With Help Here and There, Preserving Independence in Old Age

The following is an excerpt from an article in:


The New York Times
Tuesday, December 25, 2012

With Help Here and There, Preserving Independence in Old Age

By JANE E. BRODY

My 92-year-old aunt, who is cognitively impaired and requires a walker or wheelchair to get around, still lives in her own apartment, where round-the-clock home health aides help her get to and from the bathroom, bathe, dress and undress, and go outside each day for some fresh air. The aides shop, prepare and serve meals, do light housekeeping and make sure she takes her medications on time.

But last month, my aunt's long-term care insurance ran out, and her meager savings will soon do the same. Then what?

Her daughters, both of whom work to support their families, cannot afford the $150 a day for 24-hour care by a certified home health aide, and my aunt has nothing to sell that could bring in the needed cash. Nor does she yet qualify for Medicaid or have a terminal illness that would justify hospice care, which would be covered by Medicare.

Complicating matters, her daughters long ago promised that they would not put her in a nursing home.

Such dilemmas are increasingly common as people live longer. The number of Americans 65 and older is expected to double to 80 million in the next three decades. People 85 and older are the fastest-growing age group; by 2020, there will be 6.6 million people in that age bracket, when rates of debilitating ailments soar.

Most Americans over 65 will eventually need help with the so-called tasks of daily living - eating, dressing, bathing, shopping and the like. But with family members spread all over the map or unable to be full-time caregivers for other reasons, the need for new and better options will only increase.

When asked, 80 to 90 percent of older people say they want to remain in their own homes as long as possible. Yet remaining in one's home indefinitely is not always the best choice, even if it is financially feasible. As life draws near a close, many older adults need more care than can be provided safely at home. Simply finding reputable home health aides can be a nightmare, and family members often are forced to fill gaps in even the best caregiving plans.

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