Home, Unsafe Home

As individuals age, they often recognize that their capabilities and sense of independence are diminishing, and they may gradually begin to police themselves, adjusting situations  that feel too burdensome or unsafe.  They may downsize the family home; they may relocate to a smaller home or apartment.  Or they make their current homes more accessible by adding bathroom safety rails or handicapped ramps.

But what should caregivers do when elderly loved ones are reluctant to change their habits or their homes?  What can we do when our elderly loved ones don’t recognize they are no longer capable of living as they once did? 


Ralph and Lorraine had lived in their current home since they married more than 50 decades ago. They had raised two children there.  The children had families of their own now and were living in distant parts of the state.  The neighborhood had changed, and they could no longer safely leave their home at night and they lived behind locked doors 24 hours a day.  Yet they remained determined that they would die in this home -- it was theirs!  

Unfortunately, Lorraine had rapidly progressing dementia and required around-the-clock supervision. Ralph did not hesitate in adding this new responsibility to his day.  Their daughter visited every other weekend with her husband; they would bring groceries, clean the house and do the yard work.  Each time, their daughter would ask her parents to come and live with them or at least closer to them.  Her parents were defiant in their desire to stay where they were.  

Ralph began to experience heart problems and his doctor wanted him to go into the hospital for testing; he refused, so the home care nurse was sent into their home to monitor his condition.  The nurse expressed concerns about the couple's safety, but Ralph would not consider other options.  Then one day, the inevitable happened:   Ralph fell and fractured his hip.  His recovery was going to be a lengthy one; decisions had to be made quickly for Lorraine and himself.  They were relocated to an assisted living facility near their daughter's home.

All too often, our loved ones do not want any interference in their lifestyle until emergency strikes.  They resist our attempts to be proactive in planning for their futures.  While respecting their desire for independence, we simply must begin these discussions when our loved ones begin to decline.  We can begin by asking; “Where would you choose to live if you couldn’t stay here anymore?”  Listen with an open mind and heart, always respecting their dignity.  These conversations aren’t intended to reach immediate decisions; rather, they are the beginning of learning a loved one’s wishes, introducing them to new possibilities, and gradually creating an action plan for the future.

When changes must be made, safety must be the first priority.  Some options may include:  

• Creating a village of caregivers. Talk to neighbors, church members, extended family and close friends.  Simply state the individual’s needs and ask for their help.
• Utilizing community resources.  Call a senior center or eldercare service and find out what they offer and what your loved one may be entitled to.  Many of these services are free or covered by insurance plans.
• Hiring caregivers. Assistance with the upkeep of the house and yard can greatly decrease stressors and improve in-home safety.  Arranging for a geriatric care manager to oversee your loved one’s well-being and organize needed services if you do not live nearby.
• Investigating other options when staying home alone is no longer feasible. Plan  for part-time or full-time live-in help; merge households; or find an assisted living, personal care home, or a skilled nursing facility to meet your loved one’s changing needs may be required.