Many aging people decide to stay within their home’s familiar surroundings and keep their independence for as long as possible. Nevertheless, many aging adults need some sort of assistance with activities of daily living (ADLs). Many of them also have injuries or health conditions that require day-to-day medical care. (See What are the 5 ADL’s)

Although aging doesn’t have to be a reason for hiring home care or relocation to a nursing home, nearly half of all people aged 85 or older have some dementia or other medical conditions or injuries that require constant support with medical and personal care. Many seniors even over 60 depend at least somewhat on others for medical care and help with ADLs.

Still, many people are resistant to the idea of leaving their home and moving to a nursing home or retirement community. If you want to age in place, home care may be the best option.

What Are ADLs For Elderly Care?

The 5 ADLs (Activities of Daily Living) involve basic self-care routines that we perform every day. These involve:

• Personal hygiene – bathing, washing hands, washing hair, grooming, oral, and nail care
• Feeding – the ability to feed oneself
• Dressing – the ability to choose and wear the proper clothes 
• Toileting – the ability to properly use the bathroom 
• Transferring – the ability to change positions and walk independently. 

What Do ADLs Involve?

Activities of daily living, or ADLs, involve routine self-care activities that most people perform independently. But, people with chronic illnesses, injuries, or dementia typically need everyday assistance with necessary activities of daily living.

Activities of daily living are essential in a person’s day-to-day life because they involve using the bathroom, dressing, preparing meals, taking prescribed medications, etc.

Persons who cannot perform activities of daily living independently often benefit from a move to a nursing home or an assisted living facility.

If you want to age at home but cannot perform activities of daily living independently, you might be eligible to receive assistance with your ADLs from in-home caregivers.

Suppose you have an aging parent who needs help with some of their ADLs. In that case, you may hire a licensed in-home caregiver who will provide assistance with activities of daily living such as bathing, grooming, dressing, shopping, etc. therefore supporting your parent’s independent living for as long as possible. Most in-home caregivers are state-certified nurse aids whose services may be covered by your parent’s health insurance (depending on your parent’s health care policy).

Nevertheless, if your aging parent with dementia or other chronic illness can only perform a few if any, daily living activities, you might have to transition him or her to a nursing home.
Nursing homes have teams of physicians, nurses, and health aides who provide around-the-clock care and supervision.

What Is In-Home Care?

Home care is non-medical care that involves providing supervisory care, helping the person who receives care with their activities of daily living.

Home care services may include assistance with day-to-day activities such as cleaning and other chores and helping with daily activities, such as bathing, eating, and dressing. It may also include monitoring a person’s medication routine, assistance with cooking, and transportation.

You can receive almost any type of care in your home. If you are looking for home care for an elderly parent, inquire with your local and state offices of aging and social services about these services’ costs.

Your loved one with dementia or other debilitating health condition may also receive home health care.

Home health care involves various health care services that patients receive at their homes for an illness or injury. While home health care’s primary goal is to help the patient with a disease or injury, it also helps the aging person live independently as long as possible. Medicare covers the costs of home health care for eligible patients.

Medicare covers services that include therapy, intermittent skilled nursing care, and care provided by a home health aide to people who are entirely confined to their homes (homebound). These services involve medical care and help with medications and medical equipment.

If aging in place is essential to you or your elderly parent, daily living activities may still be a concern. Safety, getting around, hosing, and personal care may be challenging if you live alone. You should consider getting home care services if you struggle with daily living activities, such as personal care, household chores, meals, health care, and money management.

• Personal Care

If you need help with washing your hair, bathing, toileting, or dressing, you might hire a trained home care aide to assist you with these activities daily.

• Household Chores

People who cannot handle laundry, housecleaning, grocery shopping, and meal preparation on their own anymore often opt for home care services and have a caregiver help them with these activities each day.
However, if your loved one has dementia, he or she may not recognize objects or know how to handle them, or not understand how to do something so that they might need different levels of assistance with ADLs.

• Meals

You may have difficulties planning and preparing meals or shopping and storing groceries. This may be an issue if you live alone or have no one to help you. Home care services cover this aspect of daily living, helping you shop for groceries, and preparing nutritious meals every day.

• Health Care

Although home care is not the same as home health care (medical care in-home), home care aides help with medication management and doctor’s appointments. If you forget to take your medications, have just gotten out of the hospital, and still need nursing care for a short time, the hospital discharge planner can help you make arrangements for home health care.

• Getting Around

If you are having trouble walking or getting around in-home and in town, consider getting a walker or an electric chair. Medicare sometimes covers these aids. Also, if you need someone to do shopping or accompany you on a visit to your doctor, check out for volunteers and other resources in your community.

• Money Management

If you worry about paying bills late, forgetting to pay them, or struggling to understand health insurance forms, you may get help with these tasks. If you don’t have a trusted family member or a relative to lend a hand, you may hire a financial counselor or geriatric care manager to help.

You may want to contact your local Agency of Aging for referral, though, to avoid money scams.

How to Ensure Safety at Home

Aging in place raises specific safety concerns. Home modifications allow many seniors to age at home and keep up their independence safely.

To improve safety at home, clear your house. Make sure to remove any unnecessary furniture or clutter from your home. Ensure that the pathways around your home are clear and make your home easily accessible.

Update or remodel your bathroom (for example, install a walk-in tub, or put up railings and grab bars to provide stability and safety) to make it a comfortable and safe as your needs change.
Ensure that there is home access in every room you use and make your house brighter to see your surroundings clearer and enhance your mood.

See 11 Home Safety Tips for Elderly Seniors Living at Home

About Nursing Homes

If your aging parent cannot perform most of (if any) of ADLs, it might be time to start thinking about alternate care, like home care or a nursing home.

More than a third of Americans age 65 and older move to a nursing home or other care facility because they cannot perform ADLs for themselves.

A nursing home is a residential care facility where care and assistance are available 24 hours a day. Most nursing homes provide a range of services and have skilled nurses and licensed nursing aides on hand 24/7.

Also, federal and state regulations in the United States require that a doctor routinely visits the residents living in a nursing home to assess their health status and supervise their care plan.

You may want to consider relocating your loved one to a nursing home or getting 24 hour home care when they:

• Begin to wander frequently
• Become negligent to their bathing and toileting needs
• Feel frequently agitated
• Has severely impaired memory
• Sleep poorly at night
• Cannot perform most of the ADLs

What Types of Nursing Homes Are There?

While some nursing homes try to resemble homes, others are set up like hospitals with medical staff, occupational, physical, and speech therapy. Homelike nursing homes usually don’t stick to a fixed daily schedule, and staff members are allowed and encouraged to develop relationships with residents. Some nursing homes allow aging couples to live together. Some nursing homes have select care units for people with dementia.
There are a variety of services that nursing homes provide, so ensure to choose the right facility depending on your loved one’s needs. You can opt for:

• Intermediate nursing care – provides health-related care such as medication management
• Skilled nursing care – provides 24-hour professional nurse care for both short-term and long-term stays
• Subacute nursing care – offer services that cover more intense monitoring or therapy that nursing homes typically offer and is intended for short-term stays.

The main benefit of nursing homes is a variety of professionals that are available 24 hours a day. These facilities have security and staff available around the clock, so they provide a safe environment for persons with Alzheimer’s or other types of dementia who might be likely to wander.

However, many people feel that nursing homes remove their independence and require some transition period before they start feeling comfortable. This transition can be stressful, triggering anxiety and depression, and worsening the person’s already impaired health.

Also, high-quality nursing facilities are often costly.

How to Choose the Best Nursing Home?

Here are some things to consider when choosing a nursing home facility for your loved one:

• Is the specific nursing home Medicare certified (passed an inspection conducted by a state government agency)?
• Is the nursing home licensed in your state?
• Are there resident policies my loved one must follow?
• Will my loved one still be able to see their doctor?
• Does the staff treat residents friendly and with respect?
• Does the nursing home have policies of prohibiting and reporting neglect and abuse?
• Does the nursing home run background check to ensure they don’t hire staff with a history of neglect or mistreatment of residents?
• How does the nursing home respond to concerns about the abuse that are reported?
• Does the nursing home look clean?
• Are residents clean, well-groomed, and appropriately dressed?
• Does the nursing home have a pleasant temperature and good lighting?
• Are exits from the nursing home adequately marked?
• Does the nursing home have smoke detectors?
• Are all the areas of the nursing home wheelchair-accessible?
• Are there grab bars and handrails in all bathrooms and hallways?
• Is the furniture in the nursing home comfortable?
• Does the nursing home provide for special dietary needs and nutritious snacks?
• Does the staff assist the residents in eating and drinking?
• Is there a licensed nursing staff available 24/7?
• Can residents keep their personal belongings in their rooms?
• Is there access to the internet, phone, or television?
• What activities are available to residents?
• Are there outdoor areas in the nursing home for residents to use?
• Are visitors allowed at any time?
• Is there cultural or religious support provided at the nursing home?
• Does the nursing home have a particular unit for patients with dementia?
• Does the nursing home have policies and procedures related to the care of patients with dementia?

The Benefits of Home Care

The decision between home care and a nursing home is up to you and your family. However, home care allows you or your loved one to remain in their home and age in place. In other words, home care allows for more privacy and provides your aging parent with the opportunity to stay in comfortable and familiar surroundings.

In-home care also offers a more personal, one-on-one relationship between a patient and a caregiver and allows a senior to remain as independent as possible.
Research shows that people recover faster at home than in a hospital.

Home health care provides comfort, convenience, and safety, allowing them to stick to their routines in familiar surroundings.

Finally, home care is often less expensive than care in nursing homes.