Where should seniors live? Returning from holiday visits, many families are asking this question as they realize that their older relatives need help.

Nadine suffered a hip fracture last year, and she struggles to manage her diabetes. It’s harder these days to take care of the three-bedroom house where she’s lived for 30 years. She worries that she’s imposing on her adult children too much to drive her places and help out around the house, and they’ve suggested that she move to a senior living community. But she loves her house and neighborhood! And she fears that her “fur babies,” Teddy and Blanco, wouldn’t be able to come with her if she moved.

Surveys show that most Americans would like to stay in their own homes as they grow older. When we’re younger, most of us envision our future selves as being maybe a little slower, with more gray hair, but embodying that quality referred to as “spry.”

And maybe we will indeed be among the lucky elders who retain their health and mobility well into their later years. Yet no matter how well we take care of our health, things happen, and it’s important to consider and plan for all the possibilities.

A major decision is whether we can continue to live independently in our current home. In the May 2015 issue, we took a look at home modifications that can make our homes a better fit as our health needs and abilities change. Next, it’s important to learn about the variety of senior services that are available in your community.

Here are some challenges to consider, and some services that can help us meet those challenges.

Home maintenance

The problem: Health conditions such as arthritis, vision loss or the effects of a stroke make it difficult and even unsafe to perform many of the household and yard work chores we once took for granted.

Solutions: House cleaning and handyman services can do routine cleaning, repairs and maintenance. In-home caregivers also provide light housekeeping and laundry. Your local senior services agency may offer home repairs assistance for low-income seniors.

Personal care

The problem: Reduced physical abilities make it difficult to perform routine hygiene tasks, such as bathing, grooming and dressing. This is one of the top reasons seniors move to a supportive living community.

Solutions: Home modifications can make the home a better fit. Occupational therapists can help seniors learn adaptive ways to do things. You can also hire a home care professional to come in a few hours a week or full-time to provide assistance with personal care.

Healthcare management

The problem: When seniors are living with short-term or chronic physical or cognitive health challenges, managing their healthcare can be overwhelming. There are doctor appointments, coordinating transportation, communicating with various healthcare providers, and often a complicated medication regimen—and many of these things need to happen when family caregivers who could help are most likely at work.

Solutions: Many healthcare services can be provided in the home. Registered nurses (RNs) or licensed practical nurses (LPNs) can come to the home to perform skilled nursing services such as wound care and giving injections. Less costly nonmedical home caregivers assist with more routine care tasks. Rehabilitation services, such as physical, occupational, speech-language or respiratory therapy, also can be provided in the home.


The problem: Health problems make it harder to shop for food and prepare nutritious meals. Seniors who live alone often end up eating mostly junk food, leading to malnutrition and a cycle of worsening health.

Solutions: Most communities offer food assistance programs, including “meals on wheels” that deliver meals to an individual’s home, as well as community dining sites where meals are served at designated locations and times. If you hire an in-home caregiver, they can go to the store and prepare meals and snacks.


The problem: While planning for your needs at home, don’t forget your ability to get out of the house! Eventually, most older adults must stop driving. Physical, visual and cognitive challenges make it dangerous for them to be behind the wheel. Consequently, it’s hard for them to get around.

Solutions: Learn about your public transportation options. Many transit systems offer training programs to help senior riders navigate the bus or subway. Special senior transportation is also available to encourage seniors to continue to participate in society and live independently. Home care workers also may provide transportation.

Exercise and socialization

The problem: One of the greatest disadvantages to aging in place is that seniors may become isolated and unable to get around—the situation traditionally referred to as “homebound.” Inactivity worsens virtually every health condition and raises the risk of falling. And some experts even say that loneliness is as dangerous as smoking for older adults.

Solutions: Check out the senior-friendly offerings of your local parks and recreation department. Today’s senior centers offer a variety of programming and activities for older adults and are a great place to make new friends. For seniors with significant physical or cognitive challenges, adult day centers offer social activities and intellectual stimulation, along with other services such as healthcare and rehabilitation services, personal care and meals.

Who can help?

If you or an older loved one needs some of the services above—or other help such as caregiver support services, wellness programs, financial and legal assistance, mental health services and more—navigating these offerings can seem overwhelming and intimidating! Begin by contacting your local Area Agency on Aging (www.n4a.org), and visit the Eldercare Locator online (www.eldercare.gov) or call 800-677-1116 to learn more.

Call in a professional

Consider arranging for the services of a geriatric care manager (or as they are now often referred to, aging life care professionals). These eldercare experts can perform a needs assessment and help families develop and implement a plan of care for their loved one. You can find a local professional on the website of the Aging Life Care Association (www.aginglifecare.org).

Paying for help

Certain services, such as skilled nursing care provided in the home, may be covered by Medicare, Medicaid or private insurance. If you have long-term care insurance, it may cover certain home services. Talk to your local senior services agency to find out what help may be available at low or no cost. Local community organizations, such as faith communities, youth groups and service clubs also provide help and companionship.

Remember: these public services are not “charity.” Rather, they are part of the social commitment we make as families, communities and as a society. Being on the receiving end of services is not something to make you feel embarrassed or guilty. And remember that while we all value our independence, seeking out senior services is a way to increase, rather than reduce, independence.


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