When my 87-year-old father found himself in a nursing home after a hospitalization, the first thing he did was demand his car keys. I had to beg, bargain, and cajole just to get him to agree to stay for the few weeks he needed to heal from a serious infection.

It never crossed my mind that the real problem facing growing numbers of older Americans was just the opposite -- they want and need to be in nursing homes, but those facilities are increasingly evicting them if their care grows too complex or they run through their assets and turn to Medicaid to cover the cost.

According to a recent Wall Street Journal article, across the country "nursing homes are forcing out frail and ill residents." While there's no official count of nursing home evictions, formal complaints about discharge practices have doubled over the past decade, to more than 8,000 a year at last count.

I asked Caring.com housing experts if they had run into this problem...  Read more

Recent headlines paint a troubling picture for seniors hoping to live out their years in assisted living.

• A new study from Prudential finds that assisted living costs are up 13 percent from two years ago, averaging $3,241 per month nationwide, or about $108 a day.
• NPR reports on a large assisted living chain that has been evicting elderly residents when they run through their life savings and turn to Medicaid to pay the bills. Overall, according to the NPR piece, the assisted living industry has little space for those without assets -- while the number of assisted living communities has mushroomed in recent years, the number of beds for Medicaid recipients has dropped, to about 10 percent of the total.
• Fox New offers a troubling image of 100 or so elderly folks camped out overnight in the hope of getting an application for hard-to-get affordable senior housing units in Houston, where more than 600 are already on waiting lists...  Read more

Last week I promised to test-drive one of AARP eldercare expert Elinor Ginzler's strategies for talking to your parents about introducing universal design concepts into their homes.

I tried "Dad, I need your help" on my 87-year-old father, letting him know that although I understood he was doing fine, he could ease my anxious nights by installing a second banister in his two-story condo.

Well, it flopped. He did agree that ,yes, I was a worrier (and maybe I should think about getting some help with that), but other than that, there was no problem. He'd gone up and down those stairs thousands of times without incident, he reminded me. In fact, he had developed "a system."

I had to acknowledge that maybe he was right -- and even if he wasn't, the decision wasn't mine to make. As Ginzler observes, those who talk about "role reversal" or "parenting our parents" have it backwards. No matter how old they get, our parents are still adults, with the right to make their own decisions...  Read more

Last week I wrote about universal design, a set of architectural and design principles that can make aging in place safer and more comfortable for seniors.

But first comes the tricky part -- getting your parents to sign on. It may seem like a no-brainer -- if they want to remain in their own homes as long as possible, why not make some simple changes that will up the likelihood of making that wish a reality?

But for many parents (mine included) a wall comes down when you start talking about making any kind of change to the status quo -- especially changes that have to do with accommodating the realities of getting older.

"Having a conversation about changing needs is harder than a conversation about death," says Elinor Ginzler, Senior Vice-President for Livable Communities at the AARP, citing focus group findings indicating that seniors would rather plan their own funeral than plan for when they can't make it up the stairs...  Read more

Today, there are more than 35 million Americans 65 or over. Over the next 25 years, that number is expected to double.

Where will these millions of seniors live? Contrary to myth -- or anxious expectation -- few will retire to gated communities in Florida or wind up in nursing homes. The great majority, according to researchers, will stay right where they are.

Aging in place -- or, as it is coming to be called, "aging in community" -- is the wave of the future, not to mention the present. But if your parents are among the millions of seniors who plan to live out their days in the family home, that doesn't mean that nothing has to change. The home you grew up in -- running up and down stairs, racing through narrow hallways -- isn't going to cut it as the parents who took care of you start needing more care themselves.

What to do? One increasingly popular answer is universal design -- a set of architectural and design principles that evolved post WW II for returning veterans and the disabled and are now being repurposed for older Americans...  Read more

I've written before about high-tech ways to make your parents' home safer and more accessible as they age in place. But not all safety solutions come with a microchip or a battery pack. A good part of what I call "future-proofing" your parents' home (or your own, for that matter) comes down to looking at the house through the eyes of someone who is experiencing the impairments that come with age, and making simple changes in response.

The Home Safety Council has released a new online tool that can help you do just that. At mysafehome.org, a click of the mouse takes you on a virtual tour of an online "home," with tips for accident-proofing each room. A custom tour for seniors is in the works but not released yet; however, the site does include a page of information especially for those caring for aging parents.

The site makes the sensible (but easily overlooked) suggestion that adult children "lead by example...  Read more

Earlier this month, I wrote about a new website aimed at helping seniors launch their own NORCs, or Naturally Occurring Senior Communities (neighborhoods in which older residents organize with the help of a community agency to share services and support). I've also written about other innovative options for seniors who want the independence of aging in place without the isolation that too often accompanies it.

I'll continue to explore these options because I've learned that's what the vast majority of seniors want -- to live out their days at home, not in institutions. And I've been heartened to hear back recently from Caring.com readers about other budding efforts to create a culture in which "families come together to nourish their aging citizens."

It was a reader who alerted me to the fact that cities and states across the country are revising laws and zoning ordinances that had previously...  Read more

When an illness sent my 87-year-old father to a skilled nursing facility temporarily, he was begging for his car keys from the minute he arrived. It wasn't the bland food that got to him, and he actually liked his roommate -- he just couldn’t bear the thought of all the e-mail piling up in his inbox at home.

Turns out the image of the senior set as technologically challenged is as obsolete as a manual typewriter. According to new research from the AARP and the Center for the Digital Future, seniors log on at about the same rate as younger folks to check the news, socialize, play games, shop, and -- perhaps most importantly -- maintain relationships.

With the great majority of seniors planning to live out their days in their own homes, this last finding may be the most important. Online communities, photo-sharing sites, and plain old e-mail can offer a buffer against the social isolation...  Read more

The first time I heard the term NORC (short for Naturally Occurring Senior Community) was from my 81-year-old mother, who is determined to live out her days in her comfortable cul-de-sac home rather than moving to a retirement community.

In a NORC, I learned from the file that my mother and a neighbor had pulled together, a neighborhood evolves over time and ends up with a large concentration of seniors, who then organize -- generally with the help of a community agency -- to share services and support. A lead agency coordinates with community programs, ranging from hospitals and Area Agencies on Aging to local catering and home repair businesses, which seniors can then access with a single phone call.

I found the concept so intriguing that I wrote an article for Caring.com about NORCs and other "aging in place" communities. Meanwhile, my mother and her neighbor never got past the keeping-a-file stage...  Read more

Last week, we looked at new legislation aimed at easing the epidemic of falls among elders.

Turns out -- as with many aspects of getting older -- there are some high-tech options in the works to help keep seniors steady on their feet.

Some were designed for use in nursing homes or assisted living settings but could also be used by caregivers at home. Unlike Personal Emergency Response Systems, these systems are designed to prevent falls rather than respond to them:

• The FallSaver is a small patch that attaches to the thigh with a "tilt sensor" that's activated when the wearer stands up. This is most useful for a senior who really shouldn't be walking without assistance -- if he gets up from bed or a chair, the device signals a care giver and alerts the wearer to sit down until help arrives.
• The University of Virginia is developing a Gait monitoring device that measures a user's footfalls to...  Read more

The Safety of Seniors Act, a bipartisan bill recently signed into federal law, tackles a problem that keeps many care givers up at night but has previously received little in the way of national attention: senior falls.

Falls are the leading cause of injury deaths among those over 65, accounting for about 13,000 deaths and 1.8 million emergency room visits annually. With one in three seniors experiencing a fall each year, fall-related medical costs total a staggering 19 billion annually.

If your parents have decided to grow old in their own home, there are a few simple steps you can encourage them to take right now to lower the odds of a fall (lots more information is available at stopfalls.org):

• Get rid of any throw rugs.
• Install a banister on both sides of the stairs for extra stability.
• Make sure all areas of the home are brightly lit.
• Install grab bars in the shower or bathtub and beside the toilet...  Read more

Providing care to an elderly relative can be costly not only emotionally but also financially. One study of 30 families providing care determined that collectively, they would sacrifice more than half a million dollars over their care giving years in lost wages alone.

Of course, none of us are in it for the money, but it certainly is nice when a government program comes along that recognizes the financial strain care giving can place on a family.

The Cash and Counseling Program -- which allows Medicaid recipients who would otherwise be eligible for in-home care benefits to receive the money themselves, and spend it on their own care as they see fit, including paying family members to look after them -- does just that.

Pioneered in the late 1990s, Cash and Counseling is now available in 15 states. The good news is that the federal government recently eliminated the requirement that states get a Medicaid waiver in order to offer the program...  Read more

I will never forget the image of my grandfather lying in his bed in a skilled nursing facility in Wyoming, clutching his wooden cane. Another resident had taken an unfriendly interest in him and would steal the shoes right off his feet, and my grandfather felt the need to defend himself even in his sleep.

New research from Cornell University helps explain my grandfather's hyper-vigilance. Aggression and violence among nursing home residents, the researchers found, is much more common than is generally recognized, with "serious consequences for both aggressors and victims."

Researchers at a large urban nursing home documented 35 types of physical and verbal abuse, including screaming, pushing, punching, and fighting. In a related study, nurse-observers reported 30 episodes of resident-to-resident aggression during a single 8-hour shift.

Unfortunately, the study's authors were short on solutions...  Read more

For many of us, when we think about helping our parents plan for retirement, the big concern -- and sometimes dilemma -- is keeping them nearby. Should we invite them to move in with us or to move to a retirement community near where we live? What if their need for our time and attention becomes too much for us -- the sandwich generation dilemma?

Leisureville, a new book on the world's largest retirement community, raises an entirely different -- and fascinating -- question: What if our parents' own retirement fantasy involves escaping from us, and our children, entirely?

The Villages -- the Florida retirement utopia on which author Andrew D. Blechman casts a not-so-favorable-eye -- offers its residents just this opportunity. The 20,000-acre gated community -- complete with numerous golf courses, its own newspaper and radio station, and multiple prefab downtowns -- is off limits to anyone under 55...  Read more

If you thought the new home monitoring systems for seniors were futuristic, you won't believe the I-House, just unveiled in West Bromwich, England.

A team of British engineers took a run-down home in the English countryside and transformed it into a model home for frail seniors who would otherwise need supportive living.

This nursing-home-without-leaving-home features a wheelchair lift connecting the living room to the bedroom, a keyless entry system, and memory aids that prompt residents to perform daily tasks and take medication.

Some of this may sound familiar -- U.S. companies are developing a number of technologies aimed at helping seniors stay at home with greater safety and comfort. But the I-House takes robo-retirement a step further.

Specially-designed door handles reduce the spread of infection, and hot water taps turn themselves off so that forgetful seniors won't burn themselves inadvertently...  Read more