Is it realistically possible for our parents to "age in place" in their home? How many of you have had success with this?

It can certainly be done, if there are realistic plans, reliable people and plenty of funds in place. However, in my parent’s area (East Texas), 24 hour, in home care averages 18,000.00 month... yes! I would also explore additional concerns that could occur, such as developing serious health issues or dementia. Each family is unique, with different dynamics, expendable time/energy, needs and economic resources.

It depends on what type of house they live in, their resources (financially & physically), their relationship (stable or strained), their insurance, & willingness to receive help from family, friends, & help from outside. If they are able to live on one level that has a full bath & a room that can be used as a bedroom, then it's very possible. Are they able to move from room to room with the use of walkers if needed or can accommodations be made? Would they accept help from family, friends, etc., to help them with grocery shopping, housework, yardwork, repairs & upkeep of the home? Are they a fall risk? If groceries were ordered for them, could they bring them in & put them away or is someone available to bring them in & put them away? Do they have access to emergency help (Medic Alert, Security System, cell phone, a neighbor with key to home) if one of them falls, fire breaks out, sudden illness, etc.)? When the time comes, can they afford to hire someone to help with personal care, or whatever needs to be done? Are they able to prepare or fix meals or come to the door for Meals On Wheels? Would they be able to afford live in help If needed? My mom lived at home with the help of my brother living there, me there while he was working & an aide for when I could no longer provide the heavy physical care. I was releived by my sister when she came in town. I stayed at mom's house when my brother had to go out of town for work. These are some of the questions that your parents need to consider in order to make a decision about their future living conditions. Good luck!

Both of my parents are 'aging in place' at their home. The family must assist and corporate caregivers and medicare allowances help to make that happen. My parents were adamantly opposed to Nursing Home or AL for end of life. Takes an effort but 'aging in place' is entirely possible, at least in my experience.

Interesting discussion, and yes aging in place is possible. I wrote a book about end of life "Dying Well Prepared: Conversations and Choices" which was a finalist this year for an Eric Hoffer book award. I'm currently writing a companion to it on Aging in Place which I hope will come out next year. I retired from healthcare, hospice and palliative care a few years ago but am still a long term care ombudsman. We have a local group that meets monthly of retired folks and we discuss how we can help each other and how we can work with our local council to improve the city to usefully accommodate the aging population.

My answer is yes, you can age in place, it is what my wife and I are planning to do and we have set up a plan to follow. This has meant we have made some updates to our home, to our way of life and to our expectations and see a point where we may need to transfer to a facility, but we plan to leave that till way downstream and not enter into either independent or assisted living facilities. Living in your own home and aging in place means you have the security and warmth of a place that is you. But you need develop a plan.

This is a question that has many, many answers that start "it depends". I don't think it's a question that can necessarily be answered in generalities.

My mom lived with me in my home, which is a 2 family, since 1999. Until late 2018, even at 84 years old, she was still able to live independently. The only thing I "did" for her was make dinner, and that was just more a matter of her coming down every night to eat with us. She was ready, willing and able to shop/cook her own meals, run her own errands, take herself to her doctor appointments, pay her own bills, etc. She was seeing a cardiologist for well over 10 years for beginning stages of heart failure that was very, very well controlled with medication. Then around Thanksgiving of 2018, she got a nasty respiratory infection, and so began her decline. Her doctor thought the infection did damage permanent damage to her heart. And even after, she was still able to do many things for herself - she gave up her car, but she was able to putter around her house and do her own bills, laundry, bathing, etc. until about 4 months ago, when she just became so weak that any sort of exertion wiped her out. 2 months ago, when she decided she had had enough of the revolving hospital visits, she requested hospice at home, and was here, under their care, until she passed last week. So in her case, she did successfully age in place, with our help.

However - I would never had been willing to take care of her if she had had a dementia-like illness. It would have been too much for any of us to manage, and she was very much against us having to take on that sort of responsibility. She had set up a long term care policy in case the day came that we were unable to provide her with care in our home. She never - never!! - made me make promises to keep her here - in fact, just the opposite. She fully expected if the burden became too much that we would look to place her in a facility that could meet her needs. I am grateful that I always had that option.

She also had the financial means for me to be able to get whatever I needed to make the job easier, and she had no qualms whatsoever about my using her money for that purpose. Now that I can look back with a somewhat clearer head, I realize just how more difficult things would have been if I hadn't had that financial security for her these past few months.

So I think in answer to your question - it is possible for some of our parents to "age in place" in their home. But whether or not it's a realistic expectation depends entirely on individual circumstances. I hope you can find an answer that will be agreeable to both you and your parents.

I have been working to help my parents "age in place" in their home for the past 3 years since my father (now 90) had a total knee replacement. After day 2 at the hospital he where he was hallucinating after having anesthesia, he stubbornly refused to go to rehab as planned and the staff was going to release him and send him home with my mother (now 84), who my brother and I (both living out of state) knew was getting spacey and not cognitively able to care for him. We had a family crisis. My brother was already there keeping an eye on mom while Dad was in the hospital, and I (with the support of my husband) gave 2 weeks notice, quitting a job I loved, to fly there when my brother left. I spent 3 months rehabbing Dad's knee, getting both my parents into their PCP and specialists for diagnosis, and took them to a lawyer to get their wills updated, power of attorney and medical directives. We talked with them about their wishes. Dad definitely wanted to stay in the house he built if at all possible. Mom will come live with me if Dad dies first, but if she doesn't know us or if it were too much for us she said to put her in a home. Both were diagnosed with mild cognitive impairment. Mom from Central Nervous System Lyme Disease AND Lewy Body Dementia with Parkinsonism. Dad with Parkinson's Disease and Parkinson's Disease Dementia. For the first 2 years they were able to "age in place" with me flying there from CO for 1 week or so every month to help them with the things they could no longer do for themselves, take them to appointments, etc. They paid my travel costs and the rate of 1.5 week's caregiver earnings/month. Last year I was spending 2+ weeks/mo with them until we no longer felt comfortable with them living alone. In January I hired a live-in caregiver (a loving young woman who grew up playing with my kids and had worked as a CNA) who stayed until the end of May, when my husband and I could get there for the summer (my husband is a college prof so has summers off.) In September we hired my daughter to be their caregiver since she became unemployed due to Covid-19. My parent's pay the legal minimum wage for their state for 63 hrs/week (including the state requirement of overtime after 44 hrs) plus free room and board. Even after paying for FICA, SS, FUTI, etc. this is about $63K/yr, which is FAR less than paying the rate of $14K/month per parent at their local nursing home. When needed we will be installing a stair chair. In preparation for needing to hire outside assistance (whether skilled nursing assistance or respite care) for the primary caregiver, or should their granddaughter find meaningful employment in her field and we need to hire strangers, we have installed interior and exterior security cameras so I can monitor from afar, and I have removed all paperwork from the premises that has any financial or security compromising information. It has not been easy, and is a LOT of work and often stressful to manage, especially from afar. However it has been my husband's and my choice to assist my parents in aging in place thus far and we are glad we have been able to do so. That said, Covid-19 is making things very difficult on many levels, and for that reason we asked and urged them to come to CO with us to ride out the pandemic. We are not comfortable flying, driving 3 days each way is exhausting, quarantining at my parents when we arrive is mandatory and challenging, hiring strangers to come into the house who may or may not be practicing mask wearing in their own social circles raises concerns, etc., their friends and neighbors can no longer drop by and visit to check on them, etc. If we lived nearby, it would be so much easier to manage caregivers and to continue to support them to "age in place." However, with Covid-19, we do not know how much longer we will be able to keep this up should my daughter find work in her field and we'd need to hire someone else, and as their care needs increase.

Simple answer 'YES'! It is FAR BETTER to be in your own home. As you or those you love age, there is NO REASON that you can not get additional help right in your their own house. Even if you do not have family that is able to help you can hire people through programs such as IRIS if you need help paying for it. The programs may vary state to state! My grandparents lived in their home until they passed and it was very good. What I have witnessed myself with group homes and nursing homes is how much despair they have and often DIE FASTER in these places alone and with people who do not really care. They loose everything, their homes, property, belongings. Given a small room often with people who do not even look at them as an individual with ANY RIGHTS at all. They think they can do as they please. Drugging them so they have less work caring for them as they slump in their chairs. Often making it difficult for family to visit and actually try to keep family away! I RECOMMEND THAT YOU DO NOT PUT THEM IN THESE NURSING HOMES! What they did to my sister in there was beyond horrible!

I guess it depends on one's definition of success. I think if by making arrangements to age in place, one can prolong the time in the comfort of one's home and shorten a stay elsewhere, it is a success. It really does depend on one's physical health and yes, resources. However, my mother who was low income, was able to age in place far longer because of a program through Medicaid. She ended up in an LTC for the last few months of her life instead of for the last two years of her life. To me, that was a successful age in place experience. I guess what I am saying is that to expect to never require another form of care might be unrealistic, but to instead it works to see the aging process on a scale where one can remain in the home as long as possible until such time as it isn't best. This is an individual assessment based on many things including money and community resources, the person's need for socialization, and access to helpful family and friends. My mom was so stoic, she could live on a postage stamp if she had to (and in fact her time in LTC required this!) but I know that she benefited from being in her own home and being home encouraged her to be more active and engaged than she would have been in a facility. For her, assisted living was not financially possible, but living at home, with assistance, was and it was very successful.

Everyone ages differently. Some people can handle matters well into their 90s, others may need help even in their 50s. You need to closely monitor how they are doing - both physically and mentally. From experience, I learned that our parents were able to hide some of their problems from us because we weren't there daily and didn't sufficiently scrutinize how they were really managing. Now my wife and I are in our early 70s. We are doing fine. However, I realize that this can change drastically in a heartbeat. One fall or illness could start a steep spiral downward. On the other hand, we could manage fine for another 15-20 years. If our minds stay sharp, we, hopefully, would make good decisions if our physical health starts to deteriorate. If our ability to think clearly starts to fail, we hope our kids will know when to step in and make appropriate decisions for us. However, I am not sure our kids recognize that they should start to monitor how we are doing. Your raising the question at least shows that you recognize that your parents are at a time that they need to be monitored. Good luck.

TF10862, thank you. you are very kind.

Again, each situation is unique and needs very careful planning. However, i know if i had a painful spinal problem and or had to use a walker, i definitely would want to move into an assisted livibg facility the nicest one i could find in a good location wher my friends could easily visit.I would want to be where I could get good emergency service if i should suddenly become completely crippled and or helpless.However, if I knew I had lovingreliable help readily available help while remaining in my own home, that might be different.I enjoy my home because shopping, cooking, and household chores are still fun for me. If things became too painful or difficult, I would move where i could get more help.If my children could help me and would enjoy doing so, only then would i want stay in my home after becoming crippled.

Absolutely yes, yes, yes! 1 However, you and they must face the fact that such a plan is possible only if they are both extremely mentally and physically very healthy. it is very rare for older people to be truly healthy and strong.However, if they are among those rare few, it would be silly to move and or seek help thery do not need. All of my ancestors lived in their own midsizes and or small homes into their 90's. they hired yard helpers, then eventually a once weekly maid; began grocery deliveries when no longer able to safely drive, took cabs to doctor and dental appointments; just hired whatever help they needed and were blessed to live happily independent until only a few months or in one case one week before death at 96 or older.Most older people become slowly more and more ill and or debilitated. Most old people need increasing amounts of help as they age.Some, like my grandma, find at church or some nice place a nice companion somewahat younger and also healthy to live with and help them in return fo free room and board.Thoase such such arrangements are also very rare.I am 86 and i hope to live in my own home alone until I die. However, i do have LTCI in case i ever become mentally or physically disabled.Sit down with your parents and draw up 2 careful budget plans; one for at home expenses and one for assisted living. Talk honestly about any health problems they do or do not have. Make your plans and lists very detailed, very personal and individual, and very realistic. Do not do anything in a hurry.However, do not ignore health problems until a n injury, a stroke, or some other disaster pushes you into a too quick decision of some kind.Again, staying in one's home is realistic onlfor very strong healthy people ordinarily. However, each situation is unique and needs a different assessment. God bless you all.

Aging for most of us is a gradual process. For some parents they may never need a long term care facility because they die before the need arises. To the extent that our elderly kin do not need full time care OR have the financial resources to pay for that care or family member willing to provide full time care -Than of course elderly can and should age in place.

This isn’t really an answer but reading all the answers to this problem I need to ask a question. I am 80, seem to be in good health except for spinal problems that cause pain so I must use a walker in the house—& outside —my son or daughter mows for me, I do minimal housework due to not being able to stand for long w/o my walker. Would you all think it would be a good idea to move now to elderly housing & get rid of all the stuff accumulated over the years (something my 4 kids would have to do if I was dead or alive). I still drive, have a small dog that gets me out for walks & have a slew of friends to interact with—but we all start to go downhill from here on & I thought ‘maybe I should downsize now while my kids are able to help.’
Any thoughts from all of you that have ‘been there’ at this stage in parents life? Just curious...

Why are we choosing to suffer this way. If our parents were in their right mind, I would like to think that they would not have us be their butlers, cooks, personal assists and caretakers. They become needy and demanding of our time and resources without a glimpse of how it impacts us. Yes, they had us and raised us as it was their choice to do so. It does not automatically become our responsibility when they get older. Yes we can help them out but what does that help HAVE to look like? Does it have to be all consuming at the cost of our sanity and health? Or can that help look like us helping them to help themselves by helping them to find other resources that are designed to deal with their aging issues? I have learned entirely too many new things about aging and caring for aging people, more than I ever wanted to know. But with this new info, I will better be able to make choices for myself as I age. Choices that would not put stress and Strain on my children. Where is it written that we must suffer the consequences of our elder parents and loved ones? It is a sweet thought that we can be there for them and we can. We just don’t need to takeit all on. They may not like the way you are helping by offering suggestions if outside help or independent or assisted living and somehow us dutiful children bow to their displeasure by choosing to take on their suffering and continue trying to make them happy. A quick question; how many of your parents gave you the choice as a child to go to school or daycare or have a babysitter? I would say I never had that choice. That is how they cared for us when we were young, by setting up care for us when they were not around. We may not have liked it but we became used to the idea. Maybe it is time we take that same simple cue and stop trying to make them happy and choose to instead make them safe, just like they did for us when we were unequipped to make good choices for ourselves.
just a thought🙏🏼🧚🏼‍♂️ It does not have to be all or nothing.

It depends on the expectations and outcomes for their quality of life and what is affordable and acceptable to the PoA/guardian. You can eventually have one or two parents with full-blown dementia and/or loss of control of body functions/mobility in their home with a team of people (including their legal PoAs) orbiting around them 24/7. It'll cost as much (or more) money, and require a ton of scheduling and admin.

Simply living in their own residence is not being independent. If they have caregivers, cleaners, people who bring meals because they can no longer cook, transportation services, people who shop for them, people who pay their bills for them, I would say that they are no longer living independently. If all of those services and helpers were to stop suddenly, they absolutely would not be able to survive. When this many services are needed, it’s time for either an assisted living facility, a residential care facility or a memory care facility, depending upon symptoms and related issues.

If proper planning is done it is possible.
I am VERY lucky the house that I found and purchased after my Husband was diagnosed with dementia was built Handicap Accessible.
I also made the expensive decision to purchase Long Term Health Care Insurance.
I have also made my wished known to family as to what measures I want taken if anything should happen to me.
Because of this house (home) I was able to safely care for my Husband.
I hope if and when I need it caregivers will be able to care for me in the same way.
I think to "age in place" would be difficult in many homes particularly older homes because of the barriers that are there. It would be nice if builders and architects would be building / designing houses that are not necessarily "handicap accessible" but houses that are accessible to anyone and everyone.

In a Facility I think of the terms Independent Living as much like you would think of your own apartment with the bonus of having at least 1 meal made and provided. No help at all from staff. (not counting housecleaning if that is provided)
Assisted Living pretty much along the same lines but you need a bit of help from staff and this would range in early stages very little help all the way to needing help with most ADL's .
That then transitions to either Memory Care if there is cognitive decline or Skilled Nursing if there is no cognitive decline.

I think it's possible, if the elder person can keep their mobility and mind in tact. I think that having someone close to assist and visit is a good idea -- child or younger sib. But I do think it's possible. My grandfather was a farmer and farmed until he was 97. The day he died he came in from the field early, said he didn't feel well, went to bed after dinner (that my 90 yo grandmother cooked for him), and "went to meet his Maker" sometime during the night. My grandmother died a few months later -- didn't have anyone to cook for anymore. That's the way to go.

Aging in place independently is probably an unrealistic goal. 75% of people age 75 or older have some cognitive impairment, usually Alzheimer's disease. When I first started working as an RN over 30 years ago, only 4% of seniors lived in a full time residential facility. Of course, people were dying in their 50s and 60s of heart attacks and strokes back then. Now, we can treat and even reverse damage to blood vessels that lead to those 2 killers... so people are generally living longer. It might be better to consider how to help seniors stay in their homes for as long as possible: family and friends visiting and helping out more often (while maintaining COVID precautions), driver services for those who can no longer drive, cleaning services for those who need housekeeping help, and home health aides for those needing extra assistance with medications, bathing... If a family member is retired and lives near by and is willing to be the home health aide, this can be a more realistic goal.

Whew. What a great question. I'm smack in the middle of this journey as we speak.

My 88 year old Mom lived alone without any assistance for many years. My Dad passed almost 15 years ago, and she never fully got over the loss. She still has his things in his medicine cabinet.

Mom did (reasonably) well for the first few years, but then we noticed a steady decline. The house got dirty. She stopped showering. Her odor and the odor of the house became overpowering. She was hospitalized twice for a UTI, directly related to her hygiene. She fell twice and the police came on both occasions.

All through this, she refused help at every turn. We encouraged. We cajoled. We begged. Always the same answer. "I don't want anybody in my house. You just want me to live the way YOU want me to." And on and on it went. For years.

This came to a crisis just this August. She got lost on the way home from the store - not from memory impairment - there were trees down on her street following a hurricane and she simply forgot the alternate routes. After hours of panic, and not knowing where she was, I finally got a call from her. She was in a parking lot not far from her home. I called the police to escort her home. All long distance, mind you. I live out of state.

As fate would have it, the attending officer had seen her a year ago after a fall. He saw her decline, and the decline in the house. He called me and told me point blank she couldn't drive anymore. He also said if he had to come back to respond to another fall or any other kind of emergency that he would file a report with APS, and my brother and I could be held liable.

I relayed all of that to her in a phone call the next day, and told her we all needed to discuss what kind of care she would need going forward. She called me later that afternoon saying she thought she was having a stroke. I called 911 and she was admitted to the hospital with another UTI and severe dehydration. She ended up in rehab for a month.

Now she's at home, with care 12 hours a day, 7 days a week. She doesn't sleep in her bedroom or take showers, even with caregivers there, because her bedroom and shower are upstairs, and she's afraid of falling. She spends all her time on her couch, calling me and her friends to complain about her caregivers and her complete lack of privacy. She hates her current situation, but is too paralyzed by fear of change to make the leap to assisted living. She can only continue her routine at home for another 3 years max - then she's out of money. Then she'll HAVE to sell her house and move to an ALF.

Meanwhile, she sees nobody but her caregivers. She never goes out. She lives in a nightgown and hospital socks. My Mom. Who used to be a vibrant, social, cultured woman, who taught me everything I know about food, fashion and living well. It breaks my heart to see this happen.

As Stacy0122 says below: The U.S. CDC and Prevention defines aging in place as "the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level".

Enough said. Best of luck to you and best thoughts!

When my Father died, my Mother was all set to move into Assisted Living but she changed her mind. They lived in a condo, so maintenance was not an issue. A few years later, she fell outside on an icy sidewalk and broke her arm. When she came home from hospital, she was unable to care for herself, so I got 24/7 live-in caregiver. That worked until my Mother got better and did not want "a stranger" living in her condo. So she lived alone until memory problems creeped up and she was diagnosed with Dementia. A 9am to 5pm Care Giver was hired just to make sure my Mother got up out of bed and had breakfast, lunch, dinner and was driven to store and Doctor appointments. This worked for 5 years until my Mother started falling a lot and Care Giver was afraid to leave my Mother alone at night. I moved her into Memory Care and the past two years have been guilt-free knowing that my Mother is looked after 24/7 by an entire staff of dedicated professionals. Keep parents in home as long as you can but know that probably eventually they will need to go to some sort of residential facility be it Assisted Living or Memory Care. GOOD LUCK !!! :-)

Annie, I hear the term "independent living" and think that is strange because where does the independence come in? My parents were in their early 90's and were still living in their single family home.... lot of stairs.

Oh how I wished I had set boundaries but didn't know I could. This forum suggested practice saying in the mirror "I can't possibly do that" over and over until it becomes comfortable. Your parents may look at you like your hair is on fire, and you may feel guilty, but the more you enable your parents to stay in their home the more they will ask of you.

Sadly, it took a medical emergency to get my parents out of their home. Mom [98] had to go into a nursing home. Dad was soooo ready to move out of the house, sold it, and moved into senior living, which he really loved being around people closer to his age group.

Like Stacy said.😊To stay in your home you need to be independent in all things. When the children feel they need to or are asked to mow the lawn, do upkeep, and clean the house...the house has become too much for the parents. They should either hire the people to do the work or they downsize. At 65 I was lucky to get my own house cleaned let alone my mothers. She did hire someone to mow but up until then she had done it herself. Never asked us. I read where some of the female members mow lawns for a parent. Have never done it (I had brothers) and never will. If my husband goes first and we are still here, I will sell and downsize. I wish I had talked my Mom into downsizing.

So no its not realistic. Too many variables. Its too late to "groom" our parents but we should have told them when they retired...Make plans to downsize because I will not be able to take on the burden of caring for your home and mine too. If u plan on staying where you are, then plan on hiring people to do the work when u no longer can. And realize, that as you age your needs will be more and you need to realize that your children have lives of their own. That they maybe willing to help but they can't do it all. You will have to compromise.

That is such a loaded question.

There are sooooooooooooooo many variables that change the response to people aging at home (in place).

1st and most importantly, from my view point, what is the health of all parties involved? If it is not good, then planning to remain in the house is not going to be easy.

Keeping seniors at home is really the best idea, but not when they impinge on their families lives to the point that they don't have one.

If you need help with everything, you need to be in a facility. It is unfair to put the stress of another person(s) on anyone. People can not be on call 24/7, work fulltime, raise children or interact with them if adults, be 100% responsible for the wellbeing of an aged parent and expect to retain their own health and wellbeing. We need to be able to de-stress, sleep and take care of our basic needs.

I think that you have to be able to know when it becomes more than is realistic, no matter what the elders say, if they need more than you can provide and keep yourself healthy then you need to be able to say enough. Be sure that you can say no, no more, I can't do that and you accept outside help or you have to go to a facility, before you take on caregiving. If not, you will be used up by someone that wants to stay home, even at the expense of your very life. 40% is not a small chance of dying before the person you are caring for.

It really all depends on how well the healthiest parent is doing. Sometimes that's the one you need to watch the closest.

We knew my mom had issues, took meds for them, and had dementia. My dad -- determined to honor his marriage vows for all 66 years they'd been together -- was caring for my mom, still driving, had no health issues, and was cognitively fine.

Until I realized he'd largely lost his sense of smell.

It wasn't that big a deal until I walked in the house and smelled gas. My dad was sitting there reading the paper and was unaware my mom had walked past the stove and flipped one of the knobs without the burner turning on. He never smelled anything, but fortunately, she'd just done it, so the house didn't explode.

He also didn't notice when the meat he'd bought "on a great deal" had gone bad, but again, I'd walked in the door, the smell of rotting meat was overpowering.

Also, the healthiest parent may well be the one who goes first. My perfectly healthy dad's abdomen started swelling up, he was diagnosed with liver cancer and died, all within six weeks. That left us with having to uproot my stricken mother from her home of 50 years and move her to a nursing home three days after my dad's funeral. It's been nearly two years, and I often wonder if it would have been less traumatic for Mom if they'd moved somewhere together first.

My dad was successful with this, stayed in his home until he died at 90. Unless you count the loads of family help with home maintenance, getting him to appointments, grocery runs, alterations to house, life alert, KnoxBox, part time hired helper in the last year, etc, etc, etc. That said, he was of sound mind and wouldn’t change a thing so we helped, and looking back I’m mostly glad for it

My Father dropped dead of a coronary with no warning when he was 72, so I guess it could be said that HE did, and my mother upgraded the coal furnace that was the only heat in the house, during the first year she was widowed, and continued to live there almost 20 years until she fell and broke her hip at 89, then lived another 6 years in a residential care center.

I consider the years she lived at home “aging in place”.

My mom was determined to "age in place" (my dad said "never sell the house; never pay high rent"). It turned out all the upgrades to the house had been done without permits.... Oy vey.

Mom was fine until she wasn't. She hired seasonal housecleaners, yard work guys and snow removal guys who showed up without being called. It all worked out GREAT until she was about 88.

Suddenly, she became unreasonably anxious about stuff that made no sense. We hired "visiting angels" who could keep mom company and who would do anything she asked. She refused to give them instructions; "they will break the washing machine; I need to talk to them all the time; I can't relax while they are here".

In addition, mom lived in a pretty isolated suburb with no sidewalks and no public transport. So any help had to have their own cars and in a snowstorm, couldn't get there or get home. Additionally, local pharmacies didn't deliver and she was reluctant to use grocery delivery services. Cab rides were "horrific" so someone needed to show up (were were all at least an hour away) to drive her to the doctor.

It became unsustainable. One memorable snowy day, when a truck spun out on ice in front of me and I appeared to be staring death in the face, (it was the 3rd day in a row that I had gotten "summoned" for an emergency) I got to her house and said "mom, I can't do this anymore".

If your parent can be "independent" on their own and on their own dime, that's great. What my mom was requiring of us was unsustainable and we pulled the plug on that.

It is a very individual thing. My grandparents lived in their own home until death and never had in-home care. They were both active and in good health, without chronic debilitating conditions. My grandmother died of a stroke at age 82 and my grandfather died of a heart attack a few months later.

My mother, on the other hand, had several debilitating conditions. Arthritis, anemia, diabetic neuropathy, congestive heart failure, bleeding ulcers. She had decreasing mobility for close to 10 years before she died, and frequent falls. She needed help shopping, cooking, going to medical appointments (of which there were many) and many other tasks. In the last year or two, she could feed, dress and toilet herself and that was about it. She wanted to stay in her home and she did, but with substantial help from others, especially me. She didn't have the money for assisted living and would have refused to go in any event.

So, it can work. But it doesn't always work out very well.