Remember? Around 39 columns ago we mused about how aging in the 21st century is so different from our grandparents’ move-back-in-with-the-kids-in-the-family-homestead lifestyle. Now the homestead’s gone, the family’s dispersed, and we try to make it on our own and in institutional living facilities.
Well, despite the trend’s compelling causes, the experts now are detecting a reverse trend back to the “family nest”, often with the kids becoming caregivers, at least part-time. So, whether we’re a family care receiver or giver, and of whichever generation, maybe we should explore this déjà vu.
What’s driving the reversal? Encouraged and trained by government and professional organization programs, physical and mental health care providers have acquired skills, wheels and portable high-tech tools, to deliver many services equally as well as in the institution. Insurers happily encourage and cover at-home delivery, saving them big money. Legislators, regulators, and the professions’ gurus -- they and their families are care-consumers, too -- provide legal and ethical approbation.
We rejoice in the warm-cozies of being at home, compared with the alternatives. Options abound, offering at-home and neighborhood assistance with accomplishing the activities of daily living (ADL’s).
Of course, the over-arching key driving force is the awful, unaffordable, and fast-growing cost of institutional living’s all-inclusive care and nurturing lifestyle. Remodeling, equipping, and operating the house, plus the needed at-home services, can cost a fortune, but far less than long-term facility living costs.
We’re living longer, so we’re impaired and sick longer, which takes more and more of us to Medicaid status. We hear about and witness disturbing realities of basic institutional Medicaid-level living. Even if we aren’t Medicare eligible, shortfalls in Medicaid funding generate facility operating deficits, forcing rent increases for us.
A Place for Mom, the honored and informative free senior-living info service, can fill you in on all of this (”Senior Living Blog”,
(www.aplaceformom.com/blog). It also introduces us to “senior co-housing”, a growing lower-cost self-governing cooperative living alternative, where we buy our own homes and fund and share community services, such as recreation, meal service, maintenance, housekeeping, monitoring, logistics, and transportation.
Some institutional living facilities, especially non-profit affinity-based ones (church-sponsored, etc), are controlling costs by expanding, becoming comprehensive continuing-care communities offering the entire range of late-life ADL and healthcare support. Even while you’re still fully self-reliant, you “buy in” at a bargain rate for permanent residence, and/or contract for a level periodic contribution. You’ll receive the services that you need, progressing inevitably upward as your individually deteriorating ADL abilities and health require them.
To attract more residents, and therefore, more revenue, they’re adding many community amenities on-campus. And they’re marketing, including here, at attractive prices, to younger, still-healthy future-security-and-cost-minded seniors, and to prospects who enjoy living among like-minded affinity groups.
Notice the recent study proclaiming that the Grand Strand is the nation’s second fastest-growing metropolis, powered by legions of retiring golden-agers, baby-boomers, and gen-X-ers? No surprise, right? No wonder that its real-estate developers offer countless zoning and tax-favored private “55-plus” retirement communities, with their vigorous homeowners’ associations, activities clubs, and abundant neighbor-helping-neighbor cultures. Actually, they can be an alternative to, or at least a postponer of, institutional living.
Enhanced by the area’s support services, such as Neighbor to Neighbor, Meals on Wheels, mobile health care providers, and the many local social services and counseling agencies (largely church-sponsored), many of us who otherwise would require the more expensive alternatives are OK in the “55-plusses”, or even out in the community at large. Home health care agencies abound here, filling in with when-needed credentialed, vetted aides, guidance, and logistical support. If beloveds, siblings, the kids and the grandchildren can help, it’s even better. And if they can’t (or don’t), we can engage local personal responders, personal friends / neighbors or professionals, equip them with our “Mayday and Doomsday File” and prepare them to jump in when urgencies happen.
Despite all of that, one welcome amenity of institutional living is the availability of in-house, or at least expedited, primary health care. Harry Willoughby, of the local Right at Home help agency and popular CCU/OLLI guest presenter, tells us that we can arrange that at home, too, via providers such as for-fee Home Based Primary Care, based in Conway. Further, our area now also has two credentialed professional direct-engagement personal health care case managers, skilled and experienced in strategizing and implementing our wellness and sickness programs. You might have met one, Reagan Callaghan, also a popular veteran guest presenter in my OLLI seminars. There’s also the free V.A. Clinic at Market Commons for our many qualified veterans.
So, Grandma and Grandpa, maybe we’re not going back to the future, but forward to the past.
There’s much more to know about in-place senior living. Next time we’ll explore some vital decision factors -- questions to ask and answer.
Do share your wisdom and experience, and do stay tuned!
Contact Gary Newman at firstname.lastname@example.org. Your ideas and comments are always welcome.