Client Education

Housting Options

There's No Place Like Home

By: Margaret N. Gallos, Special to AccentCare

Travel to Paris. Spend a few days with an old friend. Still, it's good to put your feet up on your own couch. We say children need the stability and nurturing of home. We spend middle age improving our home's comfort and attractiveness. Is home wrong for us, then, when we get older?

Elderly Americans don't think so. For them, home means:

• Security
• Familiarity
• Family and friends
• Favorite activities
• Privacy
• Individuality

According to a report in "Understanding Senior Housing: An American Association of Retired Persons Survey of Consumer Preferences, Concerns and Needs," 70 percent of the elderly wish to stay in their own homes. A 1996 Gallup poll revealed that nearly nine out of 10 American adults would prefer to be taken care of in their own homes or the home of a family member rather than a hospital, nursing home or similar facility if they had a terminal illness.

Less than 1 percent of America's 35.5 million elderly live in congregate or group housing, one researcher found. About 1.5 million live in nursing homes. Ten percent to 50 percent of those in nursing homes are there because of inadequate local home-based care services, according to Joseph F. Coughlin, writing in the fall 1999 edition of Issues in Science and Technology. Coughlin leads the Age Lab, an initiative on technology and aging at the Massachusetts Institute of Technology.

Older people place independence high on their lists and have "a strong predilection for self-reliance and autonomy," according to an article written by Neal Krause, a professor in the school of public health and a senior research scientist at the Institute of Gerontology at the University of Michigan.

Barbara Allen, 70, is one of them. Her husband, Touffie, died in December and she has no plans to move.

"I'm just too independent, and Touffie loved this house. It's possible I'll feel differently in a year. Still, I think I'd rather not move," she explains.

A widow since 1992, Ceil Beidelman, 75, has stayed in the house she and her husband, Bill, bought in 1960 when their sons were young. "I have lots of memories here," she says. "I like the independence. I own the home. I come and go as I please."

Lois Wismer's mother, Frances Mount, is 67, blind and in a wheelchair. She has lived with her daughter's family for seven years. After a fall, she spent three months in a nursing home. She made friends, and staff looked after her kindly, but still Frances was glad to return home.

"They made me feel at home, but not like in your own home," she says now.

The elderly, especially Alzheimer's sufferers, need the familiarity of home, says Carol Marshall-Shoup, director of Care Coordination for AccentCare. There, they can freely pursue hobbies and interests.

For example, one elderly pair who are clients of a home-care agency love fine dining, but the husband suffered a stroke and the wife broke her hip, which makes it difficult for them to go out. They have two homes they love, one in New Mexico and another in Colorado, but need assistance with traveling and meals. The agency arranged escort and transportation between the two homes and hired a service that delivers full, nutritionally sound meals, from soup to dessert, prepared according to the couple's personal tastes.

Frances Mount listens to oldies, lifts weights and calls her sister often, and she is a lifelong cat owner who currently enjoys the company of a pudgy feline named Blackie. Barbara Allen reads for long stretches. When she feels social, there's a wide network of old friends and family nearby. Ceil Beidelman works in her garden and is very active in her church's seniors club.

The three women care about these activities; they are interests established over a lifetime and reflect each woman's individuality. Residents of an assisted living facility or a nursing home may engage in activities that are pleasant, but they do not necessarily reflect personal choice. And that can be a key factor in well-being.

"Engaging in a large number of activities was not found to ensure well-being and may in fact be detrimental to well-being if engaged in simply to pass the time," according to research from the Journal of Applied Gerontology.

Many older people value the company of a variety of ages. "I missed my grandchildren at the nursing home," Frances recalls.

It's just easier to have a relaxed visit with the grandchildren in the living room, says Marshall-Shoup. Older University of Kentucky students interviewed by researcher Deb Danner reported that younger scholars made them feel younger.

"Elderly people prefer their homes for the same reason you or I do. A nursing home is institutional, even the fanciest ones. Your privacy is severely limited. If you are not suffering from dementia, it can be demoralizing to be around people who are," says Dr. Elizabeth Liebson, a geriatric psychiatrist at Tufts University.

Research has shown that seniors benefit health-wise when they're in their own homes. The National Association for Attendant & Personal Care, a trade association that backs the notion of Americans receiving care in their own homes when it's possible, reports on a study of how intensive attendant & personal care monitoring affects the death rates of elderly patients with congestive heart failure. With "intensive home surveillance," the total hospital admission rate fell from 3.2 to 1.2 per year per person and the length of stay went from 26 days to six. Cardiovascular admissions fell from 2.9 to 0.8 per year per person, and the length of stay fell from 23 to just four days per year.

"Several studies demonstrate that people heal more quickly in familiar surroundings," says Tim Brown of the NAHC. "Happy people have happy cells." There's also a dimension of attendant & personal care that's harder to measure, but just as important.

Lois Wismer noticed her young daughter was far more at ease than other Brownies when her troop visited a nursing home. Being involved with her elderly grandmother has been a good lesson for the 9-year-old, Lois says. In fact, she says, "Both my children understand more about taking care of people."

"The best argument for attendant & personal care," states one NAHC publication, "is that it is a humane and compassionate way to deliver health care and supportive services."

Margaret N. Gallos is a writer and editor based in Milford, N.J.