Aging in Place at Home: The Definitive Guide Part 1


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Introduction

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This guide is a comprehensive, one-stop encyclopedia of products and solutions that make homes safer and more livable for Seniors. Those who can benefit most from this resource include healthcare professionals, social workers, caregivers, family members, and, most importantly, those who intend to age in place.

After reviewing this guide readers will be able to confidently select the ideal solutions to overcome challenges within the home. Aging well in the comfort and familiarity of one’s own home and neighborhood is possible; the detailed information presented in this guide is the blueprint.


Guide Organization

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This guide organizes aging in place solutions by activity. There are four main activity categories and a total of 14 sub-categories. The extensive length of this guide made including all the solutions on a single page implausible. Instead, the guide is divided into 14 pages (one for each sub-category) to offer faster-loading pages and streamlined navigation.

Immediately below is a brief description of all four categories and their respective sub-categories. Also, there are instructions explaining how to quickly navigate to certain sections of the guide.

The last portion of this introductory page defines important terms related to the solutions featured in the guide. Getting acquainted with such terminology gives readers a good foundation of knowledge before diving into the guide; those who are new to aging in place especially stand to benefit.


Mobility

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Mobility encompasses all functional activities that share a primary goal of moving from one location or position to another. As it pertains to safely aging at home, there are four categories of mobility: ambulating; ascending and descending stairs; getting into and out of bed; and sitting down and standing up.

Ambulating covers mobility aids and accessibility modifications that assist users with general ambulation inside or outside of one’s home. Ascending and descending stairs includes home modifications that allow users to circumvent the burden of climbing stairs. Getting in and out of bed lists solutions that help users transfer in and out of bed. Sitting down and standing up provides durable medical equipment, assistive devices, and home modifications for lowering onto and raising up from a seated position.


Hygiene

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Hygiene includes all functional activities that share the primary goal of maintaining personal cleanliness. There are four areas of hygiene in regards to daily activities: showering, grooming, dressing, and toileting.

Showering contains a wide variety of home modifications, durable medical equipment, and assistive devices that increase the safety, accessibility, and functionality of the shower space. Grooming is mostly comprised of assistive devices specially suited to overcome the physical challenges that come up during routine grooming activities like make-up application, facial hair maintenance, oral care, and more. The dressing section outlines solutions that simplify the process of dressing and undressing. Finally, the toileting section lists durable medical equipment and home modifications that make using the toilet easier and more accessible.


Housework

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All functional activities that share a primary goal of tending to one’s home and completing household chores fall within the category of housework. There are four sections of housework: maintenance, laundry, washing dishes, and yard work.

Maintenance features tools and devices that assist with non-room-specific cleaning such as vacuuming and routine upkeep like replacing light bulbs. Laundry contains home modifications to make washing and drying clothing less taxing. The section for washing dishes includes assistive devices and home modifications that make cleaning dishes easier. Finally, yard work details modifications and tools that enable aging homeowners to keep up with gardening and other outdoor activities.


Nutrition

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Nutrition includes all functional activities that share the primary goal of taking care of one’s body through diet. There are two parts of nutrition: cooking and eating.

Cooking explores unique tools that introduce greater levels of safety and ease of use. Additionally, this section details home modifications that make cooking easier by improving the efficiency and accessibility of the kitchen space. The eating section features assistive devices that make feeding oneself easier. Those with sensory deficits and limited coordination can find solutions to promote independent eating.


Guide Navigation

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Those who want to follow the guide in order can simply click on the “Next” and “Previous” buttons at the top and bottom of each page to either proceed to the next page or revert back to the previous page.

Below are more advanced instructions for how to quickly navigate throughout this guide on desktop, tablet, and mobile devices.


Desktop

As mentioned earlier, this guide has 14 pages with each page dedicated to one specific kind of activity. Desktop users have two navigation menus on the right side of the screen. 

The first menu allows users to jump from one page in the guide to another. This menu lists all 14 pages of the guide broken up into their respective categories.

Aging in Place Guide Navigation Menu

Visitors need only to click a sub-category activity to immediately go to that specific page within the guide.


The second menu allows users to jump to a specific section of the current page rather than manually scrolling down. This menu conveniently stays visible on the screen at all times. The follow image is the table of contents menu for this particularly page.

Aging in Place Page Navigation Menu

Click on any section or sub-section listed in this hierarchical table of contents menu to immediately go to that specific spot on the current page. Longer menus may require users to use the tab bar or scroll with the mouse to see all the available sections for the page.

Should the user ever need to scroll back to the top of any given page, simply click the “Back to top” button at the bottom right-hand side of the screen.


Tablet and Mobile

Table and mobile users share the same navigation menus. Just as is the case with desktop, there is a menu for jumping from one page to another and a second menu for jumping to a certain section of the current page.

Both of these menus are within a black button that sits at the top right side of the screen. Tap the black button to reveal the menus.

Aging in Place Mobile Menu - Minimized

Minimized Menu

Aging in Place Mobile Menu - Expanded

Expanded Menu

Tap the down arrow at the right of the first menu section entitled “Jump to a page in the Guide” to reveal the four activity categories as well as the introduction that make up the guide. Tap the down arrow at the right of any of these five options to display its sub-category pages.


Aging in Place Mobile Menu - First Menu
Aging in Place Mobile Menu - First Menu with Subsections

Tap any sub-category page within this first drop-down menu to immediately go to that specific page within the guide.

Tap the down arrow at the right of the second menu section entitled “Jump to a section on this Page” to reveal the hierarchical sections of the current page. Tap the down arrow at the right of any of these sections to display its sub-sections.


Aging in Place Mobile Menu - Second Menu
Aging in Place Mobile Menu - Second Menu with Subsections

Tap any section or sub-section within this second drop-down menu to immediately go to that specific spot on the current page.

When the menu is expanded, swipe up and down to scroll through the selections. Tap the X button at the top left of the expanded menu to minimize it. Tap any section or sub-section to immediately go to that specific spot on the current page.

Should the user ever need to scroll back to the top of any given page, simply tap the double up arrow button at the bottom right-hand side of the screen.


Terminology

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There are three types of solutions that increase safety, functionality, and comfort for those who are aging in place: durable medical equipment, assistive devices, and home modifications. Understanding the definition of each term will facilitate clear communication with physicians, insurance agencies, and other healthcare professionals. So before delving into the practical application, it is important to take time to understand the underlying principles.


Durable Medical Equipment

Durable medical equipment (D.M.E.), also called home medical equipment (H.M.E.), is equipment that helps manage specific diagnoses, expedite post-hospitalization recovery, and relieve chronic symptoms. Users can employ durable medical equipment for as long as necessary; in fact, some may require certain equipment indefinitely. The portability of durable medical equipment allows users to quickly introduce new equipment into their home, transport equipment during a move, and remove equipment when no longer needed. Some equipment is intended for use in settings outside of the home. For this reason, “durable medical equipment” serves as a more apt term than the more confining “home medical equipment.”


Significant Risk

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Some pieces of equipment only address the medical needs of certain health conditions. The F.D.A. labels this type of equipment as “significant risk” because there is a great enough possibility of misuse that can result in serious health complications for users.

The exclusive features of significant risk durable medical equipment restrict its benefits to a very limited scope of users. For health safety reasons, users must have a prescription from a licensed practitioner to legally purchase durable medical equipment classified as a significant risk. Examples of significant risk durable medical equipment include oxygen concentrators, C.P.A.P. machines, and home infusion pumps.


Nonsignificant Risk

Many pieces of durable medical equipment, however, consist of basic enough features that they are capable of offering benefits to a broader range of users. The F.D.A. labels this second type of equipment as “nonsignificant risk” because the chances of improperly using the equipment, and its resulting in severe health issues, is very low. Hospital BedThe generally-beneficial features of nonsignificant risk durable medical equipment expand its utility to a wide variety of users.

Users can purchase nonsignificant risk durable medical equipment without any physician authorization whatsoever. For health insurance coverage purposes, however, physicians may write prescriptions for nonsignificant risk durable medical if the equipment is deemed a medical necessity. Examples of nonsignificant risk durable medical equipment include commode chairs, shower benches, and hospital beds.


Insurance Coverage

Health insurance policies with durable medical equipment benefits will only offer coverage if a doctor determines that the equipment is medically necessary for the policyholder. So regardless of the durable medical equipment risk classification, users who want to make an insurance claim must have a prescription from a physician. Furthermore, users with health insurance through Medicare and Medicaid must comply with Section 6407 of the Affordable Care Act, which requires doctors to hold a face-to-face encounter with users no more than six months prior to making claims for certain durable medical equipment.

Needless to say, durable medical equipment benefits vary greatly depending on the insurance provider and policy; therefore, policyholders should take the time to fully understand their coverage and contact their insurance carrier with any questions before purchasing durable medical equipment.


As mentioned above significant risk durable medical equipment is specialized equipment intended for a narrow spectrum of users with very specific health conditions and symptoms. Therefore, in an effort to maximize relevancy and impact, this guide strictly addresses durable medical equipment that carries nonsignificant risk since such equipment has the capacity to serve all users, irrespective of diagnoses and symptoms.


Assistive Devices

Grabber toolAssistive devices, also referred to as assistive technology, are tools and living aids used to promote independence and increase safety. Although assistive devices can provide indirect therapeutic benefits, they differ from durable medical equipment in that they are not primarily medical in nature. As such, assistive devices are unregulated and do not require a prescription to purchase. Insurers do not cover the cost of assistive devices since they do not meet the definition of medically necessary. Similar to durable medical equipment, assistive devices are portable and many can be used both inside and outside the home. Examples of assistive devices include reach grabber tools, fall detection alert systems, and long handle bath brushes.

There are plenty of discrepancies among authorities within the healthcare industry as to what is considered durable medical equipment (primarily medical) vs. assistive devices (primarily non-medical). Sources with conflicting labels abound. Of course, the only objective that matters is helping others find solutions that support aging in place, regardless of classification.


Home Modifications

Home modifications are physical changes made to one’s living space to provide accessibility, enhance safety, and improve independence. This guide thoroughly outlines which designs and installation practices are best for each home modification solution. Unlike durable medical equipment and assistive devices, home modifications are fixed in place and actually become a permanent part of the physical environment.

Although non-clinical in nature, home modifications can still offer medical-related benefits. Always follow local building codes and permitting protocols when implementing home modifications. Also, the Americans with Disabilities Act Accessibility Guidelines (A.D.A.A.G.) offer good benchmarks to follow in some instances.

Roll-in Shower Home Modification

State Medicaid programs with Home and Community Based Services (H.C.B.S.) waivers and U.S. Department of Veterans Affairs grants are the only options available to cover the costs of home modifications. Click here for an exhaustive list of state-by-state assistance programs available to Seniors. Unfortunately, Medicare and private health insurance do not include benefits for home modifications.

Typically issues that can be resolved with durable medical equipment or assistive devices can also be remedied with home modifications. In such cases, users can select the solution that makes the most sense for their circumstances. This guide shares all the available options for addressing unmet needs at home. The more options, the better.


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