The Physical Challenges of Aging in Place

According to AARP aging in place is a goal for 3 out of 4 Americans aged 50 or more. These seniors and near seniors are willing to employ alternative solutions to facilitate this. The alternatives include home sharing (32%), building an additional or accessory dwelling unit (31%) and locating into villages that provide services which enable aging in place (56%). These communities become a source of support and engagement for residents and give a sense of grounding through memories of a long-time home environment.

Seniors who want to reside in a community (aka, age in place) rather than seek residential institutions or nursing homes are mostly dependent on unpaid caregivers and family members for assistance with activities of daily living (ADL). These activities include laundry, self-care actions like bathing and dressing, meal preparation, and transportation. Medicare provides some long-term care services and supports (LTSS); however, the LTSS program falls far short of the need. While the aging population in America is rapidly increasing, lawmakers are slow to respond to the insufficient funding to increase the availability of LTSS for seniors choosing to age in place. The goal of LTSS is not to replace but to supplement the contribution of unpaid family and caregivers. The addition of a Medicare benefit to support family caregivers as they help their loved ones would enable more aging adults to successfully remain in their homes.

Technology has provided some solutions for caregivers, allowing caregivers to monitor their loved one remotely while they stay engaged at work. Smart environmental controls and personal assistants have lightened the load of constant oversight but cannot replace the helping human touch. Nearly 60 percent of seniors who have seriously compromised mobility report being house or apartment bound, while 25 percent of those seniors say they often remain in bed and do not dress daily.

Low tech devices like canes, walkers, ramps, grab bars, shower seats and raised toilets to increase the level of accessibility and safety for aging in place seniors, however, transferring in and out of bed and moving around their homes still provides notable difficulty for many. The senior who wants to age in place is typically independent-minded and therefore have trouble foreseeing a time when help is not a want but a need. Aging adults and their families need to plan to address changing physical capacities before an adverse health event such as an unintended fall or dementia challenges change everything. While aging in place is a great goal for many seniors it requires planning just as if they were planning on moving into an assisted living facility.

Johns Hopkins researchers report 42 percent of older adults who have problems performing ADLs or are living with probable dementia receive no assistance at all from family, friends or paid caregivers. That is a staggering number of unaided seniors. Additionally, twenty-one percent of seniors with a minimum of three chronic conditions and high needs received no assistance at all. LTSS through Medicare will have to make changes to meet the ever-increasing demand for human caregiving.

Approximately 60 percent of at home seniors use at least one low tech device, most commonly for bathing, toileting or in-home movement, throughout their day but their needs multiple as they age. Unfortunately, Medicare does not cover the expenses of most of these nonmedical devices and services. The resulting problem is seniors near, or at the bottom of the income ladder go without assistance, human or device, putting their daily lives in a very precarious position. Hardships for these seniors on the razor’s edge include the inability to pay medical bills or prescription costs, utilities or rent, and some resort to skipping meals to balance out their unaided lifestyle. At best this is heartbreaking, at worst it is inhumane.

The CHRONIC Care Act will allow Medicare Advantage plans to offer supplemental benefits for seniors to cover devices such as wheelchair ramps, grab bars, personal care, and transportation to chronically ill seniors however there are 21 million people who have needs to be met and how this will be paid for is unclear. Meanwhile, the 39 million people enrolled in traditional Medicare are entirely left out of any supplemental benefit. Affordability for at home care is a significant issue on a personal, family, and government level.

Caregivers and assistive low tech devices are an absolute necessity for seniors opting to age in place. The extent of the adjustments senior adults make as their needs become more profound are not well documented. As aging in place is a common strategy now, new solutions and programs must be explored to ensure successful aging.

If your strategy is to age in place, have a discussion early on with trusted counsel and family members to address some of the challenges you will eventually have to overcome. If we can assist you, please don’t hesitate to reach out.

America is Facing a Family Home Caregivers Shortage

The aging population of the United States is widely reported as the bulk of the baby boomer generation is already retired or nearing retirement. However, what has not been widely reported is how the rest of the nation will provide care for this large, aging population. According to a 2017 Merrill Lynch study, nearly 95% of caregivers are family members. These family members are providing over $500 billion worth of free care annually. For perspective, that’s three times Medicaid’s professional long term care spending.  The number of family caregivers is shrinking at a time when the population that needs them is expanding at a rapid rate. In 2020, there will be over 56 million people in the U.S. age 65 and older. In 2010, that number was just 40 million.

This is a unique problem for the baby boomer generation for several reasons. The main reason is the simple fact that there is just an unusually large number of people in this generation. Unfortunately, every elder who needs care will not have a family member willing to give care. This responsibility will then fall to professional home care workers. Government statisticians project that the nation will need an additional million home care workers by 2026, an increase of 50% from 2014. Fulfilling the need for this many additional workers will be difficult, however.

Home care workers face extremely low wages, inconsistent work schedules, and there is little, if any, room for advancement in the industry. For example, the median salary for a home care worker is a minuscule $10.66/hour according to the U.S. Bureau of Labor Statistics. For comparison, that’s about the same hourly wage as a fast-food cook and about 30% less per hour than a veterinary technician makes. Looking beyond just salary, benefits are dismal, also. Only a third of home care workers are full-time and qualify for benefits. Further, there is a better chance you get injured on the job as a home care worker than if you worked in the oil and gas extraction field.

Another reason why this is such a unique problem for baby boomers is that it was more common in the past for children to stay in the same geographic area as their parents and be able to provide free care to them when it was needed. With advancements in travel and technology, it has become exponentially easier for people to move away from their parents, whether it be for job seeking reasons or simply for a change of scenery. Also, with the increasing rate of debt Americans are taking on, some family members just do not have the means to take time away from work to care for ailing family members.

There are several small initiatives taking place to help combat this shortage. In Massachusetts, the Home Aide Care Council has started a two-week training program that introduces new home care workers to what the job entails before they start their formal training as a home care worker. Also, some states are starting programs that provide opportunities for advancement. New York has a program that trains home care workers to administer routine medication, which gives them experience that can help them move into other positions in the healthcare industry.

There are options that should be explored now that can help you or a loved one prepare for a possible shortage in caregivers.  Contact our office to discuss steps you can take now to ensure you have the best care possible if needed.

Seniors Heading Back to Work

Many of the 50-year-old and older workers are raising children and helping aging parents, and it is putting a strain on budgets. There are over 3 million seniors or near-seniors looking for full-time employment and millions more looking for part-time work. Seniors are finding that to make ends meet and have a financially secure retirement they need additional income especially now that people are living longer than ever before. The good news is jobs are available, companies are hiring “seasoned” workers, and there are programs to help those aged 50 and older find the type of work that is right for them.

If you are age 50 or more, the American Association for Retired Persons (AARP) runs a program called BACK TO WORK 50+ that targets workers who previously worked at moderate income level jobs but who may lack the education level and computer skill sets that presents a barrier to employment in situations that lead to better economic security. There is also SCSEP, the Senior Community Service Employment Program, which is the only federal program targeted to help older workers. AARP works in conjunction with SCSEP and provides employers with qualified candidates who are pre-screened for placement. These programs support the employer in finding a skilled worker at a low cost and allow the senior to bypass the interview process. Both of these programs will train seniors to give them the skills and confidence they need to find a job so that they can provide for themselves financially. According to AARP, senior employment is becoming so prevalent that by the year 2022, workers aged 50 or more will comprise thirty-five percent of the workforce.

If you are a senior with a college degree and solid computer skills, AARP can also help place you in a meaningful work environment. More than 500 companies nationwide have signed the AARP Employer Pledge “We believe in equal opportunity for all workers, regardless of age, and that 50+ workers should have a level playing field in their ability to compete for and obtain jobs. Recognizing the value of experienced workers, we pledge to recruit across diverse age groups and to consider all applicants on an equal basis as we hire for positions within our organization.” This pledge affirms the value of an experienced senior worker and many companies are on board. The belief is that a workforce that leverages talent from all age groups is a stronger workforce. Jobs AARP and other employer resources connect 50+ job seekers with employers who recognize the value of experience that comes with a more senior and seasoned worker. These companies who have signed the pledge are on the AARP job boards, in the job search tools, and even participate in online recruiting fairs.

As more seniors are becoming computer savvy, remote work opportunities are becoming more popular and mainstream. Companies do not have to provide a physical workspace and employees have no commute and no need to spend money on proper work attire; overhead is lower for the employer and the employee. Seniors can use the AARP tools to find legitimate online job prospects. If a senior prefers to work with people for socialization purposes as well as earned income, the senior living industry has excellent opportunities and needs workers. Senior living facilities management acknowledges the expertise, dependability, and worth ethic that is common in the mature workforce. Currently, there are high rates of staff turnover in senior living environments, and a senior employee can make a positive difference in the rate of employee retention.

There is an undeniable benefit to remaining active as you age and work is a significant component of that activity. Old notions of ageism are changing at precisely the right moment to help you create a better retirement living situation for yourself through additionally earned income. If you are 50+ and looking for work, take advantage of these national programs to identify the right job for you.  There is no better time than now to look forward to your own retirement needs and have the peace of mind that additional income brings.

It is essential to meet with an ElderCounsel attorney to ensure that you are increasing income without reducing benefits available to you. You don’t want to cross a threshold that would deny you a government benefit unless it would be financially beneficial.  Many components need to be considered to plan a successful retirement. Contact our office today and schedule an appointment to discuss how we can help you with your planning.

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