Aging in Place - Elderly Living Options: Independent Living vs Assisted Living

Posted by Syifa Shodikin on

What is Aging in Place? 

It refers to when an elderly person lives in their own home or with their family. This type of housing is recommended if the elderly are still independent. Should they require assistance, they can still get help through in-home caregivers. Home modifications can also make the home more safe (e.g grab bars, alarm button, etc)

Why is it important?

As we get older, we may experience new problems such as mobility issues and difficulty in managing daily activities such as bathing, dressing up and cooking. However, with the right planning, we can spend our golden years at home.

How?

Families can help to plan out the golden years of their loved ones by thinking of the type of care that is required by the individual. For example, they can plan around the illnesses that the elderly person has. For caregivers, they can learn about the support that the elderly person needs in order for them to continue to stay at home.

Some tips to encourage Aging in Place:

  • Personal care: Ask a family member/relative or hire a caregiver to help with bathing, washing or dressing.
  • Housekeeping: Purchase items through deliveries or hire cleaning services.
  • Meals preparation: If it is difficult to cook, they can choose to eat outside. Alternatively, they can also apply for meal delivery programs from centers or organizations.

 

Aging in Place - Difference between Independent Living (IL) and Assisted Living (AL) for the Elderly

What kind of home arrangement to go for- Independent Living or Assisted Living? This depends on the needs of the elderly. It is determined by the elderly person's ability to do their daily activities, such as personal care, meals preparation, health management, housekeeping, etc., without help.

Some questions from 'AgingCare' that caregivers can use as a guideline: 

  • Are they in good health?
  • Can they manage medications on their own?
  • Do they need assistance with activities of daily living? 

 

Independent Living (IL)

  • Live independently but enjoy having the access to assistance when they need it
  • Safe environment at home while they are able to freely exercise their mobility
  • Elderly can continue their daily activities without much disruption
    • Home modifications can facilitate when doing daily activities
    • Caregivers/Family members are there to provide help but not necessary to depend on them entirely

SOS Button

Instead of having the caregiver monitoring them constantly, the elderly can use this to alert someone when they need it

Walker

If they have mild mobility issues and can still walk, choose a walker instead of a wheelchair. This is to encourage the elderly to improve their stability while keeping them safe

Bed rail

When deciding beds for the elderly, think of their needs. Bed rails provide a specific function for the user - to help them get out of bed. 


BUT, there are some things to note for IL housing arrangements:
Even though the elderly are encouraged to live independently, it is also important to make sure their needs are met! At times, elderly may reject any form of help or might not even know they need assistance. Thus, caregivers have to evaluate their needs and must think of ways so the elderly can get the right support.

 

Assisted Living (AL)

  • For elderly living at home who require more support in their daily activities.
  • Usually their homes are equipped with medical devices such as wheelchairs and nursing beds
    • We might be thinking these products provide the safest and most secure environment for them but in reality, it might not be that helpful.
    • Rather than complementing their mobility, these products might be replacing it instead.
    • Normal activities will be affected as they are completely dependent on a device or a caregiver to help them

Wheelchair

Opt for a wheelchair ONLY if they have serious mobility issues. If they need a wheelchair, they also need to consider getting ramps. Before deciding, evaluate other options such as canes, walkers or rollators as they can be more helpful for their mobility.

Nursing bed

Opt for a nursing bed ONLY if the elderly really needs the functions. Otherwise, they might provide unnecessary features that might not be helpful for the elderly's mobility and it can be quite costly. The user may also feel uncomfortable having to change their regular, familiar bed.

 

How to plan for an AL housing arrangement?

  • Rather than focusing on the product features, user's needs should be prioritised
  • Ask the elderly questions and evaluate their mobility before making a purchase

It is best to avoid turning the home of the elderly into a nursing home, with the over-reliance on assistive products. How can Nursing Homes fall under Assisted Living?


Nursing Homes are often used interchangeably with Assisted Living. Although there are differences in features and services offered, there are reasons why they are considered similar:

  • Both offer assistance with daily living and medical care (although Nursing Homes provide a higher level of care to residents) and can take away the elderly’s independence to a small or huge extent. 
  • However, elderly who need constant supervision and frequent help should opt for Nursing Homes as they provide round-the-clock care. They will provide help with managing the medications for the elderly, dressing the elderly, preparing meals, caring for their personal hygiene and more. 
  • Common elder care products include nursing bed, wheelchairs, ramps

  • Otherwise, if the elderly can still manage themselves in terms of doing daily activities, it is better to live in a home (or their own home) that complements their mobility, promotes independence and allows them to age well.


    Elderly Living Options & Trends in SG

     

    #1: For elderly who want to live their senior years at home, they can modify their home to make it elderly-friendly. According to AIC, most common home modifications include:

    • Installing grab bars along bathroom walls, corridors
    • Converting into non-slip floors with mats or flooring treatments
    • Glow-in-the dark or fluorescent features on products to improve visibility 
    • Removing hazards that can potentially lead to falls such as loose carpets, stacks of newspapers, tangled wires
    • Put corner protectors on furnitures with sharp edges to minimise the risk of injuries

     

    #2: According to this article, a new type of housing will be made available in May 2020: 

    Assisted-living flats comes with 24/7 emergency response

    Details:

    • Who? For single seniors who live alone.
    • What? 
      • A type of housing that is in between a home and a nursing home. 
      • There will be an on-site community manager to monitor the health status of the resident and link them with relevant care services if needed.
      • Programmes will be curated to encourage interactions among residents.
    • Why? Challenges among older people: Social isolation, self-isolate at home, mental state is affected and can deteriorate over time. As such, assisted-living flats are created to tackle this issue.

     

    References:

    https://dailycaring.com/senior-housing-options-overview/
    https://www.nia.nih.gov/health/aging-place-growing-older-home/ 
    https://www.umh.org/assisted-independent-living-blog/bid/245242/the-difference-between-assisted-independent-living/ 
    https://www.agingcare.com/articles/3-types-of-independent-living-for-seniors-136657.htm/
    https://www.seniorliving.org/compare/assisted-living-vs-nursing-home/ 
    https://www.aic.sg/caregiving/Home%20Modifications/ 
    https://www.straitstimes.com/singapore/assisted-living-flats-give-seniors-option-to-age-at-home/ 

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