Saturday, March 31, 2007

Aging in Place, Aging Alone

As a provider of elder care and an advocate for our elders, I am very frustrated with the current mind set of Americans. I am speaking of the mind set regarding where we should grow old, and where we should be cared for when we have aged to the point of needing assistance.

I am speaking to the current belief that the best option for aging is aging in place. That is; the assumption that aging and being cared for at our home is the best option and the one that we, (society and the elderly) desire.

I think that people do not desire to be alone, isolated or vulnerable. yet, these are three common things that happen when we age alone in our own homes. I would argue that you will find more lonely, vulnerable and isolated elders in their own homes than you would in a "facility" type setting.

Take time to seriously think about the single elders you know. Perhaps it is someone from church, a relative, a neighbor or an acquaintance. Do these individuals have great support systems at home, are they happy, and do they seem safe to be alone? Or if you really think about it, do they appear vulnerable to solicitors, and being taken advantage of for their assets and belongs; or worse could the be physically abused? Do they look well groomed, nourished and cared for?

Those of us who work in elder care can tell you countless horror stories about elders who were abused physically, emotionally and even sexually. We can talk of exploitation from their friends and worse; family. We can tell stories of the environments that these elders were left in to fend for themselves. Yet, none of these stories make the press.

I would argue that it is the common theme not the uncommon theme that we see from elders who are left to fend for themselves with limited to no support, and no advocacy.

Yet the desire to stay in our homes by ourselves to the last possible day is what we are told we should want, and what we have "accepted" as our social norm? Why?

I think our current beliefs about aging come from several stereotypes and fears that we are inundated with about aging, nursing homes, and being "dependent" on someone to care for us.

We read the stories of abuse and neglect that occurs in nursing homes, and for those who have never experienced that environment come to believe that all "facilities" are places we should avoid at all cost. The reality is that we are hearing of the worst case scenarios and not the norm.

However, when we hear, see or read these horrendous scenarios we come to believe that they are the norm and not the exception.

As Americans, we also have been "socialized" to be independent, self supporting and self reliant. Anything other then these traits are taught to us as signs of weakness.

I am on a mission to change the paradigm of aging in place. We need to start asking ourselves, if living alone, with a limited support system is really going to be in our best interest, and does it really reflect how we have lived our lives until that point? I became focused on this topic when I recently experienced being alone when I could have used some help.

My husband had left for a three day trip and I was left alone to fend for myself on a morning of snow and ice. As I drove down our isolated dirt road that morning; it occurred to me that I had no one to call and come to my immediate assistance if I became snowbound or stuck. I felt vulnerable and a little helpless, not a good feeling. As I drove to work I pondered being in my very rural home at the age of 85 and alone. Would I want to stay on the farm, living alone with very limited support from family and totally at the mercy of strangers to provide me with one to one care?

My answer came later that day at work. As I talked to a coworker and spent time laughing with an elder it dawned on me that being alone is something I will never crave.

In fact if we think about our generation we are very different social animals then our parents and grandparents. We are used to group socialization, traveling, eating out, (I often joke that when my generational peers are demented we will need the cue of a steering wheel in front of us to remember to eat); and having a huge social network via phone, Internet and work.

For most of us communal living, reminds us of college dorm and apartment days, great memories and fun. It is something we think fondly of.

For women, the change in our socialization has been huge. Most women are now working, or have worked outside of the home the majority of their married and adult lives. We have become independent, socially confident in new settings and we enjoy our social outings. Further, I think today's women find safety and confidence with friends more then ever being alone to fend for themselves.

As the next generation of elders we need to be very vocal, and involved in the planning of environments, financial needs and speaking to our families and spouses about where and how we want to age.

Simply because we are told that staying home is the best option, we need to really think about or needs and not accept the social norms of the previous generation as our own. We will have very different needs and wants.

Think about it the next time you are stranded alone, your power goes out, your car breaks down and you have to depend on the aid of a stranger. Now imagine yourself alone at 90 with the same scenarios. Not a comforting thought is it?