Ins and outs of aging in place

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Aging isn’t what it used to be. And innovations in senior living and care are coming in time for the elder boom.

In 2050, the population aged 65 and older is projected to be 83.7 million, almost double its estimated population of 43.1 million in 2012, according to the U.S. Census Bureau.

One new concept is the naturally occurring retirement community, or NORC, a type of senior housing that develops over time. “The common link is that the residents of these communities have chosen to age in place together, either delaying or forgoing a move to traditional senior housing altogether,” according to

Another is the cluster care concept, in which service providers operate in the same building as senior residents. This arrangement can reduce the number of car trips seniors need to take to doctors, the pharmacy and the hair salon.

Two local experts on aging discussed these and other innovations recently as they spoke to about 50 seniors at Young Israel Shomrei Emunah in Silver Spring. Stuart Rosenthal, publisher of the Beacon Newspapers, and Alan Dubow, president and CEO of the National Association of Retirement Counselors, also laid out the nuts and bolts of aging in place and care options.

“The more we think ahead, the more we can make ourselves available to the resources available,” Rabbi Dovid Rosenbaum of Young Israel told the group.

Why do people want to stay in their homes?

Rosenthal cited several reasons: living at home is comfortable, it’s comforting because there’s an emotional connection to the home, downsizing is hard, it’s difficult to leave one’s community and, thank you very much, the end isn’t so near.

What help might people need to stay in their homes?

Companion care and friendly visitors. These are typically volunteers and their services are usually free.

Other nonmedical home care includes light housework, making and serving meals, help with bathing and dressing, and accompanying people to doctor appointments.

Other services that are not health care include organizing stuff in the house, money management, handyman services, housekeeping, meal or grocery delivery and transportation.

Suppose you can’t stay at home anymore?

The growth of the variety in services and living arrangements has come just in the last generation, Dubow said.

“There used to be the nursing home, also known as the rest home, and the retirement home, also called the old folks home,” he said. “Forty years ago that’s all there was when you couldn’t stay in your home anymore.”

Nursing facilities are now health-care facilities, he said. “Everyone is there under doctor’s orders for one of two things: specific rehabilitative care or long-term care.”

Dubow said putting care into the hands of professionals is often better for the patient and the patient’s family, particularly the spouse.

“When a well spouse is taking care of a sick spouse, the chance is 50-50 that the well spouse will die first,” he said.

What are some of the senior living arrangements?

Dubow explained the differences in them:

Retirement communities are totally independent living with amenities such as meals, transportation and activities.

Assisted living are multi-unit residential facilities that provide assistance with medications and daily activities, such as bathing and dressing.

Continuing care communities are full-service offering independent living, assisted living and nursing services on one campus, with a promise of lifetime care in return for an entry fee and monthly payments.

Hospice is end-of-life care that includes managing pain so the person can be comfortable and have the maximum quality of life.

Dubow said many family members avoid contacting the facilities with their concerns. Or they call and say, “I’m sorry for being a bother.”

“Be a bother,” he said. “The best way to improve our country’s health care is if you’re an advocate. The best providers understand that.”

Alan Breitler of Silver Spring came to pick up all the information he could.

“What brought me here?” he said. “I’m 79 years old.”

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