Case Study of Aging in Place by NAIPC of Baltimore (Hired Help)
- 72-year-old retired PhD scientist living alone in Baltimore County
- In a single family home where she has lived for last 45 years.
- Divorced many years ago, no contact with former husband.
- Only sister lives in North Carolina and; has been asking her to move to a retirement village near her home.
- Client has two grown children with busy families of their own, closest child 1 ½- 2 hours away, and they have not been to her house in over 5 years.
- She usually goes to them because of the large number of people involved. They have busy lives and visit together only every 4-6 months, although they maintain regular phone contact. She has begun to limit her driving, but still has car, and occasionally uses it. Not sure if she feels safe venturing to daughter’s house anymore, as it’s near DC and; unfamiliar, congested area.Her children have no idea of her financial situation, and have let her take care of her own finances/affairs up until now. They are noticing cognitive decline which concerns them, confusion and forgetfulness at times, and they are wondering if she can safely stay home by herself. Family has asked, with her permission, for GCM to do assessment.
- Minimal medical treatment, and has blood pressure issues and heart condition
- Hoarding for years! Stacks of newspapers, trash and discarded household items in every room of the house. Only small path from front door to living room chair, through kitchen, and to bed, only ½ of which is clear to use.
- She has a “nice couple” down the street who is now taking her to store in her car weekly. Recently, she has said they can just keep the car at their house, since she’s not using it anymore.
- Unendorsed checks sitting around the house, in plain view of visitors
- Stacks of opened mail in piles, and she’s verbalizing that she has no idea what it all means. (much of it junk mail, some investments, retirement package info etc)
- Getting late notices and collections calls on bills due.
- Dish of crackers and milk on kitchen floor to “feed the poor, hungry mice”
- No POA, no advanced directives and no clear idea of benefits available in medical package. Needing medical evaluation/follow-up for heart condition and blood pressure matters.
- Confusion that is noticeable upon assessment, but hard for outsiders to detect.
- No support system locally, doesn’t really know neighbors well. Young teen boy will shovel her walkway or take out trash. She prefers to “keep to herself,” and has always been that way.
Steps to Successful Aging in Place for this Scenario
Step 1 Hire Geriatric Care Manager
The initial assessment findings were discussed with senior and family and a report with recommendations outlining:
A. Immediate/acute concerns
B. Short Term Concerns
C. Long Term Concerns
Step 2 Hire Elder Law Attorney and or CPA
Inventory assets, piece together financial profile, insurance coverage, estate planning, wills, Trusts, Power of Attorney, Healthcare Directives, and Medicaid eligibility, etc
Step 3 Hire In-Home Care Assessment
Determine if homecare was a possibility; complete a health history and assessment to develop a plan of care.
Two potential outcomes:
A) In-home care to help the client keep organized and safely get through the day and night hours; schedule and level of care all dependent upon assessment
B) Decision that it was not safe or possible financially for client to remain at home with one-on-one care
Step 4 Hire (consider) A Reverse Mortgage
Can help borrower use the money to pay for the services needed. For example: home health
care, medical costs, property taxes and others (Powers Of Attorney are acceptable if necessary)
Step 5 Purchase an Emergency Response System (encourage daily use)
Step 6 Hire a Senior Move Manager to help de-clutter and organize the Living Space
A. Immediate clear out and clean-up of clutter and mess in the home to address safety and hygienic issues
B. If aging in place (client staying), downsizing and more in depth clean out over time
C. If client is moving to an assisted living or retirement community, provide moving assistance including but not limited to packing, unpacking and set-up of new living situation
Step 7 Hire Senior Care Organizer (non-affiliate) the Organizer would collect and put into order, all bills and other important papers and create an easy to use filing system
Step 8 Hire an Aging-in-place CAPS certified Remodeler has been trained in:
-The unique needs of the older adult population
-Aging-in-place home modifications
-Common remodeling projects
-Solutions to common barriers
(Source of case study National Aging in Place Council)
This case study is an example of successful interventions when financial resources are available.