As Dorothy famously said in The Wizard of Oz, “There’s no place like home.” It’s a sentiment that holds true whether or not you’ve been whisked away by a tornado, but there’s one type of home it rarely applies to: nursing homes. This is unfortunate, but unsurprising, as many skilled facilities lack the much-treasured comforts of home Dorothy would have longed for from Kansas. Characterized instead by clinical white walls, stereotypical nursing homes can seem more like hospitals than intimate dwellings.
This is one reason the idea of “aging in place” may be so appealing to today’s seniors. According to the AARP nearly 90 percent of seniors want to stay in their own homes as they age, and 82 percent would still prefer it even if they need day-to-day assistance.
While nothing may be as attractive as living at home forever, the truth is it’s simply not feasible for all seniors and seniors-to-be to age in place. In his book “Aging in Right Place,” Stephen Golant argues that the concept of aging in place is oversold, as the Washington Post put it, “by home health-care providers, builders eager to capitalize on renovating homes for older people, and financial institutions who have popularized reverse mortgages.”
One could certainly debate this sentiment, but the main point is sound: it’s more important that seniors age in the “right” place, whether or not that place happens to be their long term home.
By 2030, roughly one in five Americans will be over 65, according to AARP estimates. The number of seniors will have almost doubled since 2006 to roughly 71 million, making comfortable and affordable accommodations more important than ever before.
Existing housing is, unfortunately, quite limited. “Most homes were not designed with older adults in mind,” Caroline Blakely, President and CEO of Rebuilding Together says. “Steep staircases, too-narrow doorways and other basic housing features pose serious safety risks to older homeowners.” Aging-related home modifications can cost from $70 - 100K, expenses that are paid out of pocket as much as 80 percent of the time, according to the National Association of Homebuilders.
Individuals who express the desire to age in place may also fail to consider advanced life events that are likely to prevent them from staying at home in their later years. According to research published by Archives of Gerontology and Geriatrics, “A gap exists as to what these advanced life events (ALEs) entail and the planning that older adults perceive is necessary.” These events include “hospitalizations, falls, dementia, spousal loss, and home upkeep issues.”
How can assisted living centers and nursing homes do their part to help when aging in place won’t do? Affordability, for one, is critical. In fact, some people who end up “aging in their place” do so only because they can’t afford not to and suffer because of it. In this way, making sure that attractive habitation options are available to all seniors may be the number one challenge for the eldercare industry.
Assisted living is already abundant with benefits worth listing, among them a built-in community for seniors fit for socialization and round-the-clock access to medical assistance. The biggest drawback is lost independence and the unique sense of home.
That’s why modern nursing facilities and assisted living centers should do everything they can to “homify” their spaces, maximizing comfort for those who come to stay. Doing this takes an attention to detail and demographics to tailor a facility to the specific individual and communal needs of its residents.
For nursing homes with religious residents, on-site services, religious texts, and holiday observations can keep their spiritual needs fulfilled. The same goes for culture — food that reminds residents of home can maximize their comfort, whether that’s authentic Chinese cuisine or Latin American food. In places like New York City, where there are cultural enclaves everywhere, this is especially important, as are staff members that speak second languages.
Amenities and decor are likewise essential. While there is necessary crossover between hospital and nursing home, they don’t have to look the same. Residents can have private or semi-private rooms with access to Internet, TV, and reading materials as they would at home, along with other home-like accommodations. Amenities that they might have missed out on at home are great too: beauty services, gyms, activity/excursion calendars and more.
The impulse to age in place is understandable, but individuals nearing retirement need to plan diligently and invest significant funds in order to do so. We must have more-than-just-adequate places for seniors to relocate to if and when the time comes.
With assisted living centers, retirement communities, and nursing homes that really emphasize qualities that are familiar and comfortable for residents, we can show our nation’s seniors the respect they deserve in their later years. There may still be no place like home, but the closer we can get to that back-from-Oz feeling, the better.
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