In a 2023 survey conducted among 1,000 adults ages 55 and above, 89% of adults said they want to age in place.
For many, the choice comes from a desire to preserve independence, quality of life and essential relationships. However, the need for assistance with health management, home safety, daily activities, transportation, personal care or household support often arises. This is where home health care providers play a pivotal role in helping seniors stay safe and comfortable where they want to be—at home.
As a physical therapist, researcher and former leader of BAYADA’s home health and hospice practices, I have thought much about how an individual’s needs can evolve. The aging process is highly individualized. For some, it can be a sudden and rapid decline; for others, it can be a gradual loss of independence.
To age in place with confidence, seniors should plan with their families for the contingencies and supports they may need down the road. If a senior sustains an injury, receives a life-changing diagnosis or needs help managing multiple conditions and medications, a comprehensive home health care provider who offers a full spectrum of services can be their family’s trusted safety net.
Common Experiences of Senior Homecare
For many aging adults, home health is generally their first experience with homecare services. These home health offerings include short-term nursing and rehabilitative and therapeutic services that can help the patient recover from a hospitalization or manage a chronic illness, such as chronic obstructive pulmonary disease or diabetes. When providing home health services, a nurse or therapist visits the patient at home until they reach the goals of their personalized care plan, such as healing a wound or regaining strength and mobility after surgery.
Personal care, household support and companionship are other common services that are necessary for aging-in-place seniors. These services include hourly non-medical care that can help with activities of daily living. To prevent caregiver burnout and help fill in when a loved one cannot provide care, it is highly recommended that family caregiving is supplemented with professional caregiving or other community services. These alternative caregiving methods can be found through local area agencies on aging, tribal or religious organizations or various disease-related organizations, such as the Alzheimer’s Association.
Professional Home Assessment & Care Management
Ongoing needs assessments are a crucial benefit of using professional homecare services. Through these assessments, providers assign patients receiving medical or non-medical homecare with a clinical manager who works with the patient and their loved ones to create and oversee a safe home environment and personalized care plan that is integrated with their lifestyle and preferences.
An expert care team can provide education and safety assessments, support dietary and medication compliance, catch signs of a change in condition and help connect the patient with the necessary clinical care, medical equipment and resources to maximize their health and quality of life. These homecare clinicians often have a full view of the patient’s challenges that may not be self-reported, such as uncleanliness, economic or food insecurity, loneliness or depression.
The homecare provider’s approach to home modifications, durable medical equipment and assistive devices is to recommend “as much as you need and as little as necessary” to keep the patient’s space safe without feeling institutional. For example, the provider may recommend lighting, grab bars, a hearing aid or a hospital bed. As needs evolve, a ramp, electric scooter, chair lift or Hoyer lift may be recommended.
Regular interaction is what matters most, as it allows providers to recognize real-world needs and offer tailored solutions. These solutions can include immediate interventions in a medical emergency or guided transitions to a higher level of care.
Higher Levels of Homecare, According to Needs
When it is no longer safe for a senior to be home alone, around-the-clock personal care and companionship services are recommended, as either live-in care or 24-hour care. Both options provide the same services as hourly aides, but on a more consistent basis, to give families peace of mind.
Live-in care is often best for those who need ongoing support during the day but don’t usually need help at night. A dedicated caregiver requires a private bedroom and spends at least eight hours at night off-duty; however, they remain nearby in case of emergency. With this care model, another aide or a family member can cover care duties on the live-in caregiver’s days off.
Twenty-four-hour care is typically the better option for a senior who needs supervision day and night, such as someone with dementia. In this case, multiple aides would work in shifts.
Dementia care is provided by specially trained aides and may include personal care, household support or companionship on an hourly, live-in or 24-hour basis. Dementia specialists ensure the safety and comfort of their patients while offering respite care, encouragement and education to their family members. Working together with the family, a dementia care team can demonstrate and teach adaptive strategies and techniques that can help to manage the person's irritability and forgetfulness, as well as support a senior’s well-being, independence and dignity.
If a senior wishes to age in place and has one or more serious medical conditions that require regular, complex care, they may be referred to adult nursing services—also known as private duty nursing. This style of care can be provided hourly or in consecutive day and night shifts for higher-acuity cases that may depend on medical equipment like a ventilator.
When someone receives a life expectancy prognosis of six months or less, they become eligible for home hospice care. When this is the case, it is important to choose hospice early—as soon as care goals shift from seeking a cure to maximizing the patient’s quality of life.
Hospice experts can explain every facet of hospice care and walk seniors and their relatives through the decision-making process. Home hospice typically costs nothing out of pocket and offers medical, emotional, social, practical and spiritual care and support services for patients and loved ones. Additionally, hospice care has been shown to significantly extend life and improve the end-of-life experience.
Simplifying the Journey
In any setting, the aging journey is defined by unpredictable, changing needs and various levels of care and support. Selecting the right home health care company that can provide a comprehensive continuum of care is crucial for the quality of life and peace of mind of those aging in place and for the people who love them.