Given the choice between aging in place — staying at home — and moving into a nursing home, the majority of seniors would rather stay at home. A survey conducted by AARP found that 87 percent of people over age 65 wish to remain in their homes as they get older. Among people between the ages of 50 and 64, around 71 percent would like to age in place.
Staying at home can make sense for some older people, but it also raises concerns about what older people will do if they get sick or need care. A paper published in Nursing Economics in 2015 pointed out that 90 percent of adults over the age of 75 in the US had at least one chronic illness. About 20 percent of those over the age of 75 had more than five chronic conditions.
Seniors with one or more chronic conditions often need medical care, which they can easily get at a nursing home. But even seniors with multiple chronic conditions don’t need to rule out aging in place. Modern day seniors can choose from a wide range of health care options, which means that the medical attention they need could be within reach even if they remain in their home.
What to Consider When Deciding Between In-Home Care or a Nursing Home
Weighing the pros and cons of in home care vs. a nursing home involves a lot of important factors. You want to think about the wishes of your parent or loved one, as well as whether the option he or she wants is going to provide the care needed.
1. Access to Care
One significant consideration when making this decision is how much care a loved one will need. Although chronic illnesses are common among older people, being old doesn’t necessarily mean that a person is sick. An 85-year-old parent might need less medical care and attention than a 60-year-old son or daughter.
The amount of medical care a loved one needs plays a crucial role in deciding whether in-home care or a nursing home is most appropriate.
One of the benefits of choosing in-home care is that the amount of care provided is flexible. If you are the regular caretaker of your parent or other loved one and just need someone to stay with your loved one while you work, home care could be the way to go.
Home care services don’t have to focus exclusively on providing a person with medical care. Home health care companies offer a range of services. For example, you can schedule a caretaker to visit your home loved one at home for several hours a day just to provide companionship.
A caretaker can also help an older person complete daily errands, tasks or chores that have become difficult for him or her to do, such as:
- Meal preparation
- Dusting and vacuuming
- Basic grooming
- Hygiene help
- Transportation to appointments or meetings
- Helping a person change position
It’s also possible to arrange for a therapist or nurse to provide home care to your loved one. If your parent is recovering from hip or knee replacement surgery, for example, they might welcome the chance to have a physical therapist stop by several times a week rather than stay in a nursing home or rehabilitation center during the recovery period.
How frequently a caretaker visits with an older person can vary based on your specific needs. Some caretakers come by just once or twice a week. In some instances, a caretaker can stay overnight a few times a week. People who need more round-the-clock help and care might benefit from having a live-in caretaker.
When it comes to access to care, a nursing home might be the most convenient option. In a nursing home, a team of nurses and other medical providers is on-hand at all times to care for the people who live there.
A nursing home might be a welcome relief for older couples, especially if one half of the couple is ill, but the other is healthy. Moving into the nursing home will allow the sicker person to get the medical care and attention they might need. It will also ease a bit of the burden on the healthy partner, as they won’t be entirely responsible for attending to the medical needs of their spouse.
Access to care isn’t the only thing to consider when deciding between a nursing home and in home care. You also want to think about your loved one’s comfort. How familiar the settings will be plays a big role in determining whether one option is better than the other.
If your mom and dad have lived in the same home for decades, staying in the house is going to be the most familiar option for them. People get attached to their homes, and for good reason. The home is where they saw their children grow up, where they celebrated holidays and family milestones together and where all of their belongings are.
Providing care in a familiar setting can be especially useful to people who are in the early stages of Alzheimer’s or are suffering from another form of dementia. A person with dementia might have greater difficulty doing new things and might struggle when placed in a new, unfamiliar setting, such as a nursing home.
That said, even a home that is very familiar and that a person has lived in for decades can become dangerous as that person gets older. Along with hiring in-home care, it might be a good idea to take steps to senior-proof the home of your loved one.
Senior-proofing a home means making changes to the interior to help reduce the risk of falls or other injuries. About 60 percent of falls take place in the home. These falls are often easy to prevent.
Sweeping clutter off of the floor, securing the edges and corners of carpets and installing handrails along the walls and stairs can reduce the risk of falls. Making sure the inside and outside of the home is well lit can also reduce this hazard.
Compared to in-home care, a nursing home isn’t a familiar place. The move to a nursing home can cause some consternation, especially if a person is also dealing with Alzheimer’s or another form of dementia. There are ways to make the transition go smoothly and to make living in a nursing home feel like home.
Having a group of familiar faces around to help your loved one make the move will be particularly helpful. Staying with your parent or relative throughout the move-in process provides a familiar presence.
Bringing beloved items from your parent’s or relative’s old home to their new room or apartment in the nursing home can also create a feeling of familiarity. Your loved one might not be in the same house where they celebrated holidays and birthdays, but they will be surrounded by the things that were there during those celebrations.
One of the most common reasons why people today prefer to age in place is because they want to stay independent. According to a study from HomeAdvisor, 68 percent of people who wanted to remain at home stated that they felt independent in their homes.
While receiving in-home care does help a person remain independent for longer, moving into a nursing home doesn’t have to mean becoming completely dependent on others.
Older adults who want to stay at home and live on their own need to be able to complete what is known as “activities of daily living” or ADLs. ADLs include basic things such as using the toilet, bathing and eating. There are also instrumental ADLs (IADLs), which include tasks such as household chores, paying the bills, taking the appropriate medicines at the right times and cooking.
A person needs to be able to do all of the above to live independently successfully. In-home care can provide a sufficient amount of support to allow a person to continue to live on their own, even once ADLs and IADLs become challenging.
Home care coupled with innovations in technology can allow a person to maintain his or her independence for longer. While a caretaker can come in and assist with daily tasks, certain technologies can help ensure that an older person is living his or her best independent life at home.
For example, lights that switch on automatically at the same time each day can properly illuminate the inside and outside of a home, reducing a person’s risk of tripping and falling. Smart refrigerators can detect when certain foods are running low and can automatically schedule grocery deliveries.
The one barrier to using smart technology and maintaining independence at home is the cost of some of these technologies. While automated light switches and smart thermostats aren’t costly, devices such as smart refrigerators are. The cost of certain kinds of technology might make them out of reach financially for a significant number of people who would like to remain in their homes.
Moving to a nursing home doesn’t have to be synonymous with giving up independence, as not all nursing home facilities are the same. Some do offer higher levels of care and have a more hospital-like feel than others. Some look like apartment buildings and offer many comforts of home, along with a nursing staff on hand all day, every day.
If your loved one is struggling to take care of a larger home or needs help with tasks such as cooking and cleaning, moving a to a nursing home can help them regain some degree of independence. Your loved one will be able to enjoy the room or apartment they live in, can invite friends and family over and no longer need to worry about mowing the lawn, cooking dinner or vacuuming the hallway.
5. Access to Support Systems
Whether your loved one decides to remain in the home or move to a nursing home, access to a support system is important for their well-being. These support systems can be found in a variety of places. Even older adults known as elderly orphans, because they have no spouse or other family members to provide care for them, can find the strong support system they need.
Adults who remain in their home might have the most access to support systems, including:
- Family. If family members are in the area, they can often help their loved one with necessary chores. If the older person is more independent, family members can simply be there to provide companionship.
- Friends and neighbors. One benefit of living in the same home for years and years is that many older people have developed strong bonds with their neighbors. In some cases, neighbors are willing to pitch in and help older people on their block with tasks like shoveling and basic lawn care.
- Local or state department of aging. Many states and regions operate aging councils or departments of aging, which provide services to seniors in the area. The Maryland Department of Aging, for example, sponsors programs such as meal services, a senior center, and caregiver services.
- Church or religious community. Often, local churches will arrange to have people visit and help out older people in their homes.
- In-Home Caregiving. It’s also possible for a person to get assistance from an in-home caregiver, whether that caregiver provides respite care, physical or rehab therapy or skilled nursing.
One of the sad truths of about living in a nursing home is that many residents don’t have much in the way of a support system. Around 60 percent of those who live in nursing homes don’t get visitors regularly. This lack of visitors and support could be because many people who move into nursing homes don’t have family or friends. Around 22 percent of people over the age of 65 are “elder orphans,” which means they don’t have children, spouses or other relatives.
In some ways, a nursing home itself can provide a support system for its residents. Nurses and medical staff at the home can provide care and therapy. Additionally, local religious organizations and charities often visit lonely residents throughout the year.
In-home care and nursing homes both have their benefits and disadvantages. In-home care allows people to remain in their homes for longer and can help them preserve their independence. Nursing homes can provide shelter, support and some degree of independence to older people who might not be able to find that in their own homes.
Guardian Community Health Systems offers a variety of home care services for people of all ages. Contact us today to learn more about how we can help care for your loved one at home.