Creating a Plan for Successful Aging at Home

Tips for planning an independent future, falls prevention, making healthy lifestyle choices, financial concerns and more.

Plan for a self-reliant future
Some simple strategies and preventive measures can help seniors stay independent, healthy and living at home. For example, many seniors wonder whether they can continue to afford living in their home, particularly after their spouse dies. Advance financial planning is an excellent solution to resolve these worries. A social worker can help sort out current and expected income and living expenses to put the mind at ease so today can be enjoyed instead of worrying about tomorrow.

Engage social and community support
Studies indicate that 85% of people over 65 prefer to continue to live at home. This can be achieved by recognizing that a network of friends, family, healthcare workers and local services are an important resource to maintain independent living.

The difference between staying at home or living in a nursing home can be as simple as hiring yard care and snow removal services to keep the yard looking great and minimize potential injuries due to falling or heavy lifting. A house cleaning service can do likewise indoors, ensuring that the home is kept clean, neat and tidy and clutter is kept off the floor. Many such services offer seniors’ rates.

Decline is not inevitable
Aging doesn’t necessarily mean that abilities will decline. Good diet, exercise, modifying the living space to minimize fall hazards and utilizing Physiotherapy, Occupational Therapy or a registered dietitian to work on trouble spots can make a significant difference to general vitality and mobility.

Therapists can minimize or eliminate symptoms of chronic conditions such as diabetes or arthritis. Check with the family physician to see how the current level of physical functioning can be maintained or improved and how to prevent accidents or illnesses that might impair the chances of living independently in the future.

Make healthy lifestyle choices
Good health is a prerequisite for aging well. Everyone can maintain or improve their current level of function by adopting healthy living choices. Our team of therapists, which includes Dieticians, Physiotherapists and Occupational Therapists, can advise on dietary choices, exercise regimens or adaptations to the home and lifestyle.

Know how to navigate the healthcare system
It is important for all seniors to be actively involved in their own health and lifestyle decisions. Keep a binder of contact information, brochures and information sheets from physicians, pharmacists and other healthcare personnel. Keep informed by asking questions and researching health information on reputable websites.

Well-informed family and friends can act as advocates in times of illness or injury. Keep children, spouse and other family members informed of changes in health status and services being used.

The family doctor can link to a host of healthcare-related resources. In Ontario, calling the local Community Care Access Centre is another good way to get education, advice and access to community-based service providers. The CCAC is an excellent link to local services and organizations that help seniors

Challenges Involved in Aging at Home

Falls

Prevalence of falls among seniors
A fall is “an event that results in a person coming to rest inadvertently on the ground or floor, or other lower level”. Each year, 1 in 3 older Canadian adults fall – this risk increases as seniors get older.

Personal cost of falls
Falls impact older adults and their families beyond injury. Fear of falling, loss of independent living and even death due to falls are other potential costs of falling. The following statistics about the impact of falls on seniors’ health and quality of life are from Tools for Living Well: Assistive Devices to Prevent Falls among Seniors and Veterans.

Injuries
Falls are the most common cause of injury in elderly people. Over 90% of seniors’ hip fractures are the result of a fall. Of those who suffer hip fractures, up to 24% die within a year and 80% will be unable to subsequently perform at least one activity of daily living such as driving or house cleaning.

  • Fear of falling

Seniors who fall may limit their activities for fear of falling again. By limiting their activities, they become less physically active and begin to lose strength and flexibility, which only increases the risk of a subsequent fall.

  • Loss of independent living

Approximately 40% of nursing home admissions are the direct result of a fall. Older adults who have fallen are three times more likely to be admitted permanently to an institution than those who have not fallen.

  • Death

Falls are the sixth leading cause of death among older Canadians. They account for 57% of deaths due to injury for senior females, and 36% for males.

Economic cost of falls
Falls cost Ontarians $1.9 billion in 1999, with $927 million attributed to those 55 years and older. This statistic is particularly sobering given that the proportion of seniors in Ontario will grow to 24% of the population, from the current 13%, by 2031. Preventing falls is therefore particularly important not just for seniors and their families, but for the economy and healthcare system.

Preventing Falls
Recognizing and acting on risk factors can help prevent falls. Risk factors for falling include:

  • a history of falls
  • impairment related to cognition
  • balance and gait difficulties
  • lack of exercise
  • low body mass index
  • multiple medications
  • hazards in the home

Using fall-minimizing strategies can reduce the incidence of falls among seniors by more than 20%. This would lead to 4,000 fewer hospital stays, 1,000 fewer permanent disabilities and a health care savings of nearly $121 million per year.

Know whether you are at risk for a fall.
Do you have balance problems? Do you reach for walls or furniture to move around your home? Are you weak or have compromised joints due to arthritis or other joint ailments? Do your feet drag as you walk?

A Physiotherapist can develop an exercise program to increase strength, endurance, balance and mobility – all of which can help prevent a fall. An Occupational Therapist can assess the home and recommend adaptations to reduce risks.

Here are a few more suggestions for fall-proofing the home:

1. Tape down the edges of area rugs and remove scatter rugs entirely
2. Consider arranging for “home help” services to keep a neat, clutter-free interior
3. Move furniture out of main walkways
4. Make sure there is adequate lighting
5. Ensure that light switches are easily accessible
6. Install or strengthen railings at staircases
7. Install or strengthen handrails near the tub and toilet

Physiotherapists and Occupational Therapists can recommend more options for fall-proofing the home.

Cognitive Changes and Dementia
A decline in cognition, or reasoning ability, can be difficult to detect because it is often very gradual. Symptoms such as loss of reasoning, memory lapses, increased wandering, abusive behaviour and helplessness are not only difficult for caregivers to deal with – they may signal an underlying medical problem.

Working with the family physician and accessing resources and educational materials through the CCAC will help to anticipate and handle cognitive decline.

Financial Concerns
The senior years are a time of change. Any change can be stressful, but financial concerns are particularly anxiety-provoking. Retirement, the death of a spouse, a changing lifestyle or a sudden health crisis can all impact a senior’s financial bottom line.

Analyzing the financial future will allay anxiety and help seniors to live an affordable lifestyle. Social workers can help seniors prepare a long-term financial plan to assist them in coping with the financial fallout of a health crisis.

Mobility Limitations
Having trouble walking or moving around doesn’t mean becoming a recluse or living in a long term care facility. It is very likely that independent living in the home is possible in spite of mobility limitations. Please read about Mobility and the Assistive Devices Program more information.

Caring for an Ailing Spouse
Senior couples are often each others’ primary caregivers. Caring for an ailing spouse is particularly challenging for someone who is also aging. Fortunately, there are community-based and medical services to support the aging spouse in their caregiving role.

End-of-Life and Palliative Care
These days, many people with terminal illnesses choose to pass away at home. Should that be the choice, there are resources available to make the person more comfortable and provide extra support for family and caregivers. Contact the Community Care Access Centre or the Canadian Hospice Palliative Care Association to learn more.

Recommended reading:
Navigating Canada’s Healthcare System by Michael Decter and Francesca Grossso. 2006, 368 pages, ISBN 0143050451, published by Penguin Group, Canada

Tools for Living Well: Assistive Devices to Prevent Falls among Seniors and Veterans Lockett, D., Edwards, N., Boudreau, ML, Toal-Sullivan, D., Sveistrup, H., and von Zweck, C. (2004).. University of Ottawa and Canadian Association of Occupational Therapists. Ottawa, Ontario, Canada

© 2008 Community Rehab

About Community Rehab
In response to a growing need for community based therapy services, a dedicated group of therapists established Community Rehab in 1985. In 2008 Community Rehab was acquired by Saint Elizabeth Health Care (SEHC) and is now a part of the SEHC family.

Community Rehab provides a complete range of rehabilitation services for clients when and where they require them. A dynamic team of Physiotherapists, Occupational Therapists, Speech-Language Pathologists, Dietitians and Social Workers offers innovative, ethical, client-centered service.

We combine best practices with cost-effective processes to deliver rehabilitation services in the home, office, hospital, school or clinic…anywhere our clients need us.

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