Tuesday, March 04, 2008

Living In Place

Independent Living Option

Healthcare System Need

Living In Place is my retirement plan, if the support system I need is present and my circumstances are such that I am able to enjoy living independently in my home, or smaller private living quarters for my remaining years. The Los Angeles Times regular weekly Health Section attracted my attention this Monday, March 3, 2008 when I saw the front page titled "Not leaving home -- Older Americans want to live out their days in familiar comfort. Increasingly, they can" by Shari Roan. This is what I want to know about. What support systems are available now? What services are available? I certainly hope there's more support available than twenty years ago when I was trying to fulfill my mother's desire to live independently in place.

I was even more interested in reading this section of my paper when I discovered Shari had written additional articles in that section, "A network of helping hands," one called "Health tactics that pay off," another "Older caregivers help make up for shortage of home aides," and "Resources for those aging in place." I've found these articles quite informative and would urge anyone who is interested in living independently in their own living accommodations, whether an apartment, town house, condominium, or house, read these articles. You can access some of them by clicking the links on their titles including this "Guide to Retirement Living" with independent living reference.

Following is a brief summary of her front page article I mentioned above, "Not leaving home..." This article offers some dollars and cents figures for comparison purposes of costs for living in settings other than home and that of some supplemental services costs that would be incurred should an individual choose to remain in their home.

The more aging data, informative specifics I can gather the better. Some of us may be quite familiar with some of the figures and additional elder issues from ongoing aging articles by other bloggers, especially Ronni Bennett at "Times Goes By." (An increasing number of bloggers and readers have come to refer there as a primary source for current overall aging information.)

I think Shari Roan's articles are definitely of interest to bloggers and newspaper readers (older folks, their children, caregivers desiring to offer services.) She provides cost of care dollar amounts obtained from MetLife, AARP for accommodations in more institutional type settings ranging from the

* "Average national cost per year of private-room nursing home care: $77,745* (*100,000in Southern California)" to

* "Average national base rate per year of assisted-living care: $35,628** (**As much as several hundred dollars a month may be added for..."special services of fairly routine need by many i.e. diabetics and others she describes.

She discloses details about costs associated with home health aide care for one hour per day with a base of $6,916 per year, but notes additional costs with additional services you can read about in her article.

A possibility for living independently in place on which she focuses in her article is described with the acronym "LIFE : started in 2005 as a federally funded pilot project designed to see if such communities -- called naturally occurring retirement communities...could help people remain in place as they age. Loosely defined, the communities are neighborhoods in which a large segment of the residents are older adults."

The program Shari Roan describes is located in Park La Brea where more than 500 residents are 60 and older. She says they have developed a unique network of volunteers to facilitate continued success of LIFE (Living Independently in a Friendly Environment.) "Susan Alexman, director of senior services for Jewish Family Service of Los Angeles, which operates the LIFE program..." says, "You know the saying, 'It takes a village to raise a child'? Well, it takes a community to support an older adult."

Most exciting to me is Roan's report "About 80 supportive services programs have sprung up in naturally occurring retirement communities in recent years in the United States" with "about half...funded by Congress as pilot projects" according to Peter Notarstefano, director of home and communities-based services for the American Assn. of Homes and Services for the Aging in Washington, D.C. Roan reports other Southern California elderly programs, mentioning one of the first in the Beacon Hill neighborhood in Boston in 2000 as examples of nonprofit corporations but the latter "operates with annual membership fees that give people preferred access to vendors who have been pre-screened." She says some programs "are springing up in affluent areas of the country that operate with dues paid by members."

The subject of independent living for elders has been close to my heart since the 1980s when my mother expressed the desire to continue living on her own through her elder years. My mother had lived independently for many years, coping quite competently with being legally blind, remaining active in her community with no other family members there. Eventually my family settled in California, and she came to visit. Previously, she and I had periodically considered the pros and cons of her moving closer to me. For the first time when we talked of living so far apart I could hear her increased uncertainty, hesitations about the desirability of having so many miles separate us.

She was reluctant, but I suggested we explore various types of accommodations for her consideration, just to see what might be available. Serendipitously we located living accommodations that pleased her and proved to be quite ideal for many years. As her needs gradually grew, we also discovered the challenges facing elders trying to remain independent living in place, a loved ones difficulty in meeting the need to provide increasing care and the stresses to obtain the necessary assistance to supplement what family and friends could offer.

I am aware that locally many more services are available now and I can only wish that had been so when my mother was living. Some in the U.S. and other countries may have systems in place to more readily facilitate living in place. Other people may have a serious need for more services. I am very interested in knowing what options and services exist elsewhere for possible integration into some sort of overall plan beneficial to all elders who desire to live in place. Surely, whatever health care plan any system change in our country brings should incorporate provisions enabling elders the option of independent living in place.


  1. I hope to live in place as long as I can. There are those who think I should move to an elders' apartment building but for various reasons, I would rather not.

  2. I've never met anyone who wants to go into a retirement home, and so I always wonder about why I feel so differently: every retirement home I've visited, and that's three, with my having visited two out of the three frequently over many years - I've wanted to get on the waiting list so my husband and I can move in, in ten or so years. My husband, on the other hand, feels like everyone else: he doesn't like the idea of congregate housing, retirement communities, etc. He wants to live independently, just as he always has. Perhaps the Living in Place could be the best of both.

  3. I think we all want to live independently for as long as possible. I want to be able to live out my days in my present home; but I never assume anything. One of the things I fear the most is not being able get around well or be able to take care of myself....the same thing that I think we all fear. My mother lived in an elder community for a long time...and it really did serve her well for the most part. I can't imagine being anywhere other than where I am right now.

  4. The living in place plans described here are an attempt to meet the different needs of elders at various income levels who want to live independently, but begin to require some help. Some of these services may be available through a cities Senior Services, so a coordination would be in order. I learned tonight my city Aging Committee leaders are examining just that now. Some will want and be able to afford paying for lots of extra services. Others will not. With a large group within a concentrated geographic area, i.e. apts., a neighborhood within a city, elders would be volunteer participants based on what services they are willing to provide in return for some they'll receive from others (that's what the La Brea group members do.) Beacon Hill sets up fees for services.

  5. Croak plans. I'm just not ready yet to go there.

    I'm glad others, like you, are checking all this out.

  6. h.a.page: Understand your reluctance to talk of "croak plans," but this is all about those many years BEFORE we croak. Takes years to get systems into place to provide arrangements we might desire when the time comes. Will be too late to wait until then.

    Also, hopefully, health care plan changes are in the offing and I want to see them inclusive of provisions that allow monies for living in place, not just money for nursing homes, and the variety of modified institutional settings currently being devised. Best to have such a feature in any new adopted plan -- much harder to add and change once whatever the system might be is in place.

  7. About five years ago my mother moved to assisted living, and then three years later to a nursing home where she will remain. It was her and our only choice under the circumstances since her "little house" had steps to get in and out and also up and down inside.

    Five years later she complains about two things to everyone that will listen: loss of car (freedom) and loss of her "little house" (comfort, independence, dignity).

    I do not have a good feeling that elder care and support systems will receive much more than lip service by Congress in the future. They have to make a lot of noise about it, but they will all have their own projects and priorities. How close we come to actually doing something positive in this area and in the larger category of health care, depends heavily on which party ends up in the White House, since it will be the new President's administration that must support and push the legislation.

  8. Winston: Your Mom's complaints are the ones I've always heard the most from elders, too.

    I agree that the potential for emphasis on continuing even greater expansion on transferring existing funding to enable individuals who want to do so to "live in place" (in their homes) "...depends heavily on which party ends up in the White House..."

    I just think voices, and written words from those who desire this kind of option to seek more pronounced public attention as part of any health care plan changes.

  9. I surely want to stay right where I am till it is ALL over! That is definitely my preference and in truth, I see no point in anything else. This is my home and I love it and to have to be some place else is just NOT an option. End of story.

    FYI: What you said about all that Advertisng that I can see, is true....I don't have much of a choice about it so, I had to make some kind of an adjustment or it would drive me batty....lol!

  10. I do want to stay independent for as long as possible. Several of my friends and I often talk about our "Golden Girls" plan for some sort of co-living or shared living space. This would not include nursing, but would be a general support system for a lot of single women.

  11. Yes, oldoldladyofthehills, having you be able to continue in your home is precisely what I'd like to see those who want to, be able to do. Govt. funds reimbursing nursing homes, other care levels could enable some who might not otherwise be able to do so, stay in their home.

    Virginia: that "co-living or shared living space" works well as a Living In Place arrangement with each volunteering as mutually agreed. Should there be needs requiring outside assistance i.e. health needs changing, instead of having to leave for institutional type help, likely a much smaller portion of the fee an institution, even retirement community might recive, would instead reimburse for help at home.