Homesteaders

Aging in place

By Renee Sklarew

Shutterstock/Robert Kneschke

Peggy Small is a spry 91-year-old who lives by herself in a four-level home in Mount Vernon that she and her husband bought in the 1960s. Small says there’s an accumulation of 80 years-worth of treasures in her attic, and she’s determined to clear it out of there personally: “I’m not moving out. No one else knows what this stuff is; yesterday I found a Civil War canteen.”

Her daughter and son live outside of Virginia and were concerned about leaving her alone when Small’s husband died seven years ago. Recently, Small’s daughter found Mount Vernon at Home, a grassroots movement designed to help seniors remain in their homes with the help of volunteers.

Seniors pay an annual fee of $650 per person, and Mount Vernon at Home coordinates transportation to doctors, salon appointments and shopping outings; and oversees accessibility measures in the home. One example, Mount Vernon at Home volunteers installed handrails on Small’s front steps and put grab bars in her bathroom to increase safety.

Small says, “I try not to take advantage. I store things up for several stops in a row—like going to the post office, getting my hair done and buying groceries. They can’t take the place of my son and daughter, but they do help me be independent.”

Mount Vernon at Home’s executive director, Barbara Sullivan, is also a licensed long-term care administrator who insures all volunteers and contractors are screened and vetted in order to participate. Sullivan added exercise classes to prevent falling and works with contractors to provide members with medic alert systems.

“People want to stay in the community they love. They want to go to their doctors, churches, grocery stores, but they don’t want to burden anybody,” explains Sullivan. “We get churches to recruit volunteers to drive [the elderly program participants], or hook up their TVs, and help them stay socially connected through group outings.”

Another option for seniors who require a higher level of medical care but wish to remain in their homes: Program for All Inclusive Care for the Elderly, or PACE, a network of nationwide health care providers offering the program.

PACE serves people over age 55 who qualify for both Medicare and Medicaid, meet the state’s requirements for nursing-home care, and can safely live in their community with support. Participants typically have chronic conditions like diabetes or dementia.

The PACE team coordinates adult day care and medical care, and oversees home health aides who help with chores, toileting and meal preparation. Each participant in PACE also has a personal care plan with daily nursing assessments. These evaluations determine how an individual’s disease is progressing and lead to setting up appropriate services, whether that’s seeing a specialist or installing ramps in the home.

Currently, Inova Health Care System is developing a PACE program in Fairfax County; Robert Hager leads the project locally and says, “Coordinating health care is a stressful journey for caregivers. PACE manages all their needs in one clinic—medicines, specialists, adult day care—the coordination is attractive.”

As the costs of assisted living and nursing homes skyrocket, how do people feel about remaining at home and having these resources? “It’s an answer to everything,” says Small. “It makes me feel very secure.”

(January 2012)