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| Mom, Dr. M and KK |
Aging in place is generally thought to mean staying in one’s home when frailty sets in, instead of moving to a nursing home or assisted living. It occurs, not by chance, but through careful planning. So, sometime shortly after retirement, one puts oneself and significant other into a house or apartment which is suitable for aging bodies and perhaps aging minds. The reality of future aging is embraced instead of denied; longevity into one’s 80’s or 90’s is accepted and planned for. Conditioning one’s body and mind to age in healthy ways is, of course, important but not the only ingredients to aging in place.
The ability to “age in place” also requires a simpler life style and a community where one can walk or take public transportation safely (preferably to useful shops and services to reduce dependence on cars). Other basics consist of few or no steps inside or out, good lighting, a bedroom, full bath, and laundry on the main floor, affordable rent, mortgage, and/or utilities, and family or neighbors in close proximity.
The ability to “age in place” also requires a simpler life style and a community where one can walk or take public transportation safely (preferably to useful shops and services to reduce dependence on cars). Other basics consist of few or no steps inside or out, good lighting, a bedroom, full bath, and laundry on the main floor, affordable rent, mortgage, and/or utilities, and family or neighbors in close proximity.
As a nurse who specializes in gerontology and care management for elders, I know from experience where potential pitfalls exist for aging adults, most of whom do not anticipate needing any housing modifications in their futures. But before they know it, steps become an issue, followed by transportation, decreased vision, and inability to launder clothes or bathe oneself because facilities are on the second floor or in the basement. And of course, decreased income and holes in the customary safety net for elders exacerbates all of the pitfalls and makes spur of the moment modifications costly and often impossible.
Recently, a gerontological nurse from Japan visited me to talk about Comfort Theory. She also wanted to attend a class at the university where I still teach when I want to. (I am fortunate to be in nursing, where faculty are scarce and I can pick up courses when I want them.) During that class, a case study about home-care was discussed in depth, revealing to my guest a value system in our country that she said was not present in Japan. That is: try to keep elders in their home for as long as possible with the supports they need, because they usually DO BETTER.
Recently, a gerontological nurse from Japan visited me to talk about Comfort Theory. She also wanted to attend a class at the university where I still teach when I want to. (I am fortunate to be in nursing, where faculty are scarce and I can pick up courses when I want them.) During that class, a case study about home-care was discussed in depth, revealing to my guest a value system in our country that she said was not present in Japan. That is: try to keep elders in their home for as long as possible with the supports they need, because they usually DO BETTER.
After that class, I thought we should visit my mother, nearly 92, who lives alone in her own home with help from nursing aides for a few hours every morning. After she retired, she decided to move near me, her only remaining adult child. She bought a bungalow that we have adapted over the years as her physical capabilities diminished. She can no longer walk unassisted, her vision and hearing are very poor, but she is thriving in mind and spirit. She entertains herself with books on tape, the news, and our hapless Cleveland sports teams. She knows where all her handholds are in her house, she has Meals on Wheels and warms things in a microwave, and she has Lifeline and a walker. I pour her meds, renew her prescriptions, and watch her health status. Financially, she is assisted by Medicaid and reduced utilities through a state run program for people in need. She is oriented and humorous, loves visitors, and keeps her house tidy. She says that is where she wants to die (although not in the near future!).
My visitor was amazed and said, “In Japan, our frail elders are almost always in nursing homes.” Finally, something we do well in the U.S. – at least for right now. With looming cuts in social services, I am not so confident that my adult children will have the same safety net that my mother does. But I do know, I will be set up physically in my perfect elder-friendly home and community where I can walk to stores, wash myself and my clothes, and keep my little home clean. This is where I have the most comfort, and where I will do better, just like my mom.
My visitor was amazed and said, “In Japan, our frail elders are almost always in nursing homes.” Finally, something we do well in the U.S. – at least for right now. With looming cuts in social services, I am not so confident that my adult children will have the same safety net that my mother does. But I do know, I will be set up physically in my perfect elder-friendly home and community where I can walk to stores, wash myself and my clothes, and keep my little home clean. This is where I have the most comfort, and where I will do better, just like my mom.
- Kathy Kolcaba
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Copyright 2012 Katharine Kolcaba, RN, MSN, PhD. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Chagrin Falls, Ohio 44022. E-mail: kathykolcaba@yahoo.com Phone: 440-655-2098 Web: http://thecomfortline.com/
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