If your culture expects you to age in place at home

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At the age of 60, Jessica Kim’s mother was diagnosed with pancreatic cancer. During the early years of her mother’s illness, Kim’s parents still lived in their own home in New Jersey. During one visit, Kim found fast food wrappers scattered around the house. Realizing they were struggling to take care of themselves, she moved with them into her home in Boston.

“I didn’t think twice about it,” says Kim, who is Korean. Her husband, also of Korean-American descent, was also on board immediately. Living in an intergenerational household was just the norm for her, as her grandmother lived with her family until her death when Kim was in third grade.

But the challenges of caring for a parent with a terminal illness grew severe, and Kim struggled while juggling three children and a career. After 6 months she quit her job to become a full-time nurse.

Although her mother died in the home’s hospice 5 years ago, Kim’s father, now 84, is currently living with the family. After the death of his wife, he attempted to live alone again, but after several falls and visits to the emergency room, Kim moved him back to her family home permanently. She says providing the support for an elderly loved one until they aged in place was embedded in their family values, as is the case for many families from diverse backgrounds.

“How we love and care for each other and how we express it is rooted in those cultural norms and expectations,” says Kim. “There is no right or wrong, but understanding how these cultural values ​​influence our decisions is important if we are to better support caregivers.”

Through her grief after her mother’s death, Kim realized there was a huge gap in what care and aging resources were available locally and how easy it is for people to connect with them, and she co-founded the care platform ianacare. “I really thought I was the only one in this situation and if you get pushed in, you just react and survive.”

Define aging in place

The definition of aging in place varies widely, but a 2020 article in the journal innovation in old age to define the term as “the path to maintaining independence in one’s place of residence and participation in the community”. This will look different for different families. Aging in place can be performed in the home where an older adult has lived for decades, in a new home they have moved into to be closer to family, or in a multigenerational home.

Most older adults — 88% — say they want to age in their own homes, according to a University of Michigan National Healthy Aging Survey. But it’s not that simple, as homes often need to be set up with systems and modifications (like grab bars in the bathroom, a wheelchair ramp, or technology that detects falls) to make this reality safe.

Families face many challenges, especially when they live far apart. It can be difficult to manage challenging health situations remotely — or even when you’re at home caring for a loved one.

“When things happen in the home, we consider it a private matter, and the responsibility lies with individuals and family members to find out,” says Jennifer Molinsky, PhD, project leader of the Housing in Aging Society program at Harvard University’s Joint Center for Housing Studies. Her research focuses on the lack of affordable adult housing options to make aging a reality in place. It doesn’t help that the responsibility families face to make this happen for their loved ones can be complicated — and expensive.

provide care

The financial reality of nursing can be harsh. Costs are not only focused on housing or converting an older adult’s home to accommodate their physical needs, but most people require long-term support and services (including health care and meals) provided by community programs or by families themselves can originate.

“We call it the double burden of housing and care: Can you afford your apartment and everything else you need?” says Molinksy. Multigenerational living can be a solution, and while it can be rewarding, it also places families under certain financial strains.

In 2020, 53 million Americans were providing unpaid care — and nearly half of them reported financial burdens because of the care, according to The National Alliance for Caregiving (NAC). Six in 10 employed carers say their home responsibilities have impacted their careers; Half of those who quit their jobs did so to spend more time with their loved one, the NAC finds.

Reports show that these caregivers collectively provide $470 billion in unpaid care. “Carers are becoming the invisible backbone of healthcare. For adults to age in place, we must respect the caregiver role,” said Sarita A. Mohanty, MD, MPH, President and CEO of the SCAN Foundation, a nonprofit organization focused on transforming caregiving for older adults.

Cultural expectations and a sense of obligation to offer aging in the workplace are driving factors for those who want to make aging in the workplace a reality.

“Although aging is universal, everyone’s experience of aging is different,” says Mohanty. The experience is often different for people of color, who make up 40% of the caregiver and are more likely to be of lower socioeconomic status, endure medical racism, and lack access to support services, Mental Health America points out. “Fewer Black and Hispanic caregivers feel that their communities provide good access to resources such as quality health care or socialization. There’s this intersection of racial, ethnic, and income status issues that we need to consider when we’re addressing aging in place,” says Mohanty.

Additionally, if the facility does not have staff or facilities that share the older adult’s cultural background, some families may not feel that their long-term care options are comfortable for their loved one, and there may be variations in everything Food and music to language says Allyson Brothers, PhD, Associate Professor in the Department of Human Development and Family Studies at Colorado State University. Aging at home or with a family member, on the other hand, allows people to live in a situation that honors their cultural background.

Start the conversation

For families facing these decisions, it’s important to initiate conversations with loved ones so you can get a sense of their wants and expectations.

“The data shows that most people don’t make proactive decisions about where they want to live late in life,” says Brothers. “Often it is a crisis that forces an older adult to leave their home, such as a fall and resulting bone fracture, which can be difficult for the individual and their family. It can be devastating to a person’s well-being to leave their home and never return.”

Decisions made in crisis mode often result in more regret and family stress.

As families move farther apart and people with more complex health conditions live longer, there may also come a point where you find you are no longer able to support a loved one as they age in place. You need to open up the conversation with your loved one and other family members about next steps.

find resources

One of the most important things families can do is educate themselves about the resources in their area. Finding all the supports needed to support an aging adult can be a complex puzzle, and unfortunately the responsibility rests with individual families to put the pieces of the puzzle in place. “It can be daunting to know where to start and whether a loved one is eligible for certain benefits,” says Molinksy.

If you are currently helping an aging loved one in situ, or plan to do so in the future, start your search here:

  • Territorial Agency for Aging (AAA): Agencies that coordinate programs that help older adults stay in their homes through programs like MealsonWheels.
  • Rural Health Information Center: Teaches about domestic services and community support for rural residents.
  • Access points for seniors: Developed by the Colorado State University Extension and the CSU Department of Human Development and Family Studies and other organizations, this is designed as a local resource for older adults, but Brothers says the site is attracting traffic from people in the US. You can use them to find resources on a variety of aging-related topics, from law and finance to mental health, no matter where you live.
  • American Council on Aging: Provides a resource on how to get financial compensation from Medicaid as a caregiver.
  • National Council on Aging: Find resources for older adults and caregivers to stay independent and age healthily and with financial security.
  • Alliance for family carers: A non-profit organization focused on improving the lives of caregivers and those they care for.


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