The long-accepted practice of sending older adults off to an institution once their abilities begin to decline is gradually being replaced by a kinder, more holistic approach to growing old known as “aging in place.” Aging in place allows seniors to remain close to families and communities as opposed to digging up roots and facing the unknown alone. With the help of friends, family and in-home-care agencies, older adults who “age in place” are rewarded with a wide array of benefits.

There are many emotional reasons an elderly loved one may want to age in place:

• The home is a gathering place for friends and family.

• They have pride in property ownership and ties to the community.

• The home is a source of stability during the volatile aging process.

There are also many practical reasons:

• Living at home limits exposure to multi-drug-resistant organisms.

• There is no “relocation stress” or “transfer trauma.” When older adults age in place and receive at-home care, they greatly reduce the risks of sleep disturbance, confusion, withdrawal, depression and even death.

• Living at home preserves brain function by encouraging regular daily activities such as laundry, gardening, pet care, paying bills or riding the bus (even if seniors receive help from a family member or home care worker, the benefits remain).

• Aging in place allows seniors to maintain social networks and family ties, which contributes to “environmental complexity”– a factor that provides stimulation and contributes to a longer lifespan.

• Due to the growing number of aging adults, health care costs for seniors are on the rise – aging in place is less expensive over time.

There are, however, some costs associated with aging in place:

• Housing modifications,

• Assistive technology,

• Hiring staff from a private in-home-care agency.

With aging in place, the goal is to balance aging adults’ evolving needs with the right combination of support, stimulation and care. This way, seniors can continue to live a life full of cherished activities and relationships without the risk of isolation and premature cognitive decline.

So when you are considering aging in place as an option, the greatest challenge facing our older adults is their ability to take care of their “activities of daily living” (ADLs). These ADLs include activities that people tend do every day without needing assistance. There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking) and continence. When ADLs become difficult for our aging loved ones, then there are several options available to them that they should consider.  

The type and amount of in-home senior care your elderly loved one needs will greatly depend on the day-to-day activities he or she is able to do independently, but it also depends how much help you and other family caregivers are able to provide. In-home care can typically be broken down into three levels of care: monitoring, homemaking and personal care. The best way to determine which type of care your loved one needs is through a needs assessment, but here’s a guide for what each level of care can provide:

• Monitoring: This is the lowest level of care. Older adults who are pretty independent but could use help with more difficult tasks like running errands and transportation to appointments are the right candidates for monitoring. Monitoring can also offer companionship to seniors, giving them someone to talk to for a few hours a week.

• Homemaking: Older adults who need some help around the house should consider homemaking care. Services included at this level can be anything from making meals to housekeeping duties.

• Personal care: Personal care for elderly people is often around-the-clock since it’s the highest level of care. Personal-care providers take care of monitoring and homemaking responsibilities, but they also help with personal tasks like bathing, dressing and feeding.

There are a number of ways that care can be delivered to assist our loved ones’ ability to age in place. Typically, care is delivered by family members, friends, neighbors and employees of private in-home-care agencies.

Know that there are many options out there and that you are not alone. If you have any questions or feel like you need some assistance in navigating the various options, feel free to contact me, it would be my pleasure to assist you.

Bob Roth is managing partner of Cypress HomeCare Solutions, LLC. Visit

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