Independence and Aging
As we age, we struggle and strive to stay as independent as we are able. I often hear older adults say, “I just don’t want to be a burden to anyone.” This is not unique to the aging adult as their family members will echo the sentiment, “Our goal is to keep mom at home, whatever it takes.”
I relate personally to this as my aging grandparents are just on the edge of the Texas Hill Country on a ranch twenty minutes from the nearest town and over an hour from the nearest city. They have made it clear that What Matters to them is to remain independent until, as they say, “the cows come home” (see: indefinitely). While this is a common feeling, it is often based from a very optimistic viewpoint as someone that is sixty-five today will have a 70% chance of needing long-term care services by the end of their life. The average number of years a person in the United States lives after turning sixty-five is almost another twenty years, and due to the complex process of aging we regularly increase our number of chronic diseases, chances for a terminal disease, while simultaneously decreasing our function. This horrible equation adds up to higher chances of institutionalization, a ten-dollar word for needing to move to a facility that accommodates unmet needs.
Long-term care services cover a variety of services, usually in the form of meeting Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). We can deep dive into ADLs and IADLs at another time, but suffice it to say if an individual is incapable of of completing ADLs they would pass away in a couple days and if they are incapable of completing IADLs they would pass away in weeks to months. Long-term care can be delivered at home, usually in the form of home health, but also (in the United States) through certain programs such as the Program for the All-inclusive Care of the Elderly (PACE). Increasingly common, especially as needs increase, it is delivered at a facility. These facilities range from assisted-living to memory care to skilled nursing, and differ based on the needs of the individual that are not being properly met.
So in light of What Matters to many older adults, how do we stave off what seems so inevitable? The first, and best, is to have an open and honest conversation with those that would be this type of decision making process. Whether you are the aging adult or the caregiver have tough conversations about What Matters. The next steps are practical:
Stay active, physically and cognitively
Have a health professional (physical or occupational therapist) evaluate your living place for safety
Visit and tour facilities before they are needed
Taking the above steps can reduce the common fear of the aging adult of “becoming a burden,” while simultaneously ensuring healthy and functional aging.
Key Points:
Many aging adults wish to remain independent
70% of adults sixty-five and over will need long-term care services during their life
Communicate with those important to you about What Matters in your aging process
