Aging at Home: The 5 Stages of the Aging Process

Aging at Home: The 5 Stages of the Aging Process
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Aging doesn’t happen overnight. It’s a process. And during the aging process, 70% of people will need some form of long-term care as they experience age-related changes.

Obviously, that’s an incredibly high number. But what exactly does it mean? Will your parents or other older family members have to spend years in a nursing home? Deal with huge increases in health care costs during their lifetime? Will you?

Not necessarily.

Currently, the average life expectancy in the United States is about 78.93 years — or, essentially, 79 years. And as of 2017, men in the U.S. had a life expectancy of 76.1 years, and women had a life expectancy of 78.6 years.

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Of course, everyone’s life span is different. But just based on those averages, most people have at least a decade of life left from the time they hit 65. And as we all know, quite a few people live to be much, much longer. Life expectancy does not necessarily equate to a need for long-term care, though.

What Is the Normal Aging Process?

The truth is that there is no “normal aging”. Or at least not a rigid set of events that always happens. The aging process is complicated, confusing, and different for everybody. 

Almost everyone will go through age-related changes and need more help as they go through the “normal” aging process. But what that looks like in any given situation varies. No one can predict exactly what level of care will be needed in your parent’s old age. Or when one activity of daily living or another will start to become too strenuous. 

To make things even more complicated, there are many age-related changes that can potentially occur. A number of people will experience cognitive problems towards the end of their life span. 

Many older adults will find it more difficult to engage in physical activity — especially specific types of activities. Some may withdraw emotionally — particularly as they suffer the loss of older friends, family members, or their partner.

Just as frustrating — and scary — is that you can’t really predict when care will be needed for your parent. Or how quickly. Or how long. Some people are completely functional one day and need extensive health care the next. Others go through a long, slow, gradual decline in their old age. And then there are those who go back and forth. Typically due to a serious accident or illness.

Basically, anything can happen. A medical emergency. The onset of dementia or Alzheimer’s disease. A previously undiagnosed condition. The possibilities are endless.

Does That Mean Assisted Living or a Nursing Home Is Inevitable?

Here’s the good news. Regardless of how it happens for your family member, you may not need to turn to the expensive and often disorienting prospect of moving mom and dad into a long-term care facility in their old age.

What’s the alternative? Getting longevity out of their own home — or yours. How so?

While not for everyone, in many cases it’s quite possible to modify a current home to make healthy aging at home possible for your loved ones throughout their life span. To help them maintain their quality of life even as they naturally decline.

You just have to initiate age-related changes to the space. Changes that ensure it’s safe based on their current stage in the normal aging process… and (here’s where the longevity comes in) where they’re likely to be in the future.

What Are the Stages of Aging?

Unfortunately, what constitutes “old age” is not as defined as it is for, say, child development. 

However, experts generally break down aging in older adults into five basic stages:

  • Independence
  • Interdependence 
  • Dependency
  • Crisis management 
  • End of life

What does each one look like? How do they impact your parent’s or other family member’s ability to live at home?

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Independence (AKA, They Really Don’t Need Help)

The vast majority of older adults choose to stay in their own home during this stage of the normal aging process because, quite simply, they can. 

During this stage of independent living, seniors can handle pretty much all of their needs and affairs on their own. This includes transportation, finances, health care needs, and more. No common activity of daily living should be too taxing. Mental and physical activity may experience a minor decline, but not enough to impact their lives.

Basically, age-related changes are minimal. They’re likely in good health. They’re self-sufficient and able to handle their own errands. And their quality of life is typically quite high.

If you looked at the aging process by decade, independence would include mostly people up to their 60s and 70s. With a smaller number of lucky seniors in their 80s — or even older!

While those in this group may not need help, this is a good time to sit down with them to talk. Evaluate their living situation. Plan for the future. And make any changes that seem necessary.

Take note of any existing medical issues that may be a risk factor and get worse with age, such as cardiovascular disease, heart disease, obesity, and high blood pressure.

The earlier you make plans for healthy aging at home, the better.

Interdependence (AKA, They Won’t Think They Need Help)

Mom and dad will likely start to find it more difficult to handle certain everyday tasks during this stage as age-related changes speed up. Even if they don’t want to admit it. 

Physical activity will be more straining. Mental tasks may be more taxing. You might notice them forgetting things more frequently.

They’ll still be able to do many things on their own. But typically not all. And their quality of life will suffer if they don’t get some kind of help.

An interdependent senior may need a caregiver to handle a specific activity of daily living (or several), such as driving, mowing the lawn, or paying bills. Or they might be able to do everything just fine… but slower. Seniors in this situation may benefit from a few hours of help each week to maintain their lifestyle. 

This is a complicated period in the normal aging process. Both because older people tend to be resistant to the notion of needing help… and because professional caregiver agencies tend to have minimum hour requirements that the senior may not need yet.

Those in this stage are typically between 70 and 80 years of age.

If an interdependent person has a more able spouse, relatives, or friends, typically these people can provide all the help needed at the interdependent stage to allow for healthy aging at home to continue.

During this stage, it’s important to ensure they continue to stay on top of their medicine for existing medical conditions, such as heart disease, cardiovascular disease, and high blood pressure. And seek medical intervention if needed.

Another thing to really watch for in this stage: dementia, Alzheimer’s disease, memory loss, and other types of cognitive decline. Often, a senior won’t realize they have dementia, Alzheimer’s, or changes in their cognition. Or they may not want to admit it. They may even appear normal and fully functional for the vast majority of the time. 

Worse, if they don’t notice or remember experiencing bouts of dementia or Alzheimer’s, they may fight you on trying to get them more help and even believe you’re lying to them.

This one is always tough for everyone involved. And it’s a sure sign that you’ve moved at least into the Dependency stage — and possibly all the way to Crisis Management.

Dependency (AKA, They Need a Moderate-to-High Amount of Help)

By this stage of old age, you’ll likely find that your aging loved ones have trouble handling quite a few everyday tasks by themselves as age-related changes kick into overdrive. 

Worse, many start to struggle more with both mental and physical activity. And it may be hard (or even dangerous!) for them to drive or travel to places alone, making healthy aging at home harder but still very possible.

A number of seniors find themselves in this stage by their late 70s and beyond. But some may enter it earlier.

This is the stage when most people start to need more significant assistance and their quality of life dips dramatically. Dependent seniors often require moderate help from a healthcare provider. This can include managing medication, regularly monitoring their physical condition, or having someone to prepare meals to help them maintain a healthy weight.

Some elderly people get this support by moving into an assisted living facility. And in certain cases, this may be the best route to ensure your loved one gets the medical care they need.

However, there’s an alternative. While it doesn’t work in every situation, for many families, it can be cheaper and easier to manage their aging loved ones at home. By making modifications to your own home or your parents’ home and/or hiring outside support that bolsters the ability to age in place, such as:

  • Emergency medical alert and health monitoring systems
  • Medication management solutions
  • Caregivers and companion care
  • Nutrition and meal planning
  • Housekeeping and laundry
  • Transportation

It should go without saying that you also need to keep a close eye on your family member for signs of dementia and Alzheimer’s disease during this part of the normal aging process. While every situation is different, those who suffer from these types of conditions may need additional care that a licensed senior facility will be better able to provide if proper supervision at home isn’t possible.

Crisis Management and End of Life (AKA, Medical Help Is Necessary)

By the time the vast majority of people reach these last two stages of the normal aging process — crisis management and end of life  —  they need more or less round-the-clock care. And possibly quick access to more robust health care facilities. Because of this, they tend to be in assisted living facilities, nursing homes, or even hospice care.

Just like the dependency stage, many seniors reach these last two starting in their late 70s. However, some may find themselves here earlier. While others might not enter it until much later in their life span.

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The Aging Process: How to Enable Your Loved One to Age In Place

What can you do to reduce the chances that your parents or other aging loved ones will have to live in a long-term care facility in their old age and lower their quality of life? 

It’s a two-fold process. And both things involve thinking about longevity:

  1. Engage them in the process of changing their habits and learning new things that will help them — even as they decline.
  2. Change the environment itself, and how they are able to get support in general.

Changing Habits and Learning New Things

What does this mean? Essentially, that you need to get your parents to acknowledge the fact that they’re getting older. That there are things that they must do differently if they want to stay in their own home (or yours) for as long as they possibly can.

Part of that is getting them to ask for help when they need it. But the other part is having them do what they can to stay healthy (both mentally and physically). So they can continue aging at home by remaining independent for as long as possible — and in as many ways as possible. Getting them to think about and plan for their longevity.

To that end, they should make some age-related changes that can improve their life rather than detracting from it. These include actively working on:

  • improving their diet 
  • engaging in age-appropriate exercises 
  • keeping regular medical appointments 
  • participating in activities designed to sharpen their minds

Related to that last one, it can be incredibly helpful if you can get them to attain a bit of tech savvy. Don’t worry, they don’t have to start designing apps or anything! 

But if your parents are at least able to learn how to navigate their smartphone, it can make a huge difference. Both in keeping them connected and easing the burden of lots of everyday tasks. For one example, they could start ordering their groceries online and having them delivered.

Some kind of physical activity, too, is vital at this stage to slow down the body’s natural decline. Unless they’re overweight, the goal should largely be to maintain their current condition with light physical activity that keeps them active and their muscles engaged.

All of these changes serve to keep them self-sufficient longer and minimize the outside help needed to maintain their quality of life.

Modifying the Environment and How Tasks Are Accomplished

This second part of the process to improve their chances of healthy aging at home involves making age-related changes to their living space. To make it safer and to set up systems or a plan for outside help.

“Outside help” could mean a cleaning service. Or a home health aide. Or creating a schedule for who in the family will drive them to various appointments. Whatever activity of daily living they need help with, you need to account for it.

The hardest part of this is the possibility that your parents may put up some kind of fight. Because allowing someone else to help them with tasks they could previously do on their own means they have to give up some of their independence. Something no one wants.

Changing their own home will probably go over better in an emotional sense. Especially when they realize that:

  1. It can be done in a way that doesn’t feel clinical.
  2. It will allow them to continue aging at home for longer.

Essentially, you’ll make modifications to their living space with the specific goal of helping them age in place, of planning for their longevity. 

However, if you approach the topic in the right way, you can sell the changes as quality of life improvements. Helping them complete the normal activities of daily life faster, easier, and more efficiently.

A certified aging in place specialist can help guide you in terms of what changes need to be made to the physical property. As well as what services you may need to line up as they age. That way, your family member can thrive in place for the long-term.

Generally speaking, you want to plan age-related changes based on both the current stage your loved one is at and where they will likely be in the future. For example, even those in the Independence stage can benefit from upgrades like changing door knobs into lever-style handles that are easier to turn.

Likewise, you can:

  • upgrade the flooring to minimize the risk of falls,
  • add touchless faucets,
  • widen hallways,
  • improve lighting, and
  • upgrade the home’s smart technology to make things controllable with the touch of a button.

All of these things make the normal aging process easier by reducing the amount of physical activity your parents will have to engage in. But they can also benefit anyone in the space (a quality of life enhancement) and improve the home’s resale value.

Later-stage improvements should include updates like:

  • grab bars,
  • shower chairs,
  • walk-in showers,
  • and so on.

If your family member is amenable (and you can afford it), it’s best to make all of these modifications at once. However, they can be done in stages as well.

Those who decide to make these age-related changes to their own home and move their aging parents in will get even more longevity out of the decision. Because when they begin to decline, their home will already be ready for them.

Again, it’s important to acknowledge that even these types of changes may not be enough for some people. Even with aging in place improvements, some seniors struggle so much that they need the additional support of a long-term care facility. Others may be fine for a while, only to decline faster than expected to the point where they can no longer age in place.

It’s different for everyone.

However, the earlier you make aging in place changes and improvements, the higher the chance that your loved one will be able to remain at home for longer.

Our Local Solution Providers can help you and your family make confident decisions to live in place safely.

Why Should You Consider Helping Your Loved One to Age In Place?

There are all kinds of reasons why enabling your aging parents to live in place is a better option than moving them into an assisted living facility or nursing home unless you absolutely have to do so.

Cost

Does it seem crass to be talking about cost when it’s about making sure your parents get the best possible care? Only if you assume going to a long-term care facility will get them better care.

We’ll get into that more in a bit. But first let’s talk about real numbers. So you know what you’re dealing with.

You might think that paying for all those home improvements sounds prohibitively expensive. But if you compare it to the cost of a long-term care facility, there’s a huge difference.

How huge?

Nationally, the average price to modify a home so someone can age in place is about $10,000. In contrast, the annual cost of a typical assisted living facility is $50,000.

Plus, aging in place modifications are an investment. And they can significantly increase the resale value of a home. Additionally, there are organizations, services, and breaks you might qualify for that can help to reduce the price.

Moreover, as we’ll detail below, the help seniors receive in long-term care facilities isn’t necessarily the best thing for them in terms of their quality of life.

Comfort and Familiarity

If your family member is forced to move to an assisted living or nursing facility, it means leaving behind everything they know. Losing their privacy and independence.

They may even have to share their room with someone else. And they’ll almost certainly have set meal times and find their life controlled in other ways.

Many seniors end up feeling disoriented. And even depressed.

Aging at home means familiar surroundings. Familiar routines. More control over what they do and how they live. Going through the aging process is hard enough without having to give that up.

Mental Health and Social Connection

Studies have shown that seniors who maintain strong social connections slow their cognitive decline by 70 percent as compared to those who feel alone and isolated. Which can extend their life span in addition to bolstering their quality of life.

Now, you might think this is an argument for long-term care facilities. But often when older people move away from long-time neighborhoods and contacts to a new place, they end up feeling more alone. Even if they actually have an increased number of people around. 

What matters is social engagement. Are they interacting with others regularly? Do they feel connected to those people?

Likewise, environment factors should be considered. Staying in familiar surroundings can help to trigger memories. Which can also enable seniors to remain connected cognitively and increase life expectancy.

COVID-19 and other illnesses

We’ve been inundated with stories of COVID-19 spreading like wildfire through long-term care facilities. Of people not being allowed to see their loved ones for months at a time. Some facilities have even been caught lying about the number of cases and deaths they’ve suffered.

Quite simply, it’s a terrifying time to have a family member in a long-term care facility. 

But even before COVID turned everything upside down, a shockingly high percentage of facilities around the country had received poor marks for their ability to contain and manage viral outbreaks. Because assisted living facilities and nursing homes are like petri dishes where viruses and bacteria breed.

Not something you want for mom and dad if you can help it.

The bottom line? For many seniors, aging in place is just a better alternative. And it usually offers both the elder and their adult children greater peace of mind. 

Even better? You may be surprised by how attainable it is. No matter where in the normal aging process your loved one is at, there are likely things you can do to upgrade their space — or yours. So they don’t have to move into a senior community. And the earlier you start the process, the better it will likely be for both you and them.

Want to learn how we can help? Get in touch with Live in Place Designs today.

The founder of Live in Place Designs LLC, Lori Bellport is a Certified Aging in Place Specialist (CAPS), a Senior Home Safety Specialist, and a Certified Senior Advisor. Lori and her team believe that, regardless of the limiting health conditions one may face, there is no need to lose contact with life, spontaneity, or the ability to self-renew and enjoy life.

Author: Lori Bellport

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