ASK THE EXPERT: ROBERT BORNSTEIN
Author of “How to Age in Place: Planning for a Happy, Independent, and Financially Secure Retirement” talks about how to know if forgoing a nursing home or assisted living is right for you.
I ndependence is the name of the game – at least for the later years in the game of life. Many seniors want to forgo nursing homes, full-time care or other versions of assisted living.
Those who are proactive with their health and wellness during their 50s can lay the foundation to live independently through their 70s and 80s, Robert Bornstein explains in the book he co-authored with his wife Mary Languirand. How to Age in Place: Planning for a Happy, Independent, and Financially Secure Retirement (Ten Speed Press) was released in September 2013 as a comprehensive guide to aging independently.
Dr. Bornstein, recipient of the American Psychological Association’s 2005 Theodore Millon Award for excellence in personality research, has
published more than 150 articles and book chapters on personality dynamics, diagnosis and treatment.
Here, he shares his advice on making the often difficult decisions that come with age. Q: As a clinical psychologist, have you studied the effects that living independently might have on mental health at an advanced age? If so, what have you found?
Living independently is associated with less depression, a generally better mood and more optimism. One of the things that people sometimes find surprising is people who live independently are healthier as well: they have fewer episodes of illness and the flu. So, it has a very broad base of positive effects. Q: What types of planning would you encourage senior citizens to undertake while making the
move to “age in place?”
When we talk about aging in place, it’s not something you want to start thinking about when you’re 70 but rather when you’re 50. Odds are that you’ll be able to live independently longer if you’re in a single-story home than in a multi-story home. If the issue isn’t mobility, but perhaps memory failings that a lot of people experience, keeping the environment stable (not rearranging your space) is huge. If all of that isn’t working, the next step is to get in-home care, and for many people that’s a terrific strategy for maintaining independent living. Q: When deciding whether to move to a nursing home or to continue living at home, what should senior citizens and their family members consider? The bottom line in terms of deciding whether or not you or a family member needs higher-level care is safety. One thing we like to reinforce when we do talks in this area is no one has ever had to enter a nursing home because they have Alzheimer’s. The only reason ever is because their behavior renders living alone unsafe – the source of that safety concern does not matter. Q: Many children of senior citizens may have different ideas of whether living at home or in a nursing home is best for their mom or dad. What is your advice for people in this situation?
Often, sibling conflicts around caregiving for parents, even though it’s not explicit, center on money. Very little of skilled nursing home care is covered by Medicare, and so it is often the case that one or more members of the family see nursing home care for their parent as their inheritance disappearing. Families break up over this. The best route to take is to have a family meeting and try to come to an understanding of what the best options are.
Q: Let’s face it: Some seniors are just more capable of living independently than others. How do you approach a conversation with someone who wants to live alone but might pose a danger to him or herself by doing so?
Nothing is going to make it a pleasant conversation, but I think there are two things that you can do that will help. One is to empower the person: giving them as much autonomy as possible in the decision-making process is very helpful, as you can imagine. And sometimes, if the parent is very resistant, it is helpful for the family to present a unified front. It’s very hard for any person to resist that kind of social pressure.