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November 2003

By Sarah Schmelling

Staying home. For many seniors, that phrase signifies a truly ideal way to live. And why not? How much more encouraging and enlivening is it to be able to stay independent, with one’s family, instead of moving to a new, much more structured environment in a nursing home? Of course, for many older people who require a great deal of care, staying home is not an option. But for others, many rehab professionals are doing everything they can to make staying independent for as long as possible a viable option.

When I first read about the San Francisco Institute on Aging (IOA), the cover subject of this issue (“No Place Like Home,” page 14), it was described as being based on the Program of All-Inclusive Care for the Elderly (PACE), which is now a formal benefit within the Centers for Medicare & Medicaid Services. In fact, it was the other way around. Starting in the mid 1980s, the IOA and, more specifically, its OnLok Senior Health Services program, demonstrated a way in which seniors could receive the therapy and other health care services they require within their communities during the day, while then being able to go back home at night. Its success formed the model for the PACE program, which, under the Balanced Budget Act of 1997, any state can now utilize within certain requirements. With PACE, an interdisciplinary team assesses participants’ needs, develops care plans, and delivers all services—including acute care when necessary—primarily through an adult day health center environment. This is a great example of how one successful idea for care encouraged a larger health movement—that of “aging in place.”

And it is a movement. Beyond PACE-based facilities, the American Occupational Therapy Association (AOTA) last April devoted “Occupational Therapy Awareness Month” to helping seniors “age in place.” AOTA partnered with Rebuilding Together, a national volunteer organization that rehabilitates houses for low-income homeowners, and together, the groups developed a set of strategies to help adult children of seniors assess and modify their homes to make them safer and more accessible.

These actions are just the start. As more and more Baby Boomers reach retirement age, aging in place will hopefully develop from a movement into an everyday way of living. Right at home.

—Sarah Schmelling
cwolski@medpubs.com

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