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While the vast majority of Americans want to stay in their homes as they age, it can be challenging to find the home-based care they need to age-in-place.
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You may face financial, logistical and safety challenges when you try to receive in-home care.
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The Institute for Human Caring at Providence provides resources to help people receive respectful care and overcome challenges of home healthcare.
As Baby Boomers continue to age and our population in general grows older, we are facing a huge need for home health care and caregiving services. Surveys repeatedly show that 75-90% of Americans would prefer to age in their own homes instead of moving to skilled nursing facilities or nursing homes. And staying at home has benefits, including living longer and being healthier in general.
Unfortunately, staying at home is not simple as you age or if you face a disability. You’ll face a number of the challenges below.
Financial burdens of caregiving services
Many people will need help from other people to stay at home. They’ll need help with cleaning, dressing, bathing, eating and many other activities of daily living (ADLs). At this time, about 75% of these caregiving services are provided by a family member who gives up their own job or time to provide this care.
But that’s not always possible. It may not be financially feasible for someone to give up their job to be a caregiver. You might not have family in the area who can help.
At that point, you’ll need help from personal assistance services, which might not be covered by Medicare or private insurance. And while they tend to be covered by Medicaid, Medicaid rules vary greatly by state and it can be difficult to qualify. Many people have trouble finding the money to hire these services and instead have to use services covered by Medicare, such as skilled nursing facilities.
Lack of available caregivers
Even if you can afford assistance services, they can be difficult to find. At this time, around 800,000 Americans are on Medicaid waiting lists for home health or community-based health services. These include waiting on home health aides, home care workers or other home care services.
A personal caregiver is a low-wage job with high rates of burnout. The pandemic made this situation worse. As inflation has risen, many people are looking for higher paying jobs elsewhere. Home health agencies are facing staffing shortages and retention challenges. Until wages and supports increase for these workers, it may difficult to receive adequate home health care.
Unsafe home environments
To stay home and age-in-place safely, people need to make a variety of changes to their home. They may need things like:
- Grab bars in bathrooms
- Zero-entry showers
- Wider doorways to fit a wheelchair
- Lower countertops or workspaces in the kitchen
- Wheelchair ramps or stair lifts
These changes in the home are costly and can take a while to implement. Most people don’t think about these changes until they need them; at that point, it can take a long time to get the home safe to live in.
This is one challenge that people can tackle early. When planning a home or a remodel, they can have these items included in the plans. That way they are ready to age in place long before they need these supports.
Overcoming home health obstacles
If you hope to live at home as you age or if you are facing a disability, you can start planning for these challenges. The Institute for Human Caring at Providence has a vision of creating more personalized, humanized health care services for all people. We work with health care providers to ensure that all adults can have an advanced care plan and can receive respectful care throughout their lives.
On the Institute’s website, you can find several planning tools to help you decide about your future care needs. We encourage you to make these plans early, even in your 40s, so you are ready to receive quality care at home if needed. We’ll work with you as best we can to help you overcome the challenges of home health care and find a way to enjoy your own home for years to come.
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Related resources
Hear Me Now podcast: The challenge of staying home
How you can stay home as you age
It’s time to talk about advance directives
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
