I had a chance to interview Lynda Shrager about her new book, Age In Place: A Guide to Modifying, Organizing, and Decluttering Mom and Dad’s Home, which I reviewed on this site. Shrager is a Board-certified occupational therapist, social worker, and a Certified Aging In Place Specialist (CAPS). She’s parlayed her years of experience in geriatrics and senior housing into a family-friendly, step-by-step guide for enabling aging parents to stay at home. Allowing parents to age at home is in part a matter of easing the transition to a safer environment — and getting parents on board to make any necessary changes.
So many of us would love to let our aging parents stay in their home. But how do we get them to understand there are major changes to be made in order to do that?
One of the biggest obstacles is convincing parents that they may need to make some modifications to help them get around safely. You may be convinced that your parents aren’t totally safe and are having difficulty getting around the house and managing day-to-day activities. They, on the other hand, are thoroughly convinced that they’re fine. As much as you may plead and cajole them, it’s really up to them.
What’s the best strategy for getting them on board?
The best strategy is to somehow find the middle ground in dealing with everything. Make a deal. Get them to agree to modify their surroundings so they can stay home — within a living environment that’s more accessible, safe and easy to navigate.
Age in Place shows you exactly how to do that. The process will reduce everyone’s stress levels, and hopefully lead to a resolution that makes everyone happy — or at least in a better place than they were before.
Your best chance for success is to work cooperatively with Mom and Dad, not to lose your patience, and always treat them with the respect they deserve. It’s a win-win. They’ll be safe. You’ll be sane.
What kinds of modifications can truly improve how safe seniors are in their own homes?
I often feel the most important modifications are installing grab bars in the shower and tub, and any place where a good, safe grip is needed. Other important modifications to consider include installing bannisters on both sides of staircases — projecting past the top and bottom steps; good lighting, creating clear pathways around furniture, putting in non-slip flooring and low-pile carpet, and making sure the bed’s the right height for easy on and off. In terms of kitchens and bathrooms, place the most-used kitchen items within easy reach, and install a toilet seat that’s 17-19 inches high.
What are some red flags that signal a parent’s cognitive abilities are declining, and what should be done?
What you’re looking for is a pattern of neglect over a period of time that alerts you that they need to be looked into. Losing keys? We all do. Finding the keys in the refrigerator? Could be trouble.
Behaviors that cause concern include getting lost driving home, not recognizing familiar objects or displaying unsafe forgetfulness, such as leaving the stove or oven on. Ask yourself these questions:
- Does their behavior and temperament seem status quo?
- Do you notice increased talk of feeling hopeless or depressed?
- Are they more argumentative than usual?
- Do they seem paranoid?
But changes in cognition and behavior could be caused by many medical issues besides dementia. So the first thing to do is schedule a visit with their primary physician.
When is ideal for approaching parents about making a plan — in case the time comes that they aren’t able to function independently?
The best way to avoid, or at least minimize, having to face the inability to stay at home is to have a plan in effect before a crisis occurs.
We tend to be complacent if everyone is functioning at a good level. No one thinks they will get sick until they get sick, and you often can’t anticipate a new health issue coming on. But don’t wait until mom’s knee replacement prevents her from getting upstairs to shower for eight weeks, or dad’s sudden heart attack leaves him unable to do any home maintenance.
The biggest stumbling block I experience with my patients’ families is not what should be said, but the fact they don’t say it. Getting the conversation started may not be easy, but it’s key to making it possible for mom and dad to age safely at home. Think of this conversation in a positive way — about how you and your parents can work together to keep them in their own home.
So, call a family meeting. The time to get organized is NOW.
Learn more at Other Wise Healthy.