Many Want to "Age in Place", But Few Are Prepared to Do So
by Don Drake, Connelly Law Offices, Ltd.
"It is the wish of most seniors to remain in their homes as they age," stated professional fiduciary and certified elder law Attorney RJ Connelly III. "The term 'age in place' has many definitions, with the simple one being remaining in their homes and communities as they age rather than moving into long-term care settings. The one I choose to embrace is the explanation by the Centers for Disease Control (CDC), which describes aging in place as 'the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level.' and to approach this description realistically, how many seniors are truly ready and financially able to 'live comfortably, regardless of age, income or ability level'?"
Margaret lost her husband following a heart attack he suffered while shopping at a store in Hartford, Connecticut. "He went out to the store that day to pick up some coffee, and the next thing I knew, I was talking to the emergency room doctor who told me Paul had suffered a massive stroke," Margaret said. " A neighbor drove me to the hospital, and on the way, I called our daughter living in South Carolina and told her what happened. By the time I got to the hospital, he was gone."
Margaret, who had rheumatoid arthritis (RA), struggled to get around independently due to the painful condition and joint damage. "Paul did so much for me. He would help me when we went shopping, help me get dressed when my hands were especially painful, and make our meals," Margaret said.
The couple had an estate plan, a modest house, and some savings. They planned to age in place and grow old together. But with Paul's death, things had changed drastically. "My daughter came up for the funeral and wanted me to live with her, but all my friends were here. I was born and raised in Hartford, so going to South Carolina was off the table. Anyway, I had a house to live in and friends around me, and I was sure Paul would have wanted me to stay here in Connecticut," Margaret stated.
She did well for the first year, but their savings quickly dwindled. "With Paul's money and a part-time job he had, we could keep things comfortable, but I was treading water without his income," Margaret said. "Taxes were going up, utility bills skyrocketed, and food seemed to double in price. I wasn't prepared to face this alone."
There were also other things that Margaret was not ready for. "Our home was older, and I couldn't keep it in repair as Paul did, so I had to hire contractors at prices I was unprepared to pay. I needed the grass cut, and my RA continued to get worse. I was afraid to use the stairs for fear of falling, and getting in and out of the shower seemed like a half-day chore, so I didn't pay much attention to my personal hygiene."
Those things that Margaret thought she could rely on also fell apart. "My neighbors, who helped support me after he died, began to pull away slowly. I suppose it was because my needs increased, and they had families to take care of, they didn't need my burden. Then, in January, during the pandemic, I could not get out of the house and take money out of the bank, and my oil ran out, leaving me freezing and sick. I ended up in the hospital, where a social worker suggested I sell my house. That's when I contacted Attorney Connelly for help."
"As bad as things got for Margaret, she was actually lucky in many respects," stated Attorney Connelly. "The trend to 'age in place' makes sense when one considers long-term care costs, but if a family is not prepared, the home can become a prison, far from the ideal existence they expected when choosing to age in place. In Margaret's case, she got to the hospital, where she found help, but I am aware of others who ended up in a world of isolation. In one case, a senior died unnoticed in her home. It wasn't until the neighbors smelled a strange odor and observed thousands of flies on the inside windows of the home that they found that she had passed. In other cases, seniors experience a rapid cognitive decline without anyone noticing it."
Preparing to Age in Place
"Unfortunately, Margaret's story is not an isolated one, and we will see more and more stories like this as our country continues to age," said Attorney Connelly. "As with all things, preparation is the key as it realistically weighs your ability to age in place comfortably. Here are some key points:
Can You Handle the Costs - According to a Genworth survey, the average cost of a private room in a long-term care facility is approaching $9000 monthly or a whopping $108,000 annually. Semi-private rooms fare a bit better at $260 a day or almost $8000 a month or $96,000 annually, so aging in place appears less expensive but is not without costs. For instance, increased taxes, maintenance, repairs, and upgrades exist. Utility costs are on the rise. As you age, you may need to hire someone to cook, clean, and do minor repairs. HomeHealth Aides may also need to be hired. These services are not cheap.
The Community Changes - As you grow old, so do your neighbors, those you looked toward for support in the past. They also get sick, become incapacitated, and pass away. Younger people then move in, and those social connections you once had no longer exist. Can you count on those who "were" there, and what are your relationships with the new community members? In many cases, seniors who choose to stay in their homes become isolated and lonely.
Aging Bodies Need Support - As we age, we need help as parts of our bodies fail. Our vision deteriorates, our joints don't work as before, and our cognitive abilities decline. Because of this, seniors may need to hire someone to help with cooking, cleaning, washing clothes, and even helping with things like bathing and getting dressed. Minor tasks we used to do, like shopping and paying bills, may need to be done by another. Although Medicare and Medicaid will pay for some in-home services, costs remain.
Making the Home Age Appropriate - Aging requires physical changes to the home. This requires modifications that could be costly (but for some who qualify, changes can be made without cost, a social worker or this office can identify agencies who have grants). For instance, additional lighting may be needed, knobs on drawers may need to be changed to levers, rugs should be removed to limit the chance of a fall, handrails may need to be installed in the shower, in some cases, the entire bathroom may need to be overhauled. Motion detectors may be needed. If someone in the home has a chronic medical issue such as COPD or heart disease, hospital beds may be needed, oxygen tanks may be needed and stored in safe places. Wheelchair ramps may need to be added. It is suggested that a professional do a home assessment to see if aging in place makes sense, given the physical makeup of the home and the costs involved in any renovations.
So, Should I Age in Place?
"This is an extraordinarily personal choice," stated Attorney Connelly. "Although it sounds like the right thing to do, much thought must go into the decision. For many seniors, the pandemic highlighted the problems they might face when aging in place, such as isolation and loneliness. This often leads to quicker deterioration of the body and mind and mental health problems. The hard truth is that remaining in the home alone can be an empty existence, far worse than moving into a long-term care facility. It's really about what quality of life you want."