Adapting Your Home to Care for an Aging Family Member

This is the first of a two-part series exploring modifications and home adaptations designed to help aging family members live more safely and comfortably at home. Part two in the series will deal specifically with the special needs of families dealing with dementia.

As Dorothy says, "I'm no spring chicken myself." Dorothy is a 78-year-old wife caring for her 81-year-old husband. George has advancing Parkinson's disease, which has made it increasingly hard for him to live independently. While he hasn't been well for many years, it's really been the last 18 months in which he's required around-the-clock assistance from his wife. Dorothy finds herself on call throughout the day and night, and finds it difficult to leave George for even a few hours during the day.

Despite all the physical help he requires, George remains mentally very sharp, and as a result, provides good company for Dorothy. Dorothy does not feel lonely, and, in fact, is able to stay in touch with many of the couples they've been friends with over the years. "It may take two hours to prepare him, but our friends still come over for our weekly card game--it's the highlight of my week!"

While Dorothy does not suffer feelings of isolation, she finds the care she provides very physically demanding. George relies heavily on a walker, and cannot manage stairs at all. Luckily, Dorothy's home is a split level, with the main rooms all on one floor. But getting George in and out of bed, showered, back and forth to the bathroom and in and out of the car has sometimes been more than she could handle. Dorothy is healthy, but she's only 5'1" tall, with a small frame. "I'm healthy, but have never been super strong," she stated. "I wasn't sure how much longer I would be able to do this."

Several months ago, George started receiving twice weekly home care visits, and his home care nurse made a number of suggestions to modify the home to make it easier for both him and Dorothy. For example, it was recommended that they build a ramp to the front door, install grab bars and a raised toilet seat in the bathroom, and purchase a special recliner that offers power assistance in getting up. Medicare provided coverage for a number of these items so their purchases were not a terrible financial hardship. (See below for an excerpt from Medicare FAQ "What is Covered by Medicare.")

Dorothy has found these modifications very helpful, and is planning to explore other things she can do in her home to make life easier for her and George, and also their visitors. "Since all our friends are in their 70s and 80s, anything we do will benefit them when they visit as well."

Like Dorothy, you may find that, over time, your family member's independence and mobility are decreasing, and as a result, your caregiving responsibilities are increasing. With the ever growing population of elderly living at home, a thriving market for assistive technologies has arisen to help foster safety and individual independence for as long as possible. The following suggestions from might help you further adapt your home for loved ones and aging family members:

  • When a family member can no longer walk safely up or down stairs, a threshold ramp should be considered. Permanent ramps can be installed, or there are also more affordable rubber ramps that can be cut to the desired length and width and placed up against the threshold to be moved out of the way when desired.
  • While some seniors balk at the idea of using a walker, ("I'm not that old"), walkers are a great precaution against falls in the home and a good way to help keep seniors moving. Consider a lightweight aluminum frame that uses a scissor-style mechanism to fold vertically as opposed to horizontally, making it easier to fold flat and allowing it to be rolled through narrow spaces with ease.
  • Getting in and out of a recliner or living room chair can be difficult. Rather than have to help your loved one up, risking injury to your back, consider a lift chair to enable them to sit down or stand up with ease. Some look like standard recliners, but, with the flip of a switch, the chair reclines or lifts the occupant out of it.
  • Doctors recommend an elevated toilet seat with armrests for anyone who has a hard time getting on and off the toilet. While there are models that can be clamped in place and do not require any hardware, they are typically not very sturdy, especially if the person using it is overweight. Some models combine the seat and arms with a hydraulic lifting system for extra assistance and can be used as both a raised toilet seat and a stand-alone commode. Some include a "guest" standard toilet seat which can be mounted in place when you have company over.
  • Adjustable bed rails can be put on one or both sides of a bed, which will help a person to get in and out of bed.
  • To get in and out of the shower or bathtub, grab bars are essential for safety. Some are installed permanently, and there are others that secure themselves to completely smooth surfaces using suction cups. It's very important that seniors do not use towel bars to grab onto -- they are not meant to hold weight and will come loose from the wall very easily.
  • Provide proper lighting -- remember: lighting requirements increase with age. An 85- year-old requires three times more light than a 15-year-old to see the same thing.
  • For even more suggestions on simple adaptations that can help prevent trips and falls in the home, and safeguard areas like the bathroom -- potentially one of the most dangerous rooms in the house for seniors, click here for videos from the Visiting Nurse Service of New York.

What is Covered by Medicare?
Source: PHC Online

Some home modifications can be expensive. Medicare covers some equipment but Medicare coverage typically "ends at the bathroom door." Medicare Part B helps pay for durable medical equipment, including:

  • Manual wheelchairs (capped rental)
  • Power wheelchairs
  • Some positioning devices
  • Walkers
  • Scooters
  • Seat-lift mechanisms for lift-chairs
  • Mattress over-lays (capped rental)
  • Hospital beds, semi-electric type only (capped rental)
  • Patient lifts (capped rental)
  • Oxygen equipment (capped rental)
  • Artificial limbs
  • Orthotics, splints

Durable medical equipment, such as wheelchairs, are covered only when prescribed by a doctor and the coverage criteria is meet. You can find out what equipment is covered, and whether a supplier is approved, by calling Medicare's durable medical equipment (DMERC) regional carrier for your area.

What is NOT covered by Medicare?
Equipment not covered by Medicare includes: adaptive daily living aids such as: ramps, automobile lifts, reachers, sock-aids, utensils, transfer benches, shower chairs, raised toilet seats, adjustable based beds, pulse oximeter and grab bars. Basically, Medicare stops at the bathroom door.

For more detailed information regarding coverage, call 1-800-MEDICARE.

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