For many older adults, the conversation about aging in place goes something like this: “Mom, Dad, we’re really concerned about your ability to manage the house. We’re afraid one of you will fall and break a hip, or that you might leave the stove on when you go to the grocery store. We’re not sure Dad should really be driving anymore either. It’s time to think about assisted living.”
As caregivers, while we may be saying this from a place of genuine concern, the messages wrapped in this conversation are negative—assuming the older adults are frail, questioning their independence, and suggesting a one-size-fits-all solution without hearing the other side of the story or considering other options.
Is it any wonder why most seniors resist this approach?
“As soon as they hear a negative message, they’re done,” says Louis Tenenbaum, a leading authority on aging in place and a member of the Family Caregiver Council. “We need to get the conversation to be about personal responsibility, reducing the burden on family, avoiding frailty, and preserving independence,” he says.
Empowering Older Adults vs. Taking Their Power Away
Tenenbaum also believes that elder care professionals and family members need to “lead from behind,” empowering older adults so they are comfortable with taking action instead of the other way around.
“Everything we say or do sends a message,” says Tenenbaum. “If we don’t understand its impact, we are being irresponsible.” He compares it to a remodeling project: to have success, you must know the current condition of the space—and keep the goal in mind.
Making the message positive and relevant is the key to producing a “positive cognitive reaction,” per Tenenbaum, but we also have to make it easy for the individual to take the next step—be it an assisted living move, a home modification to ease mobility challenges, or a decision to downsize.
If your Mom has expressed that she’s tired of cooking and maintaining the house, perhaps presenting senior living as a place where someone else does the cooking and cleaning (independent living) will trigger a more positive reaction than “I’d love to take over the cooking for you, Mom” (dependence). Perhaps integrating some tech tools like a home monitoring system or apps that simplify medication management and meal planning will make all the difference. Does Dad struggle with mobility? Don’t assume assisted living is the right move: a combination of assistive devices and video games that improve balance may be enough.
Readjusting the Public’s Point of View of the Aging Population
Our society’s view of older adults is partly to blame. We’re bombarded by images of happy, retired senior couples riding their bikes into the sunset, but we know that is not always a realistic picture of later life. A report produced the Frameworks Institute, Gauging Aging: Mapping the Gaps Between Expert and Public Understandings of Aging in America, seeks to address those misconceptions and in turn, spark constructive dialogue that generates productive policy action. For example: Our culture’s negative “us vs. them” attitude leads to “a sense that any public policy initiatives made on behalf of older Americans will come at the expense of actions on behalf of ‘the rest of us.’ ” Instead, we need to build a system of support that is sustainable and will empower all of us to make more informed, personalized decisions about the care we want.
Keep the Conversation Going
Perhaps what makes these conversations so difficult, both at individual and public policy levels, is that aging in place is not one-size-fits-all. There is no single, simple solution that will work for everyone, and that’s OK. Some prefer to stay at home for as long as possible. Some look forward to calling a vibrant, amenity-and service-rich retirement home or assisted living community. Some are still finding their way (read several scenarios in What Older Adults Want You to Know About Caregiving). However, if we reframe our approach from “You need help, and I suggest this solution” to “How do you want to age in place,” the end result is likely to be one that everyone can get behind.
ACT NOW: It’s time for a more positive message on aging, and it starts in our homes and neighborhoods. Share this post on your social media profiles to change our view of aging in place for the better.
Great article. I need more info for our clients: Brunswick Area Respite Care,
aglass@respite-care.org.
Can you send me a link for the publications you mention here?
thank you!
Ann Glass
Louis Tenebaum thank you for you awesome article. You were so truthful on how us elderly parents or parent would feel if we were uprooted to another state to be assisted with living. I myself want to stay where I am until I cannot handle my everyday living, cooking ,shopping,cleaning house washing clothes. ,folding & putting away. When I cannot do any of this normal daily living then I will look into getting the proper help. Thank you again for you awesome, truthful article. Sincerley, Juanita Goslin,Sacramento,Calif.
I am 78 years old and own my home with a 20′ x 20′ garden to raise my veggies. I take care of it every year, mow my lawn, plow my snow and live by myself with my kitty. My daughter and her husband just moved to Arizona, my other daughter lives in Texas and my son, who prefers to remain a hermit, lives in Wisconsin. I’ve been invited to move to AZ, moving paid for by my family, but at my age that is a HUGE move and commitment. How can I sell my home, find a new one in AZ at a cost I can afford? Going out there to find one is also a trial since there isn’t anybody to take care of my kitty and I can’t afford “cat care” or vet housing fees. The housing market is not great and I have an older home that’s been rehabbed, but very nice now. I probably won’t get what it’s worth in order to find another in an area that isn’t questionable. I would have to pack up the entire house in a matter of 1 or 2 months, find a place to live and move out……by myself! I’ve lived in this area my entire life and can’t take the snow, ice and cold anymore, but wonder if I could take the heat in AZ either and start anew. I realize that my health could fail although I’m healthy at this point. I don’t need any meds other than thyroid (for the rest of my life). I just don’t know what to do. It’s lonely, but I have my one close friend, my doctor, my church, my good neighbors, all of whom I love. What in the world am I to do with my future at stake??
Dear SMQMC: You sound great! Your concerns about moving to the unknown are well founded. Uprooting is very upsetting as seniors, especially when you are alone. However, one does need to be practical and have some plan in place, when you can’t handle the garden, the snow, the lawn etc. anymore. Your support group at church is very important and in fact may be more of a help than family. But the family will worry about you. Things can change for you in a moment, so you need to be ready. suggest you have things “in order” in case you need help immediately. Find someone whom you can trust to handle banking etc. and your outside maintenance as well as some house cleaning. You’ll be fine!
SMQUC, you go girlfriend. You sound very strong and a go getter. You stay right where your at until you are unable to care for yourself. And I know that you will surely know when the time. Comes. Enjoy your life as you have. Loved you comment. Take care,God Bless ,Sincerely ,Juanita Goslin,Sacramento,Calif.
This is a very good article, however it seems to pass over the folks who do not have the financial resources to consider assisted living, etc.Sandy Groves
Sandy, if you cannot afford assisted living , there are other avenues that you can look into at no cost. So keep that in mind. Take care an God Bless, Juanita Goslin ,Sacramento,Calif.
I hope I can age in place, but I also hope that I will be wise enough to know when its time to say I need more help.
Hi Ann!
All the publications mentioned in this piece should be hyperlinked, so you can click right on the name and find the page you’re looking for. Hope that helps!
Mary E., that’s the tricky balance we all must strike at some point in our lives. Thanks for your thoughtful comments!
Sandy, thanks for your thoughts. Assisted living is not always an affordable option, but there are alternatives. The important thing is to know what’s available and what you can afford should you need that support.
How do I tell my step son and his wife to please leave us alone. When we need their help we will ask.
I have 3 sons and live alone now,,, also 2 living sisters… None live closer than 30 miles to me,, and one is out of state, even.
My youngest son (most respective and closest) chats with me online every morning,, We exchange news and “barbs” at each other.. I enjoy doing that and being engaged in those messaging,, it reassures him that I am still able, and Lucid, and in good mental health…
Try taking up chatting with them, and they will know that you are still able to care for yourselves, Maybe select a time to do this each day…without fail, and they can see how well you are doing and they have nothing to worry about..
Marcia, you sit them down and tell them just like it is for the two.of you and taking care of yourself. When you start letting things go out of the ordinary then they may step in an see just what kind of assistance you might need until then . Just come visit and that is that.
I enjoyed the article very much. I have been actively pushing for (tiny homes, senior pods)(dwellings under 1000 sq. ft.) to be allowed on property that has a main structure. I would be closed enough for family to check on me but have a structure that is mine along with my privacy.