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Reflection on the NJAAW Housing Series

A guest blog by William Cotrone, NJAAW intern

As the global population continues to grow/age, appropriate housing for older adults is now more important than ever. Most of NJ’s current housing stock was built for young able-bodied adults and nuclear families.

Currently, 30% of homeowners in the US are single and live alone. By 2030, 20% of the US population will be considered “senior citizens,” and most older adults would prefer to live in their own homes for as long as possible. But what if their home is not designed to accommodate them as they age? Fortunately, there are solutions.

Staying in Your Home

Adaptations and renovations can allow people to stay in their homes safely for longer.

For example, AARP has a free HomeFit Guide that explains how to incorporate universal design principles and products into homes, which are safe and easy to use. Most of the elements in the guide can be done without professional assistance

Another option is to hire either an occupational therapist (OT) or physical therapist (PT) who is also a Certified Aging-in-Place Specialist (CAPS). These individuals can make recommendations on how to repurpose your home to reflect your functional, mobility, and cognitive needs so that you can live safely and comfortably.

A CAPS will examine such things as the entry and/or foyer (Is it clutter free? Is there a rug that could cause a person to slip and fall? Is there enough light?). If an individual requires a mobility device such as a walker or wheelchair, are doorways and hallways wide enough to pass? In the kitchen, a CAPS will scrutinize chair height so that sitting and rising are made easier, floor space so that mobility devices can pass, lighting to assist people with visual challenges, etc.

Probably the most important place to have examined is the bathroom, especially since 80% of falls occur here.

Probably the most important place to have examined is the bathroom, especially since 80% of falls occur here. A CAPS can make recommendations on toilet height, grab bars, slip mats or bathroom chairs for the shower area.

For the rest of the house, stairs should be well lit and have handrails. Another option is a chair lift to take older adults up and down. Smart technology devices might also be beneficial for such functions as turning on the lights or a faucet.

For outside the home, thoughtful landscaping or therapy gardens make a great addition. Engaging with nature has an immense list of health benefits, so make an outdoor space age-friendly. Comfortable furniture for the patio area, safe walkways, good lighting and smart technology increase the ability to enjoy outdoors safely.

Getting Help in the Home

Knowing when help is needed and how to find it can be challenging. One option is to hire assistance directly or via an agency. While Home Health Care (HHC) covers skilled support services (including RN/PT/OT) and is usually paid for by Medicare or insurance following a hospital stay or during recovery, older adults may need a lower level of care to assist them with activities of daily living (ADLs). These services, such as toileting, bathing, dressing, eating, moving, and grooming, can be provided by Certified Home Health Aides (CHHAs). However, CHHA services often have very limited insurance coverage, leaving most people to pay out of pocket.

When deciding what type of provider to employ, consider the following: A family member/caregiver who hires privately may save money, but the “employee” might not have the proper skill set or be insured. Engaging an agency is more expensive. However, such added benefits as knowing that the agency has supervision, specific hiring requirements, insurance, licensed staff, and compliance policies, are often worth the extra cost.

Another option is Adult Day Care. These programs provide care and companionship for older adults who need assistance or supervision during the day. This provides caregivers with a much-needed break and allows them to go to work, school, do housekeeping, etc. Research has shown that social interaction in a Day Care setting improves an older adult’s mental, physical and emotional health as well as reduces the risk of developing depression and dementia.

Finally, for people who need more help or are near nursing-level care, PACE (Program of All-inclusive Care for the Elderly) programs allow people to remain at home. While limited geographically, the number of PACE programs in NJ is increasing. More information can be found here.

Residential Options

When staying in one’s home is no longer possible, what are the options to choose from and how does one assess them?

First, independent living is an option for older adults who do not have severe physical or cognitive challenges. An independent living environment usually includes age-friendly features like grab bars, walk-in showers, emergency response services, community dining, age-appropriate entertainment, transportation services, etc. They are relatively affordable at market prices and many are designated as “affordable housing.” If needed, home care, paid by the resident, can be arranged.

The next option is assisted living. Residents of an assisted living community tend to have physical or cognitive challenges but are still able to retain some autonomy. Assisted living units are often smaller than independent living settings because they lack some of the customary rooms of a typical house, like a kitchen. Staff can help residents with ADLs and medication management.

The third option is a long-term care (LTC) facility or a traditional “nursing home,” which provides shelter and around-the-clock care for people with ADL and health difficulties. Reasons for seeking LTC might include that a person suffered a severe injury or medical emergency and needs rehabilitation to return home, or their physical/mental state is diminishing, which could make them susceptible to injuries or illnesses. Long-term care facilities can also provide hospice care and many offer memory units.

Pulling these options together is the “Life Plan Model,” also known as a Continuing Care Retirement Community (CCRC). Residents can transition their living situation and care level without having to transfer out of the facility. For example, a typical transition might be going from independent living to assisted living or independent living to rehabilitation. This may be the appropriate option for couples where one needs care services and the other doesn’t.

For all of the options in getting help in the home, or relocating to an age-focused place, it is important to plan ahead.

For all of the options in getting help in the home, or relocating to an age-focused place, it is important to plan ahead. Unless related to a hospital stay, Medicare does not pay for home care or long-term care. If someone qualifies for Medicaid or affordable housing, eligibility should be established as early as possible. Long-term care insurance or private insurance may cover some costs, but most people will be paying out of pocket.

Aging is like the weather. You can plan for it, and anticipate what will happen, but you won’t know until it actually happens. Like the weather, aging and finances can change unexpectedly. Older adults deserve to live with dignity and comfort. They deserve affordable, appropriate and accessible housing and must plan ahead and know their options.

Click here for a summary of NJAAW’s Housing Series and links to the four recorded sessions.

William Cotrone recently graduated from Bates College with a degree in psychology and is and future medical student (hopefully in a field related to aging). He previously interned at senior residential sites in Lewiston, ME.

Warning on Scams Claiming to Support Ukraine

by Cathy Rowe, DrPH, Executive Director, NJAAW

Unfortunately, we have seen this over and over: Well-meaning older adults who want to support a good cause become the targets or victims of a scam

Why Are There Scams About Ukraine?

Let’s be clear – the people of Ukraine need our support and help. Lives are disrupted, infrastructure is destroyed and peoples’ health, welfare and lives are at risk.

Scam artists are despicable when they take the focus on a crisis and use it to try and rob well-meaning people. 

NJ has a high number of Ukrainian immigrants – the 4th largest community in the United States.  Many came over in the 1980s to work and raise their families, and are now retired. The headquarters of the Ukrainian Orthodox Church of the USA is based here in South Bound Brook, at St. Andrew Memorial Church.

We know the compassion and concern are real. We just want to make sure the support that people want to give gets to the right place – and not in some scammer’s pocket.

We know the compassion and concern are real. We just want to make sure the support that people want to give gets to the right place – and not in some scammer’s pocket.

Why Do Scammers Target Older Adults?

We have this struggle – while we want to help older adults with technology and close the digital divide, we also do not want to expose them to fraud. We want people to be safe and be cautious online.

If you get emails asking for donations, check the address it came from. Do not open an email or click on a link unless you really know where it is from. If you go to a website to get information or to donate, make sure you are going to the site you want and have not been redirected to another site with a similar name. 

Also, the problems aren’t only online. There has been no slowdown in telemarketing scams.

Telemarketing has become an easy way for fraudsters to scams seniors. Many seniors will always pick up the phone – and have been doing so all of their lives. Since we are in our homes more because of COVID or the cold weather, we hear that phone ringing. As our partners at Senior Medicare Patrol advise: If you receive a call and you do not recognize the caller’s telephone number, do not pick up the call. Let your answering machine screen all of your calls.

How to Help Ukraine

Our advice is to donate through an organization you know and trust, such as the International Committee of the Red Cross or Doctors Without Borders. Locally, if your house of worship is organizing something to help the people of Ukraine, or if there is a Ukrainian church or synagogue you know that is doing something, that might be the best way to ensure that your help will really get there. Also, large church-based charities, usually covering a diocese or synod, are trustworthy places to donate to if they have set up a fund for Ukraine.

We also see that some news stations have screened organizations that are helping Ukraine and are posting this information on their broadcasts as well as on their websites. 

Fighting Scams on Any Topic

Be sure that you never feel intimidated or pressured to give money or any personal information to someone you don’t know. If you feel pressure, hang up the phone. If someone, by phone or email, is trying to make you feel flustered or dumb, know that you are not. Scammers are smart, persistent and only need to trick one person to make money.

Also, while it may be hard, share your experience with others. Tell people about the calls or emails you’ve received that seem suspicious so that they can learn. You will be providing a service by sharing our experience with others.

If you suspect that you have been the victim of a scam, report it to cyber.nj.gov or AARP’s toll-free fraud helpline at 1-877-908-3360.

Finally, always keep up your vigilance:

  • Do not respond to emails if you do not know the source
  • Initiate calls or conversations yourself
  • Double-check the website address if you want to donate online – make sure you weren’t redirected
  • Trust your instincts, not your emotions

Cathy Rowe, DrPH, was interviewed on PIX 11 TV on this topic. Click here to see the video clip and read the news report.