Age eventually changes us, regardless of our resilience, habits or lifestyle. While we can adopt a healthy lifestyle to maximize our wellness, aging brings inevitable opportunity to adapt.
Anticipating and planning for change before challenges arise allow you to shape your future and plan for preferences.
“Most of us want to be the directors of our future rather than have others make decisions for us. Researching possibilities now and talking with loved ones about your choices helps to insure healthy and fulfilled lives for as long as possible,” said Karen Daley, director of Samaritan Evergreen Hospice.
“In addition, taking the responsibility for planning is a gift to family or loved ones that may be asked to participate in implementation. Long-term planning is an opportunity to engage them in meaningful discussions,” she added.
There are several key areas to consider as you age:
Stay Put or Move?
When asked, many people would choose to live out their later years at home. If this is your desire, then now is a good time to consider your home from a different perspective.
“We tend to believe that we will always be who we are now, but the body changes with age: muscles weaken and become less flexible, affecting stability and balance. Bones lose density and become more susceptible to fracture. Often, to compensate, adaptive devices like canes or walkers are needed to help us get around,” Daley said.
If you needed a walker or wheelchair, would your current home still work? What if you can no longer climb steps? Do you need to consider moving, or could your home be remodeled or adapted for safety? What about your neighborhood -- is it safe? Are you close to services you need? Is your local social circle strong? How far away do you live from someone who could help you in a crisis?
“These are the types of questions to reflect on and consider possible solutions,” Daley said.
Most homes will require some form of adaptation before a person can safely “age in place.” Preventing falls is a key reason to adapt the home.
“Falling is not uncommon as a person ages and becomes less steady on their feet,” Daley said.
According to data from the CDC, a senior is treated in the emergency room for a fall every 11 seconds in America.
Fortunately, there are resources through Area Agencies on Aging, local senior services and other community groups, as well as online safety checklists, to help you get started in adapting your home. While many adaptations like adding ramps, widening doorways, remodeling bathrooms or kitchen counters take professional expertise, some changes you can do yourself.
“Vision weakens with age and so does depth perception,” Daley explained. “Brighter light can make activities like food preparation or reading more comfortable. It can also make you safer. Look at the lighting you currently have in each room, on the stairs and in hallways. You want light that fully illuminates your activity and any path you walk, especially the more common routes throughout the home.”
Move Items You Use Most
Think about the items you typically use each week. If you currently need to bend low or reach high to get them, it may be time to find a better place for storage.
“Reaching, bending or stepping up and down from a stepstool can throw off your balance, especially if you have any problems with dizziness or muscle stiffness,” Daley said. “Try to keep items you frequently use close at hand, on a middle shelf or counter, for example, to reduce your risk of falling.”
Minimize your risk of falling by keeping pathways free from clutter like magazines, newspapers, pet toys and awkward items that must be walked around. Look for ways to eliminate other trip hazards such as flimsy rugs and electrical cords.
Locate Where Sturdy Supports Are Needed
Grab bars and rails can be installed in many places to provide an added layer of stability. And these days, they come in many style and color options, too. Although supports need to be installed by a knowledgeable expert, you can begin to identify where the supports should go and have them installed a few at a time.
“In thinking about where to place a grab bar, it helps to remember to have three points of sturdy contact during transitions such as getting into or out of the shower and on or off the toilet. That means you’ll want to have two feet on the floor and one hand on a grab bar, or two hands on a rail and one foot on the floor during that transition,” Daley explained. “And remember, towel rods are not sturdy enough to hold a person.”
One in four adults over age 65 uses a mobility device such as a cane or walker, according to AARP, a number that has increased significantly from 15 years ago.
Designed to provide stability, these devices assist a person in getting around independently. They come in many types and sizes with variations in bases, handles, weight and height.
“Canes and walkers help differently depending on your condition. Some people need a mobility device primarily for balance or weight-bearing difficulties, and for those weakened by heart or lung problems, a device can help with endurance,” Daley said. “Typically, a medical specialist will do a gait assessment to determine which device is best, and then ensure it fits you properly.”
Proper fitting is critical for mobility device safety and effectiveness.
“It is possible to purchase a cane or walker straight off the pharmacy shelves, but I don’t recommend it,” said Daley. “If not fitted correctly, the device can throw off your gait and make you even more unstable and prone to falls.”
When a person needs greater help to continue living at home, in-home care may be a viable option. Care can range from short-term help while recovering from an injury or illness, to longer-term care lasting for years. It can also be used to help alleviate caregiver stress by giving the primary caregiver a few hours a week outside the home for personal use.
“In general, in-home care entails medically focused services or activities-of-daily-life types of support, or a combination,” Daley noted.
Medically focused care can include medication management, nursing services, physical therapy and social services, while activities-of-daily-life care might focus on personal care, household chores, meal preparation and companionship.
Whether you choose a professional caregiving agency or skilled nursing agency, or if you decide to hire your own caregiver, you’ll want to weigh the pros and cons. One key consideration is whether you or your family want the responsibility of hiring and firing a caregiver and handling payroll and taxes. A willingness to take on those responsibilities allows you to choose the exact person you want to help you, while going with an agency may mean you don’t have the same choice. Cost is also an important consideration. While Medicare, Medicaid, the Veteran’s Administration and private insurance carriers may pay for some in-home care depending on certain criteria, most people must pay out-of-pocket for such care.
Community organizations may offer useful programs as well, such as Meals on Wheels or transportation help. Check with your local Area Agency on Aging or senior center for possible resources.
“Researching now the options available in your area for in-home care or community-based services will allow you to have the information you need to make a sound decision down the road,” Daley said.
Is It Time to Give Up the Keys?
Having a car can represent independence and freedom, so to give up driving can be a difficult decision. However, older age leads to issues that make driving more problematic.
According to the Insurance Institute for Highway Safety, those age 70 and older are more likely to crash a vehicle than any other age group except drivers age 25 and younger. And although everyone is different, another statistic from the American Society on Aging reports that most people drive 7 to 10 years longer than they should.
When making this decision, it may help to remember that it’s not about competence, but changes in the body, noted Daley.
“After many decades of driving, driving can feel second nature to us. Especially if you’ve had a safe driving record for many years, it’s hard to understand why your competency would change now. However, it’s our bodies that change our ability to effectively operate a vehicle,” she said.
“When we age, our reflexes slow, our vision and hearing deteriorate and we can have diminished physical strength and range of motion,” Daley explained. “These conditions can cause delayed responses to the quick decisions and movements we need to safely operate a motor vehicle.”
Health conditions like dementia, Parkinson’s disease, glaucoma, seizures, arthritis and others, as well as many medications, create added complications, noted Daley.
Warning Signs for Unsafe Driving
While it may not be obvious when driving becomes risky, here are some signs to watch out for:
- Other drivers often honk at you.
- You have trouble staying in your lane.
- You stop at green lights or when there is no stop sign.
- You run red lights or stop signs.
- You frequently become lost, even in familiar areas.
- You’re having accidents or “near-misses”.
- You have trouble judging distances between vehicles and objects.
- Others are expressing their concern about your driving.
Get A Test
“If you or your loved one are feeling concerned, your health care provider can refer you to specialists in neuropsychology who can measure overall brain function and thinking skills such as attention, memory and problem solving. Or your doctor may feel a driving safety evaluation with an occupational therapist is the better approach,” Daley said.
A driving safety evaluation in Samaritan’s Occupational Medicine program uses driving simulators that allow therapists to obtain objective information on a person’s driving skills related to reaction time of both the eyes and foot, judgement, direction, route planning, working memory and more.
Complete an Advance Directive
It is always best if you write down your wishes for the future and share them with loved ones. An Advance Directive is a specific form that allows you to do that.
In the event you become incapacitated or unable to tell a medical professional what you would want regarding lifesaving and life-sustaining measures, an Advance Directive document becomes your voice. Anyone age 18 and older can complete this form and update as time goes by.
“While an Advance Directive takes some time to complete, it can save misunderstanding or pain in the future,” Daley said.
The document can be obtained from your clinic or hospital. Once completed and either witnessed and signed by at least two adults (other than yourself) or notarized by a notary public, you’ll want to keep the directive in your important documents and medical records.
There are many changes that come with aging and while no one ages in the same way, we do know that the clock can never be turned backward. With smart planning for the future, as well as patience, good self-care and healthy lifestyle changes, you can work in harmony with your body to create a life that is as full as possible for as long as possible.
Karen Daley, RN, is a certified hospice manager and director of Samaritan Evergreen Hospice, which provides comfort care and end-of-life care for people living in Benton, Linn, Lincoln, Marion, Polk and Tillamook counties. She can be reached at 541-812-4662.