February 2015 Bar Bulletin
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February 2015 Bar Bulletin

A Plan To Avoid Institutional Care

By Rajiv Nagaich


(Third in a series; Second of two parts)

Once the family has pondered the pros and cons of a decision to age in place and decided to age in place, they will next need to make sure that all the elements are in place to successfully age in place.

There are essentially three elements needed: (1) having a home that is age friendly; (2) having the resources to hire the help to come to the home; and (3) having the assurance of the assigned fiduciaries that they will be there to oversee the delivery of the care needed to allow one to age in place.

Age-friendly Home

It is sad to note that many people who could otherwise have aged in place have to move because their home is not age friendly and last-minute modifications are simply too cost prohibitive. The time to make sure that the client who desires to age in place is living in an age-friendly home is now, not after he or she is in the hospital screaming to be taken back home, but can't because the home is not appropriate.

What makes a home appropriate for a stroke victim is different than for a person with dementia. You need professionals who can help identify the shortcomings that need to be addressed to make the home appropriate. An attorney can accomplish this by coordinating a home safety evaluation by a qualified occupational therapist.

An occupational therapist should be briefed about the client's family medical issues so that the assessment can be tailored not only for what the client faces today, but also for any possible outcome the client might face in future. The occupational therapist can then provide a list of modifications needed to make the home appropriate for aging in place. In addition, he or she should also be able to educate clients about other issues that commonly result in institutional placement, such as fall risks.

By providing such an overview, the client is then in a position to determine whether the expense of the requisite changes is worth incurring and what lifestyle changes need to be made, or if it is time to consider other housing options.

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