Aging In Place

Not having to move from your present residence.

Aging In Place

It used to be that getting older meant moving in with family or heading to a nursing home. No longer! The idea of “Aging in Place” has gained traction nationwide. Gerontologists have said that as 77 million baby boomers reach retirement age, staffing at senior facilities will become a critical issue. If homes can be made suitable for seniors, Aging in Place will likely be the most pleasant alternative for aging Americans.

What is it?

Aging in Place is not having to move from your present residence in response to the changing needs associated with aging. The Aging in Place trend refers to living where you have lived for many years, or to living in a non-healthcare environment and using products, services and conveniences to enable you to not have to move as circumstances change. Continuing Care Retirement Communities (CCRC’s) tend to use the term in marketing to reference the multi-stage continuity of their campuses. Of course you have to move there first. Aging in Place can also mean the modifying of your long-term home to accommodate your changing needs. It often references a longer term strategy for readying your home for retirement.

Why do it?

A recent AARP survey found that most American seniors desire to stay in their homes for the rest of their lives – 80% in fact. Reasons cited for the Aging in Place preference are:

  • Comfortable environs
  • Familiarity and memories
  • Convenience to known services
  • Feelings of independence Safety and security
  • Proximity to family and friends

What is a NORC?

A Naturally Occurring Retirement Community is a neighborhood where residents remain for years and age as neighbors. It might be a specific apartment building or a particular street where residents have just stayed put. About 27% of seniors live in a NORC.

It’s possible to band together and develop access to (and perhaps preferential pricing for) services such as:

  • Social and recreational programs Information and counseling
  • Continuing education programs
  • Outside maintenance and referral services
  • Heavy cleaning
  • Home Care
  • Emergency and preventive health care programs
  • Meal programs
  • Transportation


Successful aging in place requires identifying and correcting any safety pitfalls. The major safety issues are:

  • Preventing falls
  • Fires and Emergency situations
  • Balance and coordination problems
  • Limited reach
  • Limited vision
  • Limited strength
  • Wheelchair accommodation

Most purpose-built senior communities are designed with these accommodations in mind, but it’s usually possible to modify your current home to suit your particular needs.

Home Remodeling

Even if you’re years away from retirement, any remodeling projects should be designed with consideration of possible senior needs. Even if you don’t end up staying there, you’re most likely broadening the net for potential buyers. You may wish to consult a professional early in your evaluation process. “CAPS” are contractors who are recognized by the National Association of Home Builders as being Certified Aging in Place Specialists. Some home remodeling considerations:


  • Adapt ground floors for one-level living
  • Better lighting and task lighting especially in bedrooms, baths, closets & hallways
  • Easy garage/parking access
  • Good lighting in transition areas
  • At least one entry without steps
  • Doorways 36” wide with off-set door hinges Levers instead of knobs
  • Electrical outlets at 18/24” instead of 12”
  • Easy open/lock patio doors Light switches at 42” instead of 48”
  • Rocker light switches Lower window sills, especially for windows on the street
  • Contrast colors between floor and walls
  • Rounded counter edges
  • Color borders around floor and counter-top edges
  • Non-skid and smooth flooring
  • Low-pile and firm pad carpeting
  • Non-glare surfaces and glass
  • Strobe light or vibrator assisted smoke and burglar alarms
  • Automatic garage doors


  • Lever faucets and mixers with anti-scald valves
  • Stall shower with a low threshold and shower seat
  • Hand-held shower
  • Grab bars for shower/tub/toilet (or wall reinforcement for later installation)
  • Turn-around and transfer space for walker or wheelchair (36” x 36”)
  • Higher bathroom counters
  • Elevated toilet seats
  • Telephone jack or medical response device


  • Cabinets with pullout shelves and lazy susans
  • Shelves no more than 10” deep
  • Easy to grasp pulls
  • Sink controls on the side
  • Under-counter task lighting
  • Cooktop with front controls
  • Side by side refrigerator
  • Variety in counter height – some as low as table height (30”)
  • Gas sensor near gas cooking (as well as gas heaters)
  • Color or pattern borders at counter edges
  • Ultra-quiet dishwashers to reduce background noise

Living Room

  1. Seating at least 18” off the floor
  2. Chairs with sturdy arms

Caregiver Burnout

It’s real…and its effects can be devastating.

Caregiver Burnout

Does any of this sound familiar?
  • You feel a sense of constant fatigue.
  • You’ve experienced a change in appetite or sleep habits.
  • You feel helpless, trapped and defeated.
  • You’re starting to feel resentful of the person you’re looking after.
  • You’ve been withdrawing from friends, family and activities you used to enjoy.
  • You’ve started taking your frustration out on others.
  • You have frequent headaches, back pain, muscle aches.
  • You’re relying more on food, drugs or alcohol to cope?

Caregiver burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed and unable to meet the demands put on you. Much like Post Traumatic Stress Syndrome, the symptoms of burnout can begin surfacing months after a traumatic episode. It’s not “just the way life is now”. There are ways to recover from it and prevent it from happening again.

Causes of Caregiver Burnout

Caregivers are often so busy caring for their loved one that they neglect to look after their own needs. As the stress piles up, emotional, physical and spiritual exhaustion build, frustration and despair take hold and burnout isn’t far behind.

Caregiving involves many stressors

Changes in the family dynamic – Role confusion can result when a caregiver is also spouse, child or friend.

Household disruption – You may not have time to do the things you’d like to do with or for your own family, or maybe you can’t entertain as you’d like because your dining room has become a sickroom.

Unrealistic expectations – It’s natural to expect your loyalty and hard work to be appreciated by the person you’re caring for and for it to have a positive effect on their happiness, but this isn’t always the case. Sometimes your expectations may be unrealistic if the patient is depressed themselves or perhaps suffering from a progressive disease like Parkinson’s or Alzheimer’s. Also, there are limits to what anyone can handle; you shouldn’t expect yourself to do it all.

There are also financial pressures, lack of control, lack of resources, and the sheer amount of work involved.

Preventing Caregiver Burn-out

Being able to cope with the strains and stresses of being a Caregiver is part of the art of Caregiving. In order to remain healthy so that we can continue to be Caregivers, we must be able to see our own limitations and learn to care for ourselves as well as others

Adopt healthy eating, exercising and sleeping habits. Research proves a healthy, well-rested body is better able to absorb the rigors of stressful times.

Be realistic about the situation and accept your feelings – Caregiving can trigger a host of difficult emotions, including anger, fear, resentment, guilt, helplessness, and grief.

Talk about it – Don’t bottle up your feelings. Caregiver support groups are invaluable, but trusted friends, co-workers, neighbors and family members can help too. Often, just talking about it can relieve the stress.

Maintain a sense of humor – Stuff happens; try to laugh it off.

Be flexible – Staying easy going will help you maintain your sanity.

Give yourself a break – Set realistic goals and accept that you may need to turn to others for help with some tasks. Enlist friends and family who live near you to run errands, bring a hot meal, or “sit with” the care receiver so you can take a well-deserved break. Caregiving is a job and respite is your earned right. Taking care of yourself is NOT a luxury, it’s an absolute necessity.

The Signs of Dementia

Dementia is a general term that describes a group of symptoms.

Dementia Overview

Dementia is a general term that describes a group of symptoms such as loss of memory, judgment, language and other intellectual function. It is caused by the permanent damage of the brain’s nerve cells. Causes of dementia include disease (Alzheimer’s is the most common), vascular destruction, trauma and alcohol. Clinical symptoms and progression of dementia vary depending on the type of disease and the location and number of damaged brain cells. Some types progress slowly over years while others may result in sudden loss of intellectual function. Experienced clinicians can accurately diagnose dementia 90% of the time. Accurate diagnosis is critical.

When forgetfulness could be dementia

Dementia is a loss of memory that worsens over time, but is also associated with personality changes and an inability to care for oneself. Normal forgetfulness has no effect on day-to-day activities or personality. In the early stages of dementia, memory changes can mimic normal forgetfulness, so dementia becomes apparent over time. Some memory loss – age-related memory impairment – can be normal as we get older, although this is by no means a universal experience. Unlike dementia, it can be helped by keeping the brain active. In dementia, the most recent memory tends to be the first to go, so sufferers remember childhood events but forget where they put their purse or why they went into a store. Dementia can cause disorientation, as well as personality changes. There can be mood swings and irritability plus an inability to concentrate or grasp new ideas. Self-care and personal hygiene can also be forgotten. A tendency to fall and unexplained weight loss may also be early signs of dementia. Memory problems are not always caused by dementia, so the earlier you see a GP, the more quickly these can be diagnosed. Depression can mimic dementia but resolves once treated.Other conditions such as hormone imbalance, vitamin deficiency and infections can also cause dementia-like symptoms. Certain medications slow the progression of dementia symptoms. Controversially, the medicines were previously not recommended until the disease was moderately advanced. This guidance from the National Institute for Clinical Excellence has now been reviewed and they say the drugs should be offered to those in the early stages of Alzheimer’s. Occupational therapy, physiotherapy, social services and voluntary support groups all have a role to play. Strategies to aid memory as well as exercise, reality orientation and cognitive stimulation have been proven to help.

Warning signs of Alzheimer’s

It’s hard to know to what extent memory loss is a normal part of aging. The Alzheimer’s Association says that memory loss that disrupts daily life is not a typical part of aging. It may be a symptom of Alzheimer’s Disease, a fatal brain disease that causes a slow decline in memory, thinking and reasoning skills. Every individual may experience one or more of these signs in different degrees. If you notice any of them, please see a doctor.

  • Memory loss that disrupts daily life:
    One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. What’s a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.
  • Challenges in planning or solving problems:
    Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. What’s a typical age-related change? Making occasional errors when balancing a checkbook.
  • Difficulty completing familiar tasks:
    People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. What’s a typical age-related change? Occasionally needing help to use the settings on a microwave or to record a television show.
  • Confusion with time or place:
    People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. What’s a typical age-related change? Getting confused about the day of the week but figuring it out later.
  • Trouble understanding visual images or special relationships:
    For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror. What’s a typical age-related change? Vision changes related to cataracts.
  • New problems with speaking or writing words:
    People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch” a “hand-clock”). What’s a typical age-related change? Sometimes having trouble finding the right word.
  • Misplacing things and losing the ability to retrace steps:
    A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. What’s a typical age-related change? Misplacing things from time to time, such as a pair of glasses or the remote control.
  • Decreased or poor judgement:
    People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. What’s a typical age-related change? Making a bad decision once in a while.
  • Withdrawal from work or social activities:
    A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. What’s a typical age-related change? Sometimes feeling weary of work, family and social obligations.
  • Changes in mood and personality:
    The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. What’s a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.


Again, if you think you notice any of these signs in your loved one, take him/her to a doctor. An accurate diagnosis is essential. Once you know what you are dealing with you can begin to get educated about it. Carolyn McIntyre’s article A Careful Look at the 3 Stages of Caregiving offers some interesting insights via her family’s experience.