Categorized | Family Care

The aging in place concept promotes quality of life for a frail elder

By Micha Shalev

The phrase “home is where the heart is” captures the sentiments of many older adults when it comes to making choices about where they live as they age. Eighty-nine percent of those people 50 and over surveyed in 2005 stated that they would prefer to remain in their home indefinitely. Should they find themselves unable to do so, almost 85 percent of respondents agreed with the statement “What I’d really like to do is remain in my local community for as long as possible.”

Social connections with friends and neighbors, familiarity with local amenities and proximity to services and even doctors are among the many things that may be lost when an older adult has to move from their community.

While steps are being taken to make aging in place easier, the real challenge is answering what tasks are required for aging in place to reach its promise, and what level of care can be provided at a facility level to fully embrace the concept?

As we age, health problems tend to be episodic, chronic and sometimes progressive, resulting in an increasing need for assistance. Most ordinary service-enriched assisted living, rest homes, nursing homes and independent living communities are organized to provide care at a certain level of need, sometimes too much or too little for a particular individual. As a result, a housing arrangement often becomes a poor match, requiring residents to move multiple times, until the proper level of care is found.

When dealing with individuals with dementia and Alzheimer’s disease, the situation is much more complicated. Moving between facilities is often disorienting, disturbing and undesirable, not only for the individual but for the entire family.

The process of selecting the right facility for your loved one’s long-term care can be a difficult one. Often the decision needs to be made quickly and occurs within the context of strong emotions such as guilt, fear and doubt.

Long-term facilities must respect the independence and judgment of residents. Aging in place is dedicated to maintaining and supporting independent living as long as possible. This model encourages a host of community services and resources to support seniors. Not only is remaining at home a cost-effective way to manage the upcoming surge of seniors needing such services, it also supports what many seniors want most — living in the least restrictive environment, as well as being in a place where they can wake up late, take showers as often as they wish or receive visitors any time during the day.

The very word “place” (in the aging-in-place concept) is the root cause of much of the confusion and the reason many communities use this more as a public relations gimmick. By its very nature, it implies one’s house — the place where children were raised and family experiences were shared.

We should discard the term or at least change its definition. Aging in place should have nothing to do with physical location. It should have everything to do with self-fulfillment and personal empowerment. Aging in place reflects an attitude and a way of environmentally enhancing the ability of seniors to maintain personal control over their lives — to the extent that is practical, but is important to them regardless of the fact that they are suffering from dementia and/or Alzheimer’s disease.

Micha Shalev, MHA, is the owner of Dodge Park Rest Home and the Adult Day Care Club at Dodge Park located at 101 Randolph Road in Worcester; both programs specialize in memory impairment and Alzheimer’s care. He can be reached at 508-853-8180 or by e-mail at; view more information online at


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