No Place Like Home
By A. R. Giesen, Jr.

In the movie classic, Dorothy, despite the beauty and uniqueness of Oz, learned there’s “no place like home.”  Most people wish to grow old in their own homes, near loved ones and familiar surroundings.  Fortunately, many older adults are able to do just that.

The fastest growing segment of our Virginia population is those 60 and older.  *Between 2006 and 2024, all of Virginia’s “Baby boomers” will turn 60.  Today one out of every seven Virginians is 60 or older.  In 2025, nearly one of every four will be in that age group.

The elderly among us are better off financially and physically than many in past generations.  Life expectancy has increased.  However, increased longevity can play a role in causing us to live long enough to experience disabilities related to diseases such as diabetes, stroke, heart condition, arthritis, cancer, and memory loss.  Some of us outlive retirement savings, as the cost of living tends to rise more rapidly than relatively fixed incomes.

When faced with health or financial challenges, older adults and their families have somewhere to turn: Area Agencies on Aging (AAAs).  Established under the Older Americans Act of 1965, state and local agencies on aging exist in every locality in the nation.  There are 25 AAAs in Virginia, all with the mission of helping older adults with service and activity needs.

To manage chronic disabilities well, access to adequate health care is a critical need.  Even the most independent older adult can be challenged by the maze of health care insurance options associated with Medicare and Medigap plans, including Medicare or benefits provided by Health Maintenance Organizations.  Area Agencies on Aging (AAAs) provide skilled counseling about health insurance plans.  If an assessment of financial and care needs indicates that someone may be eligible for Medicaid or other benefits, AAA staff members make the appropriate referrals.

Most older people strive to maintain independence and self-reliance.  If family, neighbors, or friends are actively involved, most will receive the assistance they need to continue to live at home in spite of disability or limited funds.  However, as the degree of disability increases, even strong support systems frequently become over stressed.  Nearby social support are at greatest risk.  AAAs assist older adults to understand housing, care and services options and to make informed decisions in selecting services.

This usually means helping older people and their families find solutions that allow individuals to live at home.  Some needs are provided directly by AAAs, such as help with meals and transportation.  Services available may vary from one locality to another.  However, all AAAs provide information and help with access to needed services.  This Care Coordination is vital to ensure that each person has the minimum help needed to maintain independence and the maximum degree of self-determination in selecting the best service option.

Some older adults need limited assistance, such as help with heavy groceries, yard work, and home maintenance.  Options in the community include involuntary organizations and chore workers.

If meal preparation becomes a challenge, home delivered meals are available in every community, often delivered by volunteers who provide a friendly visit and daily check on the welfare of older adults receiving this service.

When personal care is needed, staff of licensed home health agencies or private care workers make regular visits or provide ongoing care in the home.  Family or agency staff must be available to provide oversight to the degree that this is needed.

A significant problem not related to physical disability can be social isolation, leading to loneliness and depression.  AAA staff work with each person to determine interest and suggest participation with activities such as Senior Centers, volunteer groups, or the individual’s religious organization.  If the depression is serious, AAAs make referrals to mental health services and provide encouragement to support the person’s use of such services.

There are times when a person’s situation indicates that care in a nursing home or assisted living facility is the best choice.  AAAs provide each person with services and cost information about these options.  When an older adult is too ill to make or communicate informed decisions, AAA staff work closely with families providing information and support.

The choice to enter a care facility is the last resort for older persons and their families.  However, some circumstances indicate that there is a need to make this difficult decision.  Even then, there are resources to help.  The long-term care ombudsman program provides information and advocacy to help with selection of care facilities and assistance with complaint resolution for residents of such facilities.

AAAs work actively with older persons, their families and all available community resources to help older people “age in place.”  Area Agencies understand-for most older adults-there’s No Place Like Home.

*From “Envisioning Future,” statistical report by the Virginia Department for the Aging.