The “Aging in Place in America” study asked seniors about their greatest fears surrounding aging. While only three percent of seniors said that death is their greatest fear, loss of independence was named as the greatest fear by twenty-six percent of seniors.
The newspaper, the Telegraph, reported concurring results in a similar survey conducted in Britain. There, approximately three-quarters of respondents said losing independence was a fear they associated with aging, while only a quarter of respondents reported death as being among the most fearful aspects of aging.
Our desire to be independent and free is a core drive that is, in some sense, greater than the will to survive. Psychologist Abraham Maslow posited that independence is the cornerstone of one’s esteem, without which the rest of the psyche is liable to crumble.
Considering seniors feelings about the importance of maintaining independence, senior communities should do more than pay lip service to promoting independence. As Susan B. Anthony said, “Independence is happiness.”
Communities that really dedicate themselves to empowering their residents to be as independent as possible will have a resident population that is happier and more vital than a community where independence takes a back seat to other concerns.
Fostering a Sense of Independence at Senior Living
The challenge for providers is to foster a sense of independence while running their community efficiently, and upholding their responsibility to keep residents safe. This is a fine balance, but with careful consideration, policies can be adjusted to allow residents as much independence as possible, while still keeping residents as safe as could practically be expected.
Of course there are no one-size-fits-all approaches to this. Different senior living care types will have different levels of flexibility. For example, an assisted living community can provide a sense of independence more readily than can a secured memory care facility or a nursing home. And even within a single community, residents’ varying needs may require tailor made policies towards promoting independence.
Strategies to Promote Independence
All this being said, here are some approaches and strategies that senior living providers have used to help their residents maintain that ever important feeling of independence.
Aging in Place:
Aging in place involves providing residents increasing level of care, as needed, in the same apartment throughout their stay at a community. While some communities may have, for example, a separate wing for residents with high care needs, an “aging in place” style community brings the increased care to residents wherever they reside. Providers that allow residents to “age in place” give their residents the peace of mind that one health crisis won’t require them to move to another area of the community, or to another community all together.
Assisted living communities and nursing homes have a responsibility to check on their residents, but those checks are sometimes seen as intrusive by residents. Ambient monitoring uses technology that verifies the wellbeing of residents remotely, while at the same time respecting their privacy. Depth, motion and pressure sensors connected to artificial intelligence software continuously verifies the health and safety of a resident, and can alert staff to a problem (or impending problem), all without the use of more invasive video cameras or microphones.
Proactively Emphasizing Residents Rights:
Nursing homes are required to provide residents a copy of their the legal rights as residents, and to post the same list within the facility. Many states have the same requirements for assisted living communities. Communities may be wise to emphasize and celebrate resident rights rather than make them fine print. Going over residents’ rights with them point by point before a move-in tells the resident that the community respects the independence of residents and wants to be as forward as possible about their rights.
According to a 2012 survey by A Place for Mom, far and away the most important amenity at a community is the acceptance of pets. In other words, one of the most common questions a senior will ask a provider is whether they can bring their dog or cat. If the answer is “no”, their first impression of the community may be one of prohibition and loss of independence. Of course not all communities can allow residents to accept pets – there must always be some no-pets senior communities for seniors with pet allergies, and at communities with a resident population that is low-functioning. But at communities that do have the potential flexibility to allow pets, it is a great way to help residents feel independent and at home.
Anytime, restaurant-style dining has become a popular trend at senior living, and it goes a long way towards facilitating a sense of independence among residents. When residents can have their meals at their leisure, and order whatever they like from a broad menu, they feel as if they are living in a nice hotel rather than a “facility”.
A Key to the Front Door for Anytime Access:
In her book “Assisted Living: An Insider’s View,” assisted living resident, Carol Netzer, describes her experiences at assisted living. For her, living at a community that locked their doors in the evening and did not provide keys to residents made her feel acutely dependent. Netzer writes, “The doors are locked at 9:00 PM, which means a whole rigamarole about rousing the night person on duty when I come in after nine. I have a panicky feeling while waiting as though I am being imprisoned but I also feel as though I have been locked out of my prison home as well.” Netzer later moved to a community where “a concierge is always on duty, so the doors are never locked and people are free to come and go at will.”
Offering Choices Whenever Possible to High Needs Residents:
Senior living providers sometimes care for people who must be closely monitored in environments that are secured, particularly in dementia care communities and nursing homes. Yet even at these kinds of communities, approaches that make residents feel respected and independent are available. For instance, while memory care providers cannot allow residents to go out and about alone, and cannot expect residents to handle the complications of anytime dining, they can make a point of offering choices at frequent junctures. This assures that even high needs residents feel they still have a say in their life and enhances the dignity of residents.
As noted above, not all these approaches are feasible or advisable at every community, but by fostering as much independence as is reasonably possible, residents will feel more respected, and be more content and assured. Residents who feel good about their level of independence at the community they call home are likely to stay longer, boosting the occupancy rate of communities that emphasize the autonomy of their residents.
What approaches do you reccomend to facilitate the independence and autonomy of residents? How do you balance the need for safety with residents need for independence? We welcome your comments below.