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The Art of Downsizing for Aging in Place

When moving through the various stages of life, do you ever stop to consider what it takes to down size to the point that you are ready to Age in Place.  Aging in Place suggests that at some point you will need to also prepare your residence for a live-in caregiver.

Peter Sosnkowski lives in Victoria, and is someone we currently provide companionship for.  Peter was very gracious in allowing the writer to interview him for this article.  Peter is likely one of the most prepared individuals we have worked with, with regards to planning his home for future possible live-in care.

Peter was asked what criteria he had for choosing his residence in Victoria.  He states “Being at home” is more a psychological state of mind that a physical address. I chose Victoria because it’s smaller than Vancouver, and what I really wanted was access to restaurants and services easily accessed by walking or a short drive.  Plus, my children live on the west coast of North America, and visits can easily be accommodated”.  When asked about the actual move, Peter stated “Moving and downsizing to this extent is one of life’s traumatic experiences, with a repository  of treasures including fine art, furniture and memorabilia from many years of travel, downsizing from 6000 square feet to 1100 square feet was a great challenge.”  Peter states that in choosing his condo, he also carefully considered “dignified and adequate quarters” for a future live-in care worker.

Covid was a huge catalyst for beginning the companion process.  Peter who was used to eating out, states he lost 40 pounds in three months.  New guidelines stating that we should stay at home and avoid contact with others meant that he neglected his nourishment.  Peter states “it was providence” that he found us at a time he really needed help.

Peter states “living in my own home, making my own choices, sleeping in my own bed, and yet still having access to advice, care and atmosphere” are important aspects to him.   It is why he carefully chose an agency that was willing to provide exactly the services he wanted and on his own terms.  Choosing a carer that is the ‘best fit’ is also very important as they become an important part of your life.  Building a relationship on mutual trust and respect becomes even more important that the actual care.

Peter states that in his professional life he ate in three star restaurants all over the world and that eating meals that are prepared well, healthy, with many choices is very important to him.  To that extent he has two wonderful ladies that provide that for him 5 days per week, and whom he says have also become wonderful companions.  Peter describes his companions as “thoroughly organized and dedicated individuals with a great skill set and diverse backgrounds!”.

Peter is wonderfully prepared for his future needs.  Many however are not.  Downsizing is and can be very traumatic, and putting it off will only make the move more challenging.  Gradual downsizing through our older years, may be more reasonable and much easier to ease in to.

Our elders and their families often spend years preparing by downsizing from their family home to a condo or smaller home.  At some point, a decision has to be made whether you are healthy enough to stay in your home to Age in Place. There can often be a time when Aging in Place is not the right plan for our elders.  With that in mind, a decision frequently must be made by family and the agency with regards to the senior’s safety.  Some of these are:

  1. Is it financially viable to remain at home with care? Live-in care can be very costly and is determined by how high the level of care is.  Live-in care is priced by assessing the senior for their care needs.  Often we place a worker in a companion role, with meal preparation and cuing necessary.
  2. Does the senior put themselves or their worker at risk by remaining at home? One caregiver relayed that her client was up at night looking for matches to light the wood stove.  It was 2 am and he was cold.  When she assisted him down the stairs to the fire, she found that it was loaded tight with garbage and toys from his small dog.  Had he started that fire, there could have been very serious repercussions.
  3. Is the senior benefitting from being in their own home? As stated, live-in care can be very costly especially at the end stages of life.  If your senior is in advanced stages of dementia and sleeps most of the day, or is not aware of their surroundings, then moving to a facility are may be the better choice for your elder.

By preparing for your future care needs as Peter has, you will be able to maintain a level of living that you are accustomed to.  Planning, choosing and decision making don’t become part of Aging in Place, but a continuation of living life as you have always done!

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Fitness Programs During COVID-19

Good health practices in our youth and adult life will generally take us into old age with stronger bone density, a healthier cardio vascular system, better balance and even increased cognitive function.  This is a good thing, because on average longevity has increased 5-10 years for the average individual.  As we work with seniors, our greatest challenge is to incorporate fitness programing into our daily care regime.  The greatest challenge the Medical Exercise Specialist – MES will face is working with the frail senior with multiple medical conditions.

 

When working with a variety of age groups and medical conditions, it is very important that you first of all perform a detailed medical history account of your senior.  Ask to see their medications, know side effects and reactions and understand that your senior may have side effects directly related to the intensity of exercise combined with medications he or she may be taking.  Seek medical clearance from their physician and/or gerontologist.  Ask them specifically about medical conditions you feel may be a challenge for them and if there is anything that is contraindicated for this client.  For the senior with multiple conditions, it is key that if you aren’t sure what to do, at the very least know what you must not do that might cause further exacerbation of their medical condition.

 

With COVID-19 still being present in our communities, it’s much safer to provide exercise from the comfort of the seniors home instead.

A portable exercise kit may consist of:

  • Bands
  • Small weights
  • Door pulley
  • Step up block
  • Exercise mat

 

An exercise program incorporating the same components as you would at the gym, may be incorporated into the in-home program namely:

  • Cardiovascular conditioning
  • Stretching
  • Strength exercises
  • Specific rehab for problematic areas

 

The goal is to increase flexibility and mobility, keep or build on the strength your client currently has and to maintain that function for as long as possible.  The combination strength of biceps/triceps, quadriceps and core muscles will assist your senior with the ability to rise from a chair, or bed, and sit with control.  Some in-home programs are completely chair based incorporating all the exercise components above and may be very effective in not only maintaining strength but increasing it.

 

Functional strengthening is a priority to keeping your senior living independently.  The ability to perform activities of daily living such as transferring, dressing, toileting, eating, bathing, and ambulating are dependent upon maintaining a certain level of strength.  Check in with your senior often, ask them how they are doing, and offer reassurance and encouragement.

 

As care workers working in the community, the rewards are great as you see your frail senior not only maintain a level of fitness, but attain greater strength and balance, flexibility and mobility to age in place longer – living in the home they love!

 

 

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Aging in Place – Option or Challenge

More and more seniors are opting to age in place – stay in the home they know and love for many reasons.  Aging in place is by no means a new phenomenon.  Only a few generations ago, many families lived and died at home; families made way for grand dad to sit by the fire in a rocking chair having converted a den to a bed sitting room.  We’ve departed from this style of inter-generational living; we are however beginning to see a shift back to this model of senior care.

 

Aging in place is a term used for individuals both wishing to live at home or at a residential care complex until they die.  Seniors living at home experience rewards such as being able to stay in familiar surroundings, maintain a routine, sleep in their own bed, eat food they like to eat, and stay involved in making choices.  Many seniors and their families relate they enjoy the one on one care and consistency in care of bringing in a care worker to assist the senior to age in place.  However this model of care is not always possible.  When the time comes to interview a community of care or complex care home for your parent or loved one you should ask if they have aging in place capacity.  Our seniors do not do well with numerous moves in advanced age with the upheaval causing much stress and anxiety.

 

In a recent article a daughter remarked on the benefits of aging in place stating that “Emotionally and financially it is more rewarding.  Quality of life and personal attention, consistency of care and one on one care is better.  Family input is welcome and family are empowered.”

 

We often read of couples where one spouse requires a higher level of care due to advanced dementia and is cared for by the other spouse.  The burden is great, and sometimes the couple is split, leaving one spouse at home and the other in care.  Aging in place and providing home support services to keep them together is very important.  Seniors experience benefits emotionally, physically and financially.

 

There are however challenges in aging in place.  One of the greatest challenges seniors face is running out of funds to remain at home.  When the senior can no longer ‘bear the cost of care’ it may be time to make the transition to complex care.  Care agencies should consult with seniors and their families when they foresee an increase in future cost of care due to increased services required to assist the senior to live at home.

 

Another indicator care coordinators use as a benchmark for determining whether aging in place is a viable choice is when our seniors put the care worker or residents of the home or apartment building they live in at risk; this is usually a great indicator for moving.  We all live at risk, our seniors do so when they choose to stay in a home with stairs and experience the many challenges of living at home.  No one lives without risk – we hope as care workers to minimize that risk whether at home or in care home.

 

Seniors and families usually have a plethora of choices for care provision.  Navigating the health care system, knowing the terminology and understanding the various levels of care available to seniors is confusing at times.  Seek out reputable agencies, look into resources available in your community and check in with your local health authority for more information on how to care for your loved one to appropriately prepare for the future.

 

Written by Johanna Booy, of Care & Company Ltd., SeniorCareVictoria.ca.

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