was the agreed compromise. He had a point to prove, that he was safe living alone, and he proved it.

He is quite unusual, by the way, in being willing to prove his point, with good grace and very sweet appreciation of our help. Many seniors resent the intrusion when they don't want us there.

So. What will be "success" for this gentleman, pursuing his wish to age in place?

I live in a rural area where most people are farmers. They would nail themselves to the floor before risking inheritance or farmland to pay for care. My husband and I planned well. Even have paid all along for Long Time Care insurance. It pays some but not all. Inflation takes a big hit. Adequate cash savings also. Regardless we went wrong somewhere because my grow children do BARELY enough to keep us home so they will not loose any inheritance. They don't make a secret of their greed. Not very gracefully done either. Surprise kiddos! We will hire it all done with the best money can buy!! Then will check ourselves in the very best assisted living home. Just sign me off as hurt and sad.