The Family Health Guide

Caregiving and Eldercare

Living Arrangements

Living independently — and safely — in your later years

The majority of older people remain independent well into later life. Most seniors want to remain in their own homes, a goal that's easier to accomplish if they adapt their lives and homes to accommodate their aging bodies. Some tips for independent living include:

Redecorate. The average home is riddled with obstacles that older eyes and feet might not be able to maneuver around. Removing slippery throw rugs, using night lights, putting nonskid mats in the bathroom and kitchen, not using high-gloss floor polishes, and installing handrails that extend beyond the bottom stair can all help. You can often fit your bathrooms with items like walk-in showers, grab bars, and higher toilet seats. Ramps, elevators, and other devices can help you handle stairs. Keep often-needed items in the handiest cabinets and use a grasping tool to get things that are out of reach instead of climbing on a chair or ladder.

Lifestyle changes. Wearing rubber-soled shoes and getting regular exercise can help keep you upright. Activities like tai chi or yoga especially help since they work on balance and strength, and are not jarring on muscles or bones. Limit your alcohol intake and learn whether any of your medications might cause dizziness or affect your balance.

Seek helping hands. Shopping for groceries and other essentials can be accomplished over the phone and via the Internet these days. Meal preparation, transportation, home repair, housecleaning, and help with financial or personal tasks such as paying bills and bathing might be hired out if you can afford it, shared among friends and family, or included in the repertoire of elder services offered in your community or through insurance.

Plan for emergencies. Who can check in on you regularly? Whom can you call in an emergency? What would happen if you fell and couldn't reach the phone? Keep emergency numbers near each phone or, better still, on speed dial. Carry a cell phone or consider investing in a personal alarm system, if necessary. Look into companionship services or simple visits and phone checks from a local agency on aging or religious group. To find agencies near you, call the Eldercare Locator at 1-800-677-1116 or visit their web site at

October 2002 Update

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Home visitation program improve seniors' lives

Though many countries have nationalized home visitation programs for the elderly, controversy exists over whether they actually help improve the quality of participants' lives. A group of researchers recently analyzed much of the published data to try to put the subject to rest, and the news is favorable. The meta-analysis, published in the Feb. 27, 2002, issue of the Journal of American Medical Association (JAMA), focused on 18 trials that included over 13,000 participants.

As part of each program studied, elderly people received visits from health care workers who tried to help them prevent functional impairment and admission into nursing homes. The workers asked about health care issues like immunization and exercise, looked for untreated health problems, and reviewed the proper use of any medications the patient was taking.

Programs that evaluated many aspects of the senior's life (medical, functional, psychological, social situation, safety of the home) and included follow-up visits seem to be the most beneficial, according to the analysis. Participants in this type of program kept their independence the longest, remaining able to perform acts like dressing themselves and going to the bathroom without assistance. All types of programs appear to reduce mortality, but the older the patient, the less impact any program has on death rates. Short-term visitation programs had no significant effects on nursing home admissions. However, the rate of admission was significantly lower in people whose program included nine or more visits over a two- to three-year period.

Though the authors of the JAMA study admit that it has its limits because the comparisons made in any meta-analysis must be confirmed by other studies, they do believe it has important policy implications. They recommend that countries with home visit programs in place analyze them to see if they include the components the researchers found to be effective. They also suggest that countries that do not have such programs, like the United States, consider implementing them.
April 2002 Update

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