According to a new study from Brown University, “Widespread nursing home closures over the past decade have resulted in a five percent drop in available nursing home beds across the United States, with poor, urban neighborhoods hardest hit.”  

The analysis of Zhanlian Feng, an assistant professor at Brown and the study lead author, and his colleagues points to two main causes of this disproportionate impact of nursing home closings on minority and low-income communities.  

First, “The country’s minority population is aging at a steeper rate compared with the white population.  And so the potential need for long-term care is rising fastest in minority communities.”

Second, between 1999 and 2008 the overall closure rates for Medicare- and Medicaid-certified facilities were about twice as high in zip codes that are home to low-income and minority (black/Hispanic) communities than in the richest zip codes.

So in the very communities where the need for care is increasing, the options are decreasing. 

What concerns does this raise for residents of these neighborhoods who have aging family members and friends?

• The distance to the nearest nursing home will increase with the greatest travel increases affecting residents of poor or minority localities.
• Access to senior care will rapidly diminish in the communities with high nursing home closure rates.
• The quality of the remaining care options in those areas may also diminish.

Dr. Mitchell Katz of the L.A. County Department of Health Services notes that with more than 27 million Americans needing long-term care by 2050, either the federal government will have to increase the reimbursement rate for nursing home services, or state and federal policies will have to fund less expensive — and perhaps more preferable lifestyle — options, such as assisted living — or better yet, care for seniors right in their own home.

Home Instead Senior Care provides extraordinary senior home care, personal care and companionship services to seniors in the Richmond area which includes the counties of Chesterfield, Goochland, Hanover, Henrico and Powhatan.  We also serve all of the Northern Neck out of our Tappahannock office.  For more information, please visit our digital brochure or call our office at 804.527.1100 anytime.

 Dear Savvy Senior,

What tips or products can you recommend to make a bathroom more senior-friendly. My husband and I are looking to adapt our home for our elderly years and would like to start with the bathroom. What can you tell us?

Aging Gracefully

Home Instead Senior Care sponsors Jim Miller's Savvy Senior column

Dear Aging,

Because more accidents and injuries happen in the bathroom than any other room in the house, this is a great place to start seniorizing.

Here’s what you should know.

Small Changes

To avoid hygiene hardships as you get older, let’s start with some simple tips and a few low-cost add-ons that can make a big difference in making your bathroom safer and easier to maneuver.   

• Floor: To avoid slipping and tripping, get non-skid bath rugs for the floors or secure existing floor mats or rugs with double-sided rug tape. 
• Lights: The older we get the more light we need, so install the highest wattage bulbs allowed for your fixtures, and get a plug in nightlight that automatically turns on when the room gets dark.
• Entrance: If the doorway into the bathroom is not wide enough to accommodate a wheelchair or walker, you can easily widen your doorways (two inches) with inexpensive offset door hinges.
• Bath/shower: To make bathing safer, buy a non-slip rubber mat or put down self-stick strips on the tub/shower floor, and install grab bars for support. If you use the shower, it’s a good idea to put in a shower curtain rod that screws or bolts into the wall (versus a tension-mounted rod), so that if you lose your balance and grab the shower curtain, the rod won’t spring loose. Another safety precaution is to put in a water-resistant, wall-mounted phone in or near the bath/shower in case of a fall. And many seniors with mobility or balance problems need to shower sitting down. If this applies to you, install a hand-held, adjustable-height shower head, and buy a portable bath/shower chair.
• Toilet: Install grab bars next to the toilet too if possible, or purchase a toilet seat riser. This adds two-to-four inches of height making it easier to sit and rise. 
• Faucets: If you have twist handles on the sink, bathtub or shower faucets, replace them with lever handles. They’re easier to turn, especially for seniors with arthritis or limited hand strength. Also be aware that it takes only 130-degree water to scald you, so turn your hot water heater down to 120 degrees or get anti-scald devices for your faucets.

Bathroom Products

If you’re thinking about remodeling, there are a variety of practical and stylish products on the market that can make your bathroom more age-friendly.

For bathing, prefabricated “curbless showers” and “walk-in bathtubs” are two popular options today. Curbless showers have no threshold to step over so access is a breeze and ideal for wheelchair users. Theses showers also typically come with a built-in seat, grab bars, an adjustable hand-held shower head, and a slip resistant textured floor. Or, if you like to take baths, a walk-in bathtub with a front door may be the way to go. You can find these products at sites like Accessible-Showers.com and Premier-Bathrooms.com. 

If you’re interested in getting a new toilet, go with an ADA compliant “comfort height” toilet that’s 17 inches high, versus a standard toilet that’s only 15 inches. Kohler (Kohler.com) and American Standard (AmericanStandard-us.com) make a nice variety.

And if you’re putting in a new sink, install it at a level that reduces bending. For wheelchair access wall-mounted or pedestal sinks, or a sink built into a cabinet that’s open underneath will let you roll in nice and close. And if you get a new faucet, the single lever handle style is great for those with arthritis.

Savvy Tips: For more information on senior-friendly modification tips visit aarp.org/families/home_design/bath and Homemods.org. Also contact your nearby independent living center (ilru.org, 713-520-0232). These are nonprofit centers that provide modification information, and many even offer free or low-cost home assessments. Your Area Agency on Aging (800-677-1116) is also a good referral resource.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit http://SavvySenior.org.

About Jim Miller

Jim Miller, creator of syndicated The Savvy Senior column

Jim Miller is the creator of Savvy Senior, a syndicated information column for older Americans and their families that is published in more than 400 newspapers and magazines nationwide. Jim is also a contributor on NBC’s “Today” show, and is the author of The Savvy Senior, The Ultimate Guide to Health, Family and Finances for Senior Citizens, (Hyperion, 2004).  

Jim is frequently quoted in articles about issues affecting senior citizens and has been featured in numerous high profile publications, including Time magazine, USA Today and The New York Times.  In addition, he has made multiple appearances on CNBC, CNN, Retirement Living Television and national public television. 

The Savvy Senior column is brought to you by Home Instead Senior Care of Richmond and Tappahannock

Home Instead Senior Care provides extraordinary senior home care, personal care and companionship services to seniors in the Richmond area which includes the counties of Chesterfield, Goochland, Hanover, Henrico and Powhatan.  We also serve all of the Northern Neck out of our Tappahannock office.  For more information, please visit our digital brochure or call our office at 804.527.1100 anytime.

P.S. There are more helpful hints like this in the book, Stages of Senior Care.  Call us to inquire about how to get a copy.

There are advantages and disadvantages for Seniors to age in place in their own homes,

Aging in place enables seniors to live safely and comfortably in their own Richmond or Northern Neck homes or other primary residences, including independent living facilities. 

This is just one of many senior living options that are covered in detail in Lori and Paul Hogan’s new book:  Stages of Senior Care: Your Step-by-Step Guide to Making the Best Decisions.

Aging in place is an option that utilizes some or all of the following:  special housing design for seniors, the installation of safety and convenience equipment, and in home care service that enables the senior to remain at home while ensuring needs are met. 

The advantages of aging in place are many but we’ll list just a few here: 

• Aging in Place maintains a familiar environment for the senior or elderly person so that they can continue to live in their own surroundings without making a drastic change
• It fosters community continuity, which means the senior can continue to frequent their usual grocery store, drugstore or other places in which they are comfortable shopping and asking for help
• It maintains valuable social networks,  often keeping contact with neighbors and friends that live nearby
• It has a way of strengthening family and family ties
• It promotes physical and mental well-being, just be continuing to keep the senior in a home where they often have raised their family

Aging in place can also mean that a senior or a senior couple can move into an independent living facility or other retirement community, such as retirement villages or even a government-funded NORC (naturally occuring retirement community).  

Some of the disadvantages of having an elderly loved one continue to live at home or an independent living facility are as follows: 

• There would likely be a low to moderate investment in home equipment and home modifications.  Depending on the home and the ability for the senior(s) to easily navigate in the home, the cost of these modifications an be high depending on the extent and nature of the modifications required, particularly if ADA-compliant renovations are required.
• The lead time for renovations may be lengthy (weeks) for determining the need, finding a contractor, and completing these home modifications, especially if the home is outside of a pre-planned senior independent living facility or village environment.
• Without home modifications, structural barriers in the home may present challenges and contribute to falls and injuries.  Even something as simple as having too much furniture and rugs in the home can make it difficult for the senior to manage easily as they get older.
• Seniors may be resistant to home modifications and the installation of helpful technology.  Often a senior who has lived in their home for a long time may not want to see any modifications in their home that would signify that they’re getting older and need additional help.

Aging in place is an option that is best suited for seniors who are functional on all activities of daily living (this is often abbreviated as ADL) which includes eating, bathing, toileting, dressing, maintaining continence, and transferring (getting out of a bed or chair).  So for those who require limited or no assistance in getting around their home, the prospect is good for sustained independent living and home modifications can be a rather easy and often less-expensive solution depending on their needs and whether they’re living alone or as a couple. 

When is it time to move on? 

With a few home modifications, many seniors can live in their existing homes for many years without further help.  But when it is no longer safe for them to move about easily or if they are forgetting to take medicine or go to doctors appointments, then the situation has to be re-evaluated again.  And especially if the need continual nursing or medical help. 

This transition time period is often when Home Instead Senior Care can provide senior home care and companionship services that allow the senior to live in their homes or more independent living facilities longer, before having to consider assisted living.  When a senior simply needs medication reminders, transportation, light housekeeping, checkbook balancing – or just simply needs someone to be there to play a card game or engage in conversation to prevent loneliness — then that’s a perfect situation for our CAREGivers to lend a helping hand.  

Home Instead Senior Care serves seniors across Greater Richmond, including Midlothian, Mechanicsville, Short Pump, Glen Allen, Chester and many other towns.  Our West End offices are conveniently located off Broad Street and you can simply call us at 804.527.1100 for a free, no-obligation home care assessment.  Let’s work together to allow our Richmond seniors to remain safe and live independently in their own homes for as long as they are able.

P.S.  Does your elderly relative live in the Northern Neck?  We have an office in Tappahannock in which we serve the entire Northern Neck area.  That office number is 804.443.4885.